Stability and change in structural social relations as predictor of mortality among elderly women and men

Does personality shape the personal social networks of older Europeans?

The aim of the study was to clarify whether personality traits predict the structure, function and quality of egocentric confidant networks in later life. Data were drawn from Waves 7 and 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) (N = 39,172). We regressed network size, contact frequency and network satisfaction on the Big-5 personality traits, using a single path analysis structure, controlling for country, sociodemographic background and health status. The findings showed that the personality traits were related to the social network outcomes, but their effect was modest and less predictive than the contextual factors. The country predictors explained the most variance, generally, with some surprising results. For example, confidant networks were the largest in Scandinavia and Central Europe, and smallest in the Mediterranean region and Eastern Europe. Among the personality traits, extraversion was the most consistent positive predictor, but conscientiousness was also predictive. Neuroticism was a negative predictor, but not of network size. The sociodemographic variables, particularly partner status, explained more variance than the personality traits did. In sum, the SHARE database offers a comprehensive and differentiated view of the complex interpersonal milieus in which older Europeans are embedded.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10433-021-00678-8.

Social Network Types and Depressive Symptoms among Older Korean Men and Women

This study explores the social network types of older Korean men and women, and the relationship of those networks to depressive symptoms. A population of 4608 older adults who participated in the Living Profiles of Older People Survey (LPOPS) were included in the study. Seven criterion variables-marital status, living arrangements, frequency of contact with children, close friends, and close relatives, participation in social activities, and total network size-were included in a K-means cluster analysis. Multivariable logistic regression analysis of the impact of social network type on depressive symptoms was conducted. We identified two "diverse type" social networks (diverse-married and diverse-unmarried) in women, and one diverse type and one "social-activity-focused type" network in men. Family focused type and two "restricted type" social networks (restricted-couple-focused, and restricted-unmarried) were identified in both men and women. The restricted-unmarried and restricted-couple-focused networks were associated with more depressive symptoms in both men and women. However, the family focused type was associated with more depressive symptoms only in women. The results indicated that social network types, and their impact on depressive symptoms, differ by gender. There is a need for further research on gender differences in the social network types of older adults across diverse cultures.

Balance in life as a prerequisite for community-dwelling older adults' sense of health and well-being after retirement: an interview-based study

Purpose

This study aimed to describe community-dwelling older adults’ perceptions of health and well-being in life after retirement.

Methods

This study is part of a larger project using a mixed-methods design to address lifestyles’ influence on community-dwelling older adults’ health. Individual semi-structured interviews were conducted with 18 older adults in age 70 to 95 years. Data were analysed according to a phenomenographic approach.

Results

The results encompass four categories describing variations in community-dwelling older adults’ perceptions of health and well-being after retirement: feeling well despite illness and disease, interacting with and being useful for oneself and others, independently embracing opportunities and engaging in life, and maintaining a healthy lifestyle.

Conclusions

The absence of illness and disease is not a clear prerequisite for a sense of health and well-being. To promote and preserve health and well-being after retirement, older adults strived for—and coached themselves to uphold—a balance in life, focusing on not burdening others. This life orientation after retirement must be acknowledged by society at large, especially from an ageist perspective, and in health and social care to preserve and promote health and well-being.

Can Less Ever Be More? A Model of Emotion Regulation Repertoire of Social Support (ERROSS)

Do people really fare better if they can rely on many social ties? Research suggests that benefits of interpersonal emotion regulation (ER) can be derived from both large and small social networks. Building on the intrapersonal regulatory flexibility model, we propose the emotion regulation repertoire of social support (ERROSS) model that views effective socioemotional support as the combination of network size and ER strategies, resulting in a repertoire of ER resources one can draw on. Best outcomes in mental health should follow from both a large network and a diverse repertoire of strategies. ERROSS is applied as an example in the context of bereavement, and specific contributions of the model are highlighted.

