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While having social support can contribute to better health, those in poor health may be limited in their capacity to receive social support. We studied the health factors associated with social support among community-dwelling older adults in Singapore. We used data from the third follow-up interviews (2014–2016) of 16,943 participants of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese. Participants were interviewed at a mean age of 73 years (range 61–96 years) using the Duke Social Support Scale (DUSOCS). We first applied ordinary least squares regression to DUSOCS scores and found that those with instrumental limitations, poor self-rated health, cognitive impairment and depression had lower social support scores. We then applied latent class analysis to DUSOCS answer patterns and revealed four groups of older adults based on the source and amount of social support. Among them, compared to the ‘overall supported’ group (17%) with the highest social support scores and broad support from family members and non-family individuals, the ‘family restricted’ (50%) group had the lowest social support scores and only received support from children. Health factors associated with being ‘family restricted’ were instrumental limitations (odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.19–1.49), poor self-rated health (OR = 1.40, 95% CI = 1.28–1.53), cognitive impairment (OR = 1.19, 95% CI = 1.04–1.37) and depression (OR = 2.50, 95% CI = 2.22–2.82). We found that while older adults in poor health have lower social support scores, they were more likely to receive a lot of support from children. Our results showed that lower social support scores among Singaporean older adults in poor health may not indicate lack of social support, but rather that social support is restricted in scope and intensified around children. These results may apply to other Asian societies where family plays a central role in elder-care.
Academic debate about social isolation and loneliness, and their adverse health and well-being implications, has resulted in many policy and programme interventions directed towards reducing both, especially among older people. However, definitions of the two concepts, their measurement, and the relationship between the two are not clearly articulated. This article redresses this and draws on theoretical constructs adapted from symbolic interactionism, together with the Good Relations Measurement Framework, developed for the Equality and Human Rights Commission in the UK, to challenge the way in which social isolation and loneliness are currently understood. It argues for a need to understand experiences of social relationships, particularly those which facilitate meaningful interaction, suggesting that opportunities and barriers to meaningful interaction are determined by wider societal issues. This is set out in a new conceptual framework which can be applied across the life course and facilitates a new discourse for understanding these challenging concepts.
Healthy older adults typically retain high functioning in the social realm. Nevertheless, social networks, social support, and qualities of relationships vary in late life. This chapter addresses three questions: (1) What areas of cognitive functioning are associated with the social realm? (2) What mechanisms account for these associations? (3) Do these patterns extend to pathological declines associated with dementia? Individuals with a diversity of social partners retain general cognitive functioning more so than individuals with a limited set of social partners. Social integration provides stimulation and activities, and mitigates negative emotion in ways that contribute to cognitive health. Findings suggest that social ties cannot deter pathological declines associated with dementia. In sum, a wide range of social partners appears to be one of multiple resources (e.g., higher socioeconomic status, better locus of control, better health behaviors) that help maintain cognitive functioning in late life.
Social engagement may be an important protective resource for cognitive aging. Some evidence suggests that time spent with friends may be more beneficial for cognition than time spent with family. Because maintaining friendships has been demonstrated to require more active maintenance and engagement in shared activities, activity engagement may be one underlying pathway that explains the distinct associations between contact frequency with friends versus family and cognition.
Using two waves of data from the national survey of Midlife in the United States (n = 3707, Mage = 55.80, 51% female at baseline), we examined longitudinal associations between contact frequency with friends and family, activity engagement (cognitive and physical activities), and cognition (episodic memory and executive functioning) to determine whether activity engagement mediates the relationship between contact frequency and cognition.
The longitudinal mediation model revealed that more frequent contact with friends, but not family, was associated with greater concurrent engagement in physical and cognitive activities, which were both associated with better episodic memory and executive functioning.
These findings suggest that time spent with friends may promote both cognitively and physically stimulating activities that could help to preserve not only these social relationships but also cognitive functioning.
Today’s aging population means that retirement homes must be considered more carefully in research, particularly in terms of social ties. After moving into a retirement home, many seniors wish to remain active and contribute to society, thereby maintaining a sense of purpose. The objective of this exploratory qualitative research is to explore and better understand the perceptions and experiences of seniors living in retirement homes regarding their social participation, in terms of interpersonal relationships and recreational activities. We interviewed 11 residents of private seniors’ residences in Quebec City, Canada. At the personal level, the central factors for social participation are adaptation to the new environment, involvement in this environment, especially via volunteering, and health status. Regarding the social environment, important factors include geographic proximity to the social network, diversity of proposed leisure activities and staff permanence. In conclusion, we compiled a list of recommendations in respect of intervention strategies and defined future research avenues that would address the issues of social participation highlighted in this study.