Influence of Outdoor Living Environment on Elders’ Quality of Life in Old Residential Communities

The population is getting older in Mainland China, which presents a huge challenge of how to support these increasing elders to enjoy a high quality of life (QoL). Due to the limited nursing institutions and Chinese traditional culture, aging in place is the most common choice for elders. Up to now, most elders in cities are living in old residential communities (ORCs) rather than new ones. Poor quality of outdoor living environment (OLE) in these ORCs cannot well support the daily life of the elders, especially for those with physical problems. A questionnaire study was conducted to explore the influence of OLE on the QoL of elders living in ORCs. A total of 107 questionnaires were completed by both elderly residents in ORCs (45.79% were male and 54.21% were female). The data was analyzed by a mix of reliability analysis, correlation analysis, and regression analysis. The results showed that physical health of elders was influenced by distance, safety, greenery, seat, recreational facilities; psychological health was predicted by width, height, and greenery; social relationship was affected by distance, safety, and recreational facilities. Based on the research results, recommendations were proposed to property management service providers and local governments, including providing more seats at a reasonable height, setting handrails alongside the long ramp, installing folding seats along building stairs, and so on.

Effects of social network diversity on mortality, cognition and physical function in the elderly: a longitudinal analysis of the Chicago Health and Aging Project (CHAP)

Background

Having a larger social network has been shown to have beneficial effects on health and survival in adults, but few studies have evaluated the role of network diversity, in addition to network size. We explore whether social network diversity is associated with mortality, cognition and physical function among older black and white adults.

Methods

Data are obtained from the Chicago Health and Aging Project, a longitudinal, population-based study of adults aged 65 years and older at baseline. Using Cox proportional hazards regression, we estimate the hazard of mortality by network diversity (n=6497). The association between network diversity and cognition (n=6560) and physical function (n=6561) is determined using generalised estimating equations. Models were adjusted for age, gender, race, socioeconomic status, marital status and health-related variables.

Results

In fully adjusted models, elderly with more diverse social networks had a lower risk of mortality (HR=0.93, p<0.01) compared with elderly with less diverse networks. Increased diversity in social networks was also associated with higher global cognitive function (coefficient=0.11, p<0.001) and higher physical function (coefficient=0.53, p<0.001).

Conclusions

Social networks are particularly important for older adults as they face the greatest threats to health and depend on network relationships, more than younger individuals, to meet their needs. Increasing diversity, and not just increasing size, of social networks may be essential for improving health and survival among older adults.

Redes sociais e funcionalidade em pessoas idosas: evidências do estudo Saúde, Bem-Estar e Envelhecimento (SABE)

RESUMO: Introdução: Possuir redes sociais ativas parece influenciar positivamente o desempenho funcional de idosos. Objetivo: Verificar a associação entre as características das redes sociais de idosos e o surgimento de comprometimento funcional. Métodos: Estudo longitudinal de base populacional que utilizou as coortesde2006 (n = 1.413) e 2010 (n = 990) do Estudo Saúde, Bem-Estar e Envelhecimento (SABE). Para caracterização das redes sociais utilizou-se as seguintes variáveis: número de integrantes da rede; arranjo domiciliar; sexo e idade dos integrantes; co-residência com criança ou apenas com idosos; satisfação com a relação; recebimento e oferecimento de apoio social (financeiro, material, emocional, realização de tarefas dentro e fora de casa, companhia e cuidados pessoais). Utilizou-se regressão logística para a análise dos dados. Todos os cuidados éticos foram observados. Resultados: As redes sociais dos idosos possuem, em média, 8,15 integrantes e são constituídas predominantemente por familiares com idade entre 15 e 59 anos. Idosos dependentes recebem mais apoio material, para realização de tarefas domésticas, fora de casa e cuidados pessoais, enquanto os idosos independentes recebem mais apoio emocional e companhia. Oferecer apoio social (OR = 0,32; IC95% 0,14-0,71) diminuiu as chances de desenvolver dependência, independente de condições sociodemográficas e de saúde. Conclusão: Deve-se estimular o fortalecimento das redes sociais na velhice, uma vez que a confiança no cuidado informal, oferecido, principalmente pelas famílias, pode não ser a melhor opção para lidar com a demanda de cuidado crescente que acompanha o envelhecimento da população brasileira.