Social ties are the most important resource human beings have. Although other people can be difficult and challenging, they can also provide protection, solace, and social support, among other benefits. However, some relationships can be toxic and because these adverse conditions can be physiologically taxing, they can negatively affect both mental and physical health. Changes such as these can operate in large part through alterations in the sympathetic nervous system, the hypothalamic-pituitary-adrenal system, and the immune system. Much of the benefit of social support is perceptual and stems from the comfort of believing that supportive others can or will be there when times are stressful. The abilities to gain and perceive social support begin early in life and are heavily influenced by the climate of the family. Social support depends, in part, on reciprocity, yet many challenges to receiving support exist. Giving support to others has its own psychological and physiological benefits, although at intense levels, such as demanding caregiving responsibilities, these benefits dwindle. Moreover, social support needs change over time with changing circumstances. Public policy efforts to help people build and capitalize on their potential support networks is essential to maximize the impact of social ties on mental and physical health.
As a response to an ageing population, and to benefit from senior citizens’ resources and improve their quality of life, European countries are increasingly engaging older volunteers in the old-age sector and care environments. Older Danes’ participation in volunteer work is high; however, nursing home residents and home care recipients are typically not part of these initiatives as volunteers, but as the receivers of volunteer care. We investigate an initiative that engages frail older people as volunteer language teachers for foreigners learning Danish in an endeavour to utilise their resources as volunteers and to engage the language teachers socially. Through participant observations and semi-structured interviews with older volunteers, Danish-language students and care personnel, we explore what constitutes good social relationships in this specific initiative, how these relationships are created and the kind of subject that appears through Elderlearn. We are inspired by the sociology of attachment as we describe how frail older people emerge as engaged subjects by becoming reattached to their life histories, interests, abilities and relational skills. In this regard, good social relationships surpass the immediate volunteer–recipient bond and create a ‘blurry volunteering’ with less distinct divisions of who gives and who receives. This generates constructive relationships created through interlinguistic competences, international consciousness, and use of materials, objects and the local community. We argue that this arrangement reattaches the language teachers to their life histories, thereby enabling the emergence of a different kind of international and engaged old-age subjectivity.
Understanding how social experiences throughout life shape later loneliness levels may help to identify how to alleviate loneliness at later lifestages. This study investigates the association between social relationship adversities throughout the lifecourse and loneliness in later life. Using prospective data from the Medical Research Council National Survey of Health and Development (N = 2,453), we conducted multivariable analyses to investigate independent, cumulative and moderated effects between the number of social relationship adversities experienced in childhood, mid-adulthood and later adulthood and the feeling of loneliness at age 68. We examined interactions between social relationship adversities and current quantity and quality aspects of social relationships. We found evidence of a step-dose response where greater exposure to social relationship adversities experienced at three earlier lifestages predicted higher loneliness levels in later life with more recent social relationship adversities more strongly related to loneliness. The results also demonstrated support for exacerbation and amelioration of earlier adverse social relationship experiences by current social isolation and relationship quality, respectively. This study suggests that social relationship adversities experienced throughout the lifecourse continue to influence loneliness levels much later in life. A key finding is that adverse social relationship experiences in earlier life may explain why otherwise socially similar individuals differ in their levels of loneliness. Implications for policy and research are discussed.