Development in self-rated health among older people as determinant of social relations

Aim: The purpose of this study was to analyse whether development in self-rated health (SRH) over four years was associated with the structure of and satisfaction with social relations, at four and eight years follow-up, among elderly women and men. Methods: A longitudinal questionnaire-based study was undertaken of non-institutionalized Danes, aged 70 - 95 years, with baseline in 1986. The response rate at baseline was 69%, n=1,231. First follow-up was carried out in 1990, with 91% of eligible individuals participating (n=911). Second follow-up took place in 1994, where 83% of eligible individuals participated (n=542). The association was studied between development in SRH from 1986 to 1990 and social relations in 1990 and in 1994. Results: A sustained poor SRH predicted low contact frequency OR=1.7 (1.1 - 2.6), small contact diversity OR=1.6 (1.0 - 2.6) and low contact satisfaction OR=3.4 (2.3 - 5.2) in the two-point analyses. Furthermore, a deterioration in SRH predicted poor contact satisfaction OR=2.8 (1.7 - 4.5). All analyses were adjusted for age, gender, mental health, functional ability, cohabitation status, and a measure of social relations at baseline. Results for the three-point analyses were similar to those for the two-point analyses. The associations were weaker for contact satisfaction OR=2.8 (1.7 - 4.7), but stronger for contact frequency OR=2.5 (1.4 - 4.4) and diversity OR=2.1 (1.2 - 3.6). Conclusion: Sustained poor SRH and, to some degree, deterioration in SRH were predictors of poor social relations after four and eight years.

Influence of Social Engagement on Mortality in Korea: Analysis of the Korean Longitudinal Study of Aging (2006-2012)

The objective of this study was to investigate the impact of social engagement and patterns of change in social engagement over time on mortality in a large population, aged 45 years or older. Data from the Korean Longitudinal Study of Aging from 2006 and 2012 were assessed using longitudinal data analysis. We included 8,234 research subjects at baseline (2006). The primary analysis was based on Cox proportional hazards models to examine our hypothesis. The hazard ratio of all-cause mortality for the lowest level of social engagement was 1.841-times higher (P < 0.001) compared with the highest level of social engagement. Subgroup analysis results by gender showed a similar trend. A six-class linear solution fit the data best, and class 1 (the lowest level of social engagement class, 7.6% of the sample) was significantly related to the highest mortality (HR: 4.780, P < 0.001). Our results provide scientific insight on the effects of the specificity of the level of social engagement and changes in social engagement on all-cause mortality in current practice, which are important for all-cause mortality risk. Therefore, protection from all-cause mortality may depend on avoidance of constant low-levels of social engagement.

Longitudinal changes in social networks, health and wellbeing among older Koreans

This study investigates the changes in social network types among older adults in South Korea, and it examines whether, and to what extent, these changes influence their health and psychological wellbeing. Data were obtained from the Korean Longitudinal Study of Ageing. The sample was restricted to respondents over 65 years of age who participated in both the 2006 and 2008 surveys (N = 3,501). The social network types for both years were derived by Latent Class Analysis. Changes in network types over time were then identified. A series of multivariate regression analyses were conducted to examine the effects of social network changes on self-rated health, depressive symptoms and life satisfaction. Restricted, Family, Friend and Diverse network types were derived in each wave of the study. Although the direction of social network changes was not always towards the Restricted type, the Restricted network was the most prevalent and stable type among older Koreans. Older adults who remained in or transitioned to restricted types of social networks were more likely to have poor self-rated health, higher levels of depressive symptoms and lower levels of life satisfaction. This study adds to the limited body of literature on longitudinal network typology, and it expands the knowledge of social network types among older adults in diverse social and cultural contexts.

Social network types and well-being among South Korean older adults

OBJECTIVE

The social networks of older individuals reflect personal life history and cultural factors. Despite these two sources of variation, four similar network types have been identified in Europe, North America, Japan, and China: namely 'restricted', 'family', 'friend', and 'diverse'. This study identified the social network types of Korean older adults and examined differential associations of the network types with well-being.