Prior research has established associations between neighbourhood poverty and cumulative biological risk (CBR). CBR is conceptualized as indicative of the effects of stress on biological functioning, and is linked with increased morbidity and mortality. Studies suggest that supportive social relationships may be health protective, and may erode under conditions of poverty. This study examines whether social relationships are inversely associated with CBR and whether associations between neighbourhood poverty and CBR are mediated through social relationships. Data were from a stratified probability sample community survey (n=919) of residents of Detroit, Michigan, USA (2002–2003) and from the 2000 US Census. The outcome variable, CBR, included anthropometric and clinical measures. Independent variables included four indicators of social relationships: social support, neighbourhood satisfaction, social cohesion and neighbourhood participation. Multilevel models were used to test both research questions, with neighbourhood poverty and social relationships included at the block group level, and social relationships also included at the individual level, to disentangle individual from neighbourhood effects. Findings suggest some associations between social relationships and CBR after accounting for neighbourhood poverty and individual characteristics. In models that accounted for all indicators of social relationships, individual-level social support was associated with greater CBR (β=0.12, p=0.04), while neighbourhood-level social support was marginally significantly protective of CBR (within-neighbourhood: β=−0.36, p=0.06; between-neighbourhood: β=−0.24, p=0.06). In contrast, individual-level neighbourhood satisfaction was protective of CBR (β=−0.10, p=0.02), with no within-neighbourhood (β=0.06, p=0.54) or between-neighbourhood association (β=−0.04, p=0.38). Results indicate no significant association between either social cohesion or neighbourhood participation and CBR. Associations between neighbourhood poverty and CBR were not mediated by social relationships. These findings suggest that neighbourhood-level social support and individual-level neighbourhood satisfaction may be health protective and that neighbourhood poverty, social support and neighbourhood satisfaction are associated with CBR through independent pathways.
Efforts to differentiate between the developmental sequelae of childhood emotional abuse and childhood emotional neglect are critical to both research and practice efforts. As an oft-identified mechanism of the effects of child maltreatment on later adjustment, emotion dysregulation represents a key potential pathway. The present study explored a higher order factor model of specific emotion regulation skills, and the extent to which these skill sets would indicate distinct developmental pathways from unique emotional maltreatment experiences to multidomain adjustment. A sample of 500 ethnoracially diverse college students reported on their experiences. A two-factor model of emotion regulation skills based on subscales of the Difficulties in Emotion Regulation Scale was revealed. Significant indirect effects of childhood emotional abuse on psychopathology and problems in social relationships were found through response-focused difficulties in emotion regulation, whereas a significant indirect effect of childhood emotional neglect on problems in social relationships was found through antecedent-focused difficulties in emotion regulation. These results are consistent with theoretical models and empirical evidence suggesting differential effects of childhood emotional abuse and emotional neglect, and provide an important indication for developing targeted interventions focusing on specific higher order emotion dysregulation skill clusters.
Active participation in social activities is important for the wellbeing of older adults. This study explored benefits of active social engagement by evaluating whether relationships that comprise active involvement (e.g. co-engagement in activities) bring more social benefits (i.e. social support, companionship, positive social influence) than other relationships that do not involve co-engagement. A total of 133 adults ages 60 years and older living in a rural Midwestern city in the United States of America were interviewed once and provided information on 1,740 social network members. Among 1,506 social relationships in which interactions occurred at least once a month, 52 per cent involved engagement in social activities together and 35 per cent involved eating together regularly. Results of the generalised linear mixed model showed that relationships involving co-engagement were significantly more likely to also convey social support (i.e. emotional, instrumental, informational), companionship and social influence (encouragement for healthy behaviours) than relationships that do not involve co-engagement. Having more network members who provide companionship was associated with higher sense of environmental mastery, positive relations with others and satisfaction with social network. Interventions may focus on maintaining and developing such social relationships and ensuring the presence of social settings in which co-engagement can occur. Future research may explore whether increasing co-engagement leads to an enhanced sense of companionship and psychological wellbeing.
Twin research has offered evidence that monozygotic (MZ) twins are more socially close than dizygotic (DZ) twins, but has not paid much attention to the way twins compare themselves with their co-twin. The few studies in this area suggest that ‘horizontal comparisons’ (social comparison motivated by solidarity or communion with others) matter more for MZ twins than for DZ twins, at least when the co-twin is the social comparison standard. Consistent with this view, we predicted higher interest in MZ twins relative to DZ twins to select their co-twin rather than other people in general as the social comparison standard. The Social Comparison Orientation (SCO) scale, which measures the inclination to compare with others in a horizontal rather than vertical mode (comparing either upward or downward), was administered in 90 MZ pairs and 57 same-sex DZ pairs (63% female; average age 18.06 years) from the Netherlands Twin Register. MZ twin pairs showed significantly higher SCO scores than DZ twin pairs (with a large effect size) on the co-twin SCO, whereas the two groups did not differ from each other on the general SCO excluding the co-twin as social comparison standard. In MZ twin pairs, anxiety was associated with social comparison with others in general, not with their co-twin. For both scales, twin resemblance was explained by additive genetic variance. The present findings provide direct evidence that horizontal comparisons with the co-twin are of particular importance for MZ twins.