METHOD

The analysis used data from the 2008 wave of the Korean Longitudinal Study of Aging (KLoSA: N = 4251, age range 65-108). We used a two-step cluster analytical approach to identify network types from seven indicators of network structure and function. Regression models determined associations between network types and well-being outcomes, including life satisfaction and depressive symptomatology.

RESULTS

Cluster analysis of indicators of network structure and function revealed four types, including the restricted, friend, and diverse types. Instead of a family type, we found a couple-focused type. The young-old (age 65-74) were more likely to be in the couple-focused type and more of the oldest old (age 85+) belonged to the restricted type. Compared with the restricted network, older adults in all other networks were more likely to report higher life satisfaction and lower depressive symptomatology.

DISCUSSION

Life course and cohort-related factors contribute to similarities across societies in network types and their associations with well-being. Korean-specific life course and socio-historical factors, however, may contribute to our unique findings about network types.

Changes in social support within the early recovery period and outcomes after acute myocardial infarction

OBJECTIVE

To examine changes in social support during early recovery after acute myocardial infarction (AMI) and determine whether these changes influence outcomes within the first year.

METHODS

Among 1951 AMI patients enrolled in a 19-center prospective study, we examined changes in social support between baseline (index hospitalization) and 1 month post-AMI to longitudinally assess their association with health status and depressive symptoms within the first year. We further examined whether 1-month support predicted outcomes independent of baseline support. Hierarchical repeated-measures regression evaluated associations, adjusting for site, baseline outcome level, baseline depressive symptoms, sociodemographic characteristics, and clinical factors.

RESULTS

During the first month of recovery, 5.6% of patients had persistently low support, 6.4% had worsened support, 8.1% had improved support, and 80.0% had persistently high support. In risk-adjusted analyses, patients with worsened support (vs. persistently high) had greater risk of angina (relative risk=1.46), lower disease-specific quality of life (β=7.44), lower general mental functioning (β=4.82), and more depressive symptoms (β=1.94) (all p≤.01). Conversely, patients with improved support (vs. persistently low) had better outcomes, including higher disease-specific quality of life (β=6.78), higher general mental functioning (β=4.09), and fewer depressive symptoms (β=1.48) (all p≤.002). In separate analyses, low support at 1 month was significantly associated with poorer outcomes, independent of baseline support level (all p≤.002).

CONCLUSION

Changes in social support during early AMI recovery were not uncommon and were important for predicting outcomes. Intervening on low support during early recovery may provide a means of improving outcomes.

The impact of social support networks on mental and physical health in the transition to older adulthood

Social support is a multidimensional construct that consists of the type of support, the direction of support, the sources or targets of support, and whether support is actual or potential. We used latent class analysis to uncover network types based on these dimensions and to examine the association between network types and well-being among 6,824 adults ( M age = 54 at T1) in the two most recent waves (1992–1993 and 2003–2005) of the Wisconsin Longitudinal Study. We found six classes of social support networks. Class membership at T1 significantly predicted changes in depressive symptomatology and self-rated health over time. Our findings are discussed in light of the utility of a pattern-centered approach for uncovering heterogeneity in the social networks of adults.

Trajectories of social engagement and mortality in late life

OBJECTIVE

There is a dearth of empirical research examining how patterns of stability and change in social engagement affect mortality. This study uses social integration theory within a life course framework to examine trajectories of social engagement over time and how those patterns relate to mortality.

METHOD

Data are drawn from the Americans' Changing Lives survey, a nationally representative panel study, with mortality information spanning from 1986 to 2005.

RESULTS

Even after controlling for known predictors of mortality, membership in a trajectory of high and slightly increasing social engagement was related to lower risk of mortality. Sociodemographic, health condition, and health behavior variables mediated the impact of the other social engagement trajectories on mortality.

DISCUSSION

Findings suggest the importance of maintaining high levels of social engagement over time for the health of older adults.