To explore influences on diet in a group of community-dwelling older adults in the UK.
Data were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.
Participants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998–2001 and 2011.
Ninety-two adults participated (47 % women; 74–83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about ‘keeping going’, being motivated to ‘not give up’, not wanting to be perceived as ‘old’, as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet.
Interventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.
This study investigated the potential environmental effects of peer victimization and the quality of relationships with parents and friends on diurnal cortisol secretion in mid-adolescence.
This study used the monozygotic (MZ) twin-difference design to control for genetic effects and thus estimate the unique environmental influences on diurnal cortisol. Participants were 136 MZ twin pairs (74 female pairs) for whom cortisol was assessed four times per day over four collection days grouped in a 2-week period in grade 8 (mean age = 14.07 years). Participants also provided self-reports of peer victimization from grade 4 to grade 8 and of the relationship quality with the mother, father and best friend in grade 8.
The expected pattern of diurnal cortisol secretion was observed, with high levels at awakening followed by an increase 30 min later and a progressive decrease subsequently. Controlling for a host of confounders, only within-twin pair differences in peer victimization and a problematic relationship with the mother were significantly linked to twin differences in diurnal cortisol secretion. Specifically, whereas a more problematic mother–child relationship was associated with morning cortisol secretion, peer victimization was linked to cortisol secretion later in the day (diurnal slope).
Controlling for genetic influences and other confounders, stressful relationships with peers and the mother exert unique and time-specific environmental influences on the pattern of diurnal cortisol secretion in mid-adolescence.
Social relationships can impact youths’ eating and physical activity behaviours; however, the best strategies for intervening in the social environment are unknown. The objectives of the present study were to provide in-depth information on the social roles that youths’ parents and friends play related to eating and physical activity behaviours and to explore the impact of other social relationships on youths’ eating and physical activity behaviours.
Convergent parallel mixed-methods design.
Low-income, African American, food desert neighbourhoods in Baltimore City, MD, USA.
Data were collected from 297 youths (53 % female, 91 % African American, mean age 12·3 (sd 1·5) years) using structured questionnaires and combined with in-depth interviews from thirty-eight youths (42 % female, 97 % African American, mean age 11·4 (sd 1·5) years) and ten parents (80 % female, 50 % single heads of house, 100 % African American).
Combined interpretation of the results found that parents and caregivers have multiple, dynamic roles influencing youths’ eating and physical activity behaviours, such as creating health-promoting rules, managing the home food environment and serving as a role model for physical activity. Other social relationships have specific, but limited roles. For example, friends served as partners for physical activity, aunts provided exposure to novel food experiences, and teachers and doctors provided information related to eating and physical activity.
Obesity prevention programmes should consider minority youths’ perceptions of social roles when designing interventions. Specifically, future research is needed to test the effectiveness of intervention strategies that enhance or expand the supportive roles played by social relationships.
This article explores the social relationships created in the delivery of conditional cash transfer (CCT) programmes using a wellbeing lens. Most CCTs influence people's lives in overarching terms, including income, health and education. Their implementation process, however, also places policy participants in new and constant interactions with the front-line officers that implement the programmes. Wellbeing scholarship brings to our attention the centrality of social relationships in people's lives. This literature widely agrees that the quality of our relationships with others is possibly the most essential element of a good life. Therefore, given the recent entrance of wellbeing to the realm of policy, an exploration of the relationships created in policy contexts using a wellbeing lens is a necessary next step. This article examines this in the context of the Oportunidades/Prospera programme in Mexico, one of the most successfully regarded CCTs in Latin America. It presents primary qualitative data about the officer–recipient relationship during the delivery of the health conditionalities and explores its implications on the wellbeing of recipients. The article concludes that the relationships created during policy implementation have far-reaching effects on wellbeing and need to be better acknowledged in policy design and evaluation.