Social relationships and mortality risk: a meta-analytic review

BACKGROUND

The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality.

OBJECTIVES

This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk.

DATA EXTRACTION

Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships.

RESULTS

Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44).

CONCLUSIONS

The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality. Please see later in the article for the Editors' Summary.

Cohabitation Status and Onset of Disability Among Older Danes

Objectives: To investigate the effect of cohabitation status in older men and women on (a) onset of disability at 3- and 4.5-year follow-up and (b) changes in functional ability between 3- and 4.5-year follow-up, and to analyze whether this effect was mediated by social participation. Method: A total of 2,533 nondisabled older men and women enrolled in the Danish Intervention Study on Preventive Home Visits constituted the study population. Data were collected by mailed questionnaires in 1998-1999, 2000, 2001-2002, and 2003. Results: Living alone significantly increased the risk of onset of disability (T3 OR = 1.60[1.06-2.43], T4 OR = 1.74[1.22-2.47]) and the risk of sustained poor functional ability (OR = 2.35[1.44-3.84]) among men, but not among single-living women. Social participation mediated only a small part of the effect of cohabitation status on functional ability. Discussion: Our results underline the importance of cohabitation/marriage for maintaining a high functional ability among older men.

The measurement of change in functional ability: Dealing with attrition and the floor/ceiling effect

The purpose was to describe four-year change in functional ability among older persons and the relationship to sex, age, and other background factors. The baseline study, performed in 1986, is based on a random sample of older persons (n=1261). Follow-up data were collected four-years later (n=912). The analyses of change in functional ability were based on the assumption that the categories reflected an underlying latent continuous dimension. The change in functional ability, DeltaFA, was calculated by a logistic model for paired observations and applied in parallel analyses with and without inclusion of the dead to deal with the attrition problem. Fifty percent had no change in functional ability, 37% had declined and 13% improved. Models including the dead showed more functional decline with increasing age but this was not the case when the dead were excluded. Functional change was not related to sex, functional ability at baseline, relative wealth, social network, self-rated health, and life-satisfaction. Inclusion of the dead in statistical models for the study of change in functional ability reduced the attrition problem. A logistic model for paired observations of functional ability at two points in time reduced the problem related to the floor/ceiling problem.

Factors associated with "Ikigai" among members of a public temporary employment agency for seniors (Silver Human Resources Centre) in Japan; gender differences

BACKGROUND

"Ikigai" is culturally defined in the society of Japan as a comprehensive concept describing subjective well-being. It is considered to be related to life-satisfaction, self-esteem, morale, happiness as well as evaluation towards meaning of one's life. Although previous studies examined factors associated with Ikigai with smaller samples, consistent results have not been obtained, especially from the viewpoint of gender differences. Identification of gender-specific factors related with Ikigai among the elderly, may be of value to enhance subjective well-being.

METHODS

Self-administered questionnaires were distributed among 4,737 randomly selected members of the Silver Human Resources Centre (SHRC), a public temporary employment agency for seniors, in Osaka, Japan. This represents about 10% of all registered members (n = 41,593) in the 38 SHRC centres in Osaka. A total of 4,376 subjects (male: 2,913; female: 1,463) provided a satisfactory response to the questionnaire (response rate: 92%). The status whether they have "Ikigai" or not was evaluated by self-anchoring scale ranging from 0 to 5 (0 = lowest rate and 5 = highest rate of having "Ikigai"). Also, self-rated life-change score through work (-3 to 3) was evaluated by three items, i.e.) changes in (1) the number of friends through work, (2) social interests and (3) the quantity of conversation with others (1 = increase, 0 = no change, and -1 = decrease).

RESULTS

The factors associated with "Ikigai" for total subjects were the number of rooms in one's residence, annual income, healthy life style score (Breslow), the number of working days through SHRC, satisfaction with one's life history and life-change sore through work. The multivariable odds ratio (95% CI) of having "Ikigai" was 1.9 (1.1-3.3) for persons with no change in life thorough work compared with subjects with a score of < or = -1. Moreover, the multivariable odds ratios were 3.5 (1.9-6.6) for a life-change score = 1, 3.1 (1.7-5.7) for a score = 2 and 7.8 (4.0-15.2) for a score = 3 compared with persons with a score of < or = -1. For male subjects, other factors associated with having "Ikigai" were the number of rooms in their residence, annual income, the number of working days through SHRC, subjective assessment of health condition, and degree of satisfaction with their life history. For female, the corresponding factors were the presence of a spouse and degree of satisfaction with their life history.

CONCLUSION

Scores for life-changes through work were associated with a higher prevalence of having "Ikigai" for both male and female. For male, "Ikigai" tended to be associated with physical condition and socioeconomic factors such as the size of their residence or annual income, while for female, family relations such as having spouse and psychological factors such as satisfaction with one's life history were significant factors. In spite of the design limitations of this study, it is possible to conclude that the recognition of life change through obtaining work may enhance "Ikigai" among people who wish to engage in productive activities in their later stages of life for both male and female. SHRC has a potential to provide resources for fulfilling one's "Ikigai" through supporting working opportunities to realize life changes for both elder male and female.

Association of sleep quality and free time leisure activities in Japanese and British civil servants

Sleep disturbance as a pervasive health problem can directly affect the physical and psychological well-being of individuals. Factors that positively relate to sleep quality can therefore improve healthy functioning. We examined whether leisure time activities are associated with sleep quality in two culturally different samples of civil servants. In this cross-sectional study we evaluated 1,682 Japanese, in Toyama prefecture (T) city, and 6,914 British civil servants from the Whitehall II study undertaken in London. The Japanese version of Pittsburgh sleep quality index (PSQI-J) was used in T city and Jenkins' sleep problem scale was used in the Whitehall II study. Setting a validated cut-off point of 5.5 for the PSQI-J global score and the upper tertile point for the Jenkins' sleep problem scale, we conducted logistic regression analysis to assess the association between leisure time activities and sleep quality. In both populations, those who participated in voluntary activities in clubs or organizations were significantly less likely to have poor sleep quality with Odds ratios (OR) and 95% confidence intervals (95%CI) of 0.73 (95%CI; 0.56-0.97) and 0.85 (95%CI; 0.76-0.95) in Japanese and British civil servants, respectively. Similar findings were apparent for visiting friends and relatives (ORs 0.60 (95%CI; 0.46-0.80) and 0.71 (95%CI; 0.56-0.90) for Japanese and British subjects, respectively). Our findings suggest that engagement in social leisure activities is associated with better sleep quality and consequently better general well-being.

Social networks and pain interference with daily activities in middle and old age

Social networks have emerged as important in the development and progression of disability in aging cohorts. We have previously reported that pain that interferes with daily activities is common and increases incrementally from middle age into later life. The current study has investigated whether pain interference in this age group is related to social network characteristics. 5215 community-dwelling adults aged 50 years and over participating in the North Staffordshire Osteoarthritis Project (NorStOP) and identified as currently experiencing pain formed the sample for the present analysis. Questions on pain-related interference and the number and frequency of contact with children, close relatives, close friends, and confidant were included in the baseline postal questionnaire. The number and frequency of contact for most social ties declined with age. Being widowed (Age-adjusted OR: 1.30; 95%CI: 1.10, 1.54), the absence of close friends (2.07; 1.64, 2.63), and the absence of close relatives for women (2.24; 1.66, 3.04) were associated with increased likelihood of pain interference with daily activities. The absence of children was linked to lower levels of pain interference (0.76; 0.64, 0.91). The associations with close friends and children were reduced but remained significant after adjusting for sociodemographic factors. The association with close friends became non-significant after adjusting for depression suggesting this may form part of the pathway linking close friends networks and pain interference. Pain-related interference shows similar associations with social networks as all-cause disability and may benefit similarly from a public health perspective.