In the United States of America (USA), older adults in rural areas are at increased risk for adverse outcomes of disasters, partly due to medical needs, limited or long geographic distances from community resources, and less knowledge and motivation about preparedness steps. Older residents and ageing service providers in a rural community in the USA were interviewed regarding their perceptions about disasters and preparedness, and their reactions to the preparedness training programme using the concepts of the Extended Parallel Process Model. Participants generally indicated low motivation to engage in preparedness behaviours despite perceptions of personal risk and beliefs that preparedness behaviours were easy and could improve disaster outcomes. A theme of social relationships emerged from the data, with participants identifying social relationships as resources, barriers and motivators. People surrounding older adults can support or deter their preparedness behaviours, and sometimes elicit a desire to protect the wellbeing of others. Findings suggest two potential strategies to facilitate preparedness behaviours by moving beyond personal benefits: highlighting older adults' increased ability to protect the wellbeing of younger generations and their community by being prepared themselves, and engaging family, friends and neighbours in preparedness programmes to enhance the resilience of their social groups. Older adults in many cultures have a desire to contribute to their society. Novel and effective approaches to increase preparedness could target their social groups.
Socio-economic gradients in diet quality are well established. However, the influence of material socio-economic conditions particularly in childhood, and the use of multiple disaggregated socio-economic measures on diet quality have been little studied in the elderly. In the present study, we examined childhood and adult socio-economic measures, and social relationships, as determinants of diet quality cross-sectionally in 4252 older British men (aged 60–79 years). A FFQ provided data on daily fruit and vegetable consumption and the Elderly Dietary Index (EDI), with higher scores indicating better diet quality. Adult and childhood socio-economic measures included occupation/father's occupation, education and household amenities, which combined to create composite scores. Social relationships included social contact, living arrangements and marital status. Both childhood and adult socio-economic factors were independently associated with diet quality. Compared with non-manual social class, men of childhood manual social class were less likely to consume fruit and vegetables daily (OR 0·80, 95 % CI 0·66, 0·97), as were men of adult manual social class (OR 0·65, 95 % CI 0·54, 0·79), and less likely to be in the top EDI quartile (OR 0·73, 95 % CI 0·61, 0·88), similar to men of adult manual social class (OR 0·66, 95 % CI 0·55, 0·79). Diet quality decreased with increasing adverse adult socio-economic scores; however, the association with adverse childhood socio-economic scores diminished with adult social class adjustment. A combined adverse childhood and adulthood socio-economic score was associated with poor diet quality. Diet quality was most favourable in married men and those not living alone, but was not associated with social contact. Diet quality in older men is influenced by childhood and adulthood socio-economic factors, marital status and living arrangements.
The objective was to examine whether aspects of social relationships in old age are associated with all-cause dementia and Alzheimer's disease (AD).
We studied 1,715 older adults (≥ 65 years) who were dementia-free at baseline over a period of up to 16 years. Data on living status, contact/visit frequency, satisfaction with contact frequency, and having/not having a close friend were analyzed using Cox proportional hazards regressions with all-cause dementia or AD as the dependent variable. To control for reverse causality and to identify potential long-term effects, we additionally performed analyses with delayed entry.
We identified 373 incident cases of dementia (207 with AD) during follow-up. The variable visiting/visits from friends was associated with reduced risk of all-cause dementia. Further, a higher value on the relationships index (sum of all variables) was associated with reduced risk of all-cause dementia and AD. However, in analyses with delayed entry, restricted to participants with a survival time of three years or more, none of the social relationship variables was associated with all-cause dementia or AD.
The results indicate that certain aspects of social relationships are associated with incident dementia or AD, but also that these associations may reflect reverse causality. Future studies aimed at identifying other factors of a person's social life that may have the potential to postpone dementia should consider the effects of reverse causality.
The research reported in this article investigated the nature and the purpose of older people's social interactions in their local neighbourhood shops. Data were collected through face-to-face interviews with and observation of 11 shoppers, aged 67 years and older, and six shopkeepers. Classic grounded theory analysis method revealed a previously uncharted psycho-social process associated with these interactions entitled by the authors as Civic Socialising; it highlights that older people's interactions in their local neighbourhood shops embody authentication of themselves as individuals and as community members, and their co-construction and co-preservation of the milieu of their local neighbourhood shopping precinct with a view to sustaining their ongoing autonomy. The new conceptual theory Civic Socialising highlights that older people can be proactive, resilient and capable, dimensions integral to human fulfilment, and demonstrates that older people can play an active role in their communities where the environment is enabling. The new conceptual theory Civic Socialising has significance for the way we determine and view older people's social relationships. Crucially, in light of a burgeoning older population world-wide, it is clear that policy makers and social planners must ensure that older people can continue to interact in their communities if ageing in place is to be a satisfying and cost-effective experience. Without such consideration, ageing in place could well create dependency and despondency.