Social relations as determinant of onset of disability in aging

The purpose of the study was to analyze whether social relations are related to onset of disability among old people at 1.5 year follow-up and whether these relations vary by age and gender. The study is based on baseline and 1.5 year follow-up data on 1396 older non-disabled adults. Social relations were measured by questions about diversity in social relations, social participation, satisfaction with social relations and instrumental social support. Onset of disability was described as developing need of help in at least one of six mobility activities. The results showed that a large diversity in social relations and high social participation were important factors for maintaining functional ability among the 75-year-old men and women, while social support was a risk factor for functional decline among the 80-year-old men. The present study suggests that being "embedded" in a strong network of social relations provides protection against disability by reducing risk of developing disability.

The impact of structural and functional characteristics of social relations as determinants of functional decline

OBJECTIVES

This study examines whether aspects of social relations at baseline are related to functional decline at 5-year follow-up among nondisabled old men and women.

METHODS

The investigation is based on baseline and follow-up data on 651 nondisabled 75-year-old persons in Jyväskylä (Finland) and Glostrup (Denmark). The analyses are performed separately for men and women. Possible selection problems were considered by using three outcome measures: first, functional decline among the survivors (n = 425); second, functional decline, including death, assuming that death is part of a general decline pattern (n = 565); and third, mortality (n = 651). Social relations were measured at baseline by several items focusing on the structure and function of the social network.

RESULTS

In men, no weekly telephone contact was related to functional decline and mortality. Among women, less than weekly telephone contact, no membership in a retirement club, and not sewing for others were significantly related to functional decline and mortality. The associations were stronger when the dead were included in the outcome measure.

DISCUSSION

The results point to the importance of social relations in the prevention of functional decline in older adults.

Social relations as determinants of oral health among persons over the age of 80 years

OBJECTIVE

To analyze whether social relations during a 7-year follow-up influence oral health among generally healthy, community-dwelling persons over the age of 80 years.

METHOD

The present investigation is based on a subsample of 129 dentate community-dwelling individuals from The Kungsholmen Elders Oral Health Study (KEOHS), which included data from interviews and oral examinations. Social relations were measured in terms of marital status, living alone, frequency of contacts, number of confidants, and satisfaction with social contacts and with the frequency of contacts. Oral health was measured in terms of coronal caries and root caries.

RESULTS

The primary findings of the adjusted multivariate logistic regression analysis were that persons who lived alone or who became alone during the 7 years prior to the dental examination had greater odds of having coronal caries (odds ratio (OR): 2.4, 95% CI: 1.0-5.7) than those who continually lived with others, and that persons who were continuously dissatisfied with the frequency of their social contacts were more likely to have root caries than those who reported a sustained satisfaction with the frequency of their social contacts (OR: 2.9, 95% CI: 1.2-7.2).

CONCLUSION

This study suggests that social relations are related to the oral health status of old-old individuals. From a psychosocial perspective, our findings contribute to a deeper understanding of the background of oral health status in older adults.

Functional decline from age 80 to 85: influence of preceding changes in tiredness in daily activities

OBJECTIVE

To analyze whether functional decline from age 80 to 85 is influenced by changes in self-reported tiredness in daily activities in the preceding 5-year period.

METHOD

A prospective study of 226 75-year-old men and women with 5- and 10-year follow-up in the Western part of Copenhagen County. Tiredness in daily activities was measured at age 75 and 80 by a validated scale. Changes in tiredness from age 75 to 80: 1) Sustained no tiredness, 2) not tired-tired, 3) tired-not tired, 4) sustained tiredness. Functional decline from age 80 to 85:1) Sustained no need of help; 2) need of help at age 85, alive; 3) need of help at age 85 or dead; 4) dead.

RESULTS

The analyses among the survivors showed a slight tendency to an association between having sustained tiredness or development of tiredness from age 75 to 80 and functional decline from age 80 to 85. Persons with sustained tiredness from age 75 to 80 were at significantly larger risk of functional decline and mortality from age 80 to 85. These results were not attenuated when adjusted by the covariates.

CONCLUSION

The results in the present study indicate that it is important to take continuous complaints about tiredness in daily activities seriously, because this is an early sign of functional decline.