Exploring the stress-buffering effects of church-based and secular social support on self-rated health in late life

OBJECTIVES: The purpose of this study is to see if emotional support received from fellow church members and emotional support from secular social networks reduce the effects of financial strain on self-rated health. A second goal is to determine if church-based social support is a more important coping resource for older Blacks than for older Whites. METHODS: The data come from the second wave of interviews with a nationwide sample of older people. Two groups of older adults are included in the analyses: Older Christians who go to church more than twice a year (N=548) and older people who do not go to church as frequently (N=238). RESULTS: The data suggest that support from fellow church members tends to reduce the impact of financial strain on self-rated health, but support from secular network members fails to exert a similar effect. The findings also reveal that the stress-buffering effects of church-based support emerge among older Blacks, but not older Whites. DISCUSSION: The findings from this study suggest that there may be something relatively unique about support that is provided by fellow church members.     

Social networks among blacks and whites: the interaction between race and age

OBJECTIVES: This study examined the main and interactive effects of age and race on the core characteristics of social networks including size, frequency of contact, geographical proximity, and composition of network. METHODS: Respondents were drawn from a stratified probability sample of people aged 20-93 in the greater Detroit metropolitan area. Approximately 30% of the sample were African American, and people aged 60 and older were over-sampled (n = 1.382). The authors used hierarchical regression analysis to estimate the influence of race and age on each component of social network, controlling for marital status, gender, and education. An interaction term (Race x Age) was added to explore the extent to which age moderates any detected race differences. RESULTS: Older age was associated with smaller, less frequently seen, and less proximal networks that had a higher proportion of kin. Blacks and Whites were similar with regard to proximity, but Blacks had smaller networks, more contact with network members, and more family members in their networks. Race differences in frequency of contact and proportion of kin were moderated by age, such that the differences in these variables diminished with increasing age. DISCUSSION: A systematic analysis of how age, race, and their interaction influence the characteristics of social networks furnishes important empirical knowledge about social networks among diverse groups. Such data may provide a context for how, and some explanation for why, support exchanges occur.     

Social networks in adult life and a preliminary examination of the convoy model

This paper examines the social support networks of older adults. Based upon the Kahn and Antonucci (1980) life course social support model, a national sample of adults aged 50 and older (N = 718) was interviewed, generating support networks consisting of an average of 8.9 members. The respondents were asked questions of the structural (e.g., age, sex, closeness, years known, proximity, and frequency of contact) and functional (number and type of supports provided and received) characteristics of their social networks. These characteristics and relationships are described in detail.     

Race differences in cognitive functioning among older adults

OBJECTIVES: Explaining race differences in cognitive functioning in later life continues to challenge researchers. This study was an attempt to incorporate the clinical literature, emphasizing biological correlates of cognitive functioning, and the social research literature, emphasizing social inequalities and consequent health outcomes, in the examination of sources of race differences in cognitive functioning in older adults. METHODS: With data from Wave 1 of the Assets and Health Dynamics of the Oldest Old survey, the authors used structural equation models (LISREL 8.30) to estimate the direct effects of race on cognitive functioning and indirect effects through social and biological risk factors for the total sample (N = 5,955). RESULTS: Race had a direct association with cognitive functioning. Race also had indirect effects on cognitive functioning through social risk factors-education and health insurance. There did not appear to be indirect effects of race through biological risk factors. DISCUSSION: The direct and indirect effects of race through social risk factors attest to the importance of examining different ways through which race can influence cognitive functioning of older adults. This research also emphasizes the need for researchers to investigate more closely race differences in dimensions of cognitive functioning and cognitive functioning over time.     

Comparing Old and Young Adults as They Cope with Life Transitions: The Links between Social Network Management Skills and Attachment Style to Depression

Smaller social networks are associated with poorer health and well-being, especially as people negotiate life transitions. Many older adults, however, tend to have smaller networks, without the expected negative outcomes. To understand better how older adults avoid such outcomes we measured social network management skills, attachment style, and depression among individuals going through a life transition. Older adults who recently became caregivers were compared with young adults who recently transitioned to college. Although older adults initiated fewer and terminated more social ties (being selective in their choice of network members), both age groups had an equal number of close network members. A closer look revealed that securely attached older adults maintained their social ties, and in turn, sustained low levels of depression. These findings emphasize the importance of attachment style and network skills to mental health in general, and among older adults specifically.     

Social Network and Mental Health Among Older Adults in Rural Uttar Pradesh,India: A Cross-Sectional Study

The rapid growth of the older population in India draws attention to the factors that contribute to their changing health realities. However, there has hardly been any study in India that has looked at the effects of specific social networks with children, relatives, friends and confidant on depression among older adults. The objective of the study is to investigate the association between social network and depression among the rural elderly. The study population comprised over 630 older adults (aged 60 and above) from the rural areas of Varanasi, Uttar Pradesh. We adopted Berkman's theoretical model of the impact of social relations on depression among the elderly in the Indian context. Results of the Confirmatory Factor Analysis (CFA) demonstrated that the four specific social network types: children, relatives, friends and confidant were tenable. The results showed that a better social network with 'friends/neighbours' was protective against depression among the rural elderly. This clearly points to the need for more social network centres for older adults, so that they can interact with friends within the community or between communities and participate in group activities.     

Low supply of social support as risk factor for mortality in the older adults

ObjectivesTo determine the relationship between social support and mortality in older adults, independent of other health conditions.MethodThis was a longitudinal study using the database of the 2006 SABE Study (Heath, Well-being and Aging), composed of 1413 individuals aged 60 years and over, living in São Paulo/Brazil. The present study used a questionnaire constructed for the SABE Study, which was reviewed by experts of Latin America and the Caribbean. The social network was evaluated using the variables: social support received; social support offered; number of members in the social network. The covariates included were age, gender, living arrangements, marital status, income, education, comorbidity, depressive symptoms, cognition and functional difficulties. Death as an outcome was evaluated after four years of follow-up.ResultsFrom a total of 1413 older adults at baseline, 268 died in a mean follow-up period of 3,9 years (SE = 0,03). In the model adjusted offering social support and having networks composed of 9 or more members reduced the risk of death in the older adults.ConclusionsThis study suggest that older adult who are offered support can benefit from mutual exchanges since reciprocity in relationships improves psychological well-being and is indicative of the quality of relationships. Thus, the older adults are part of a group of people whose role is not only to receive, but also to provide help to others, and the support offered seems to be as important as that received.     

Factors Associated with Hopelessness and the Role of Social Networks Among Chinese Older Adults

ObjectiveThe levels of hopelessness affect older adults’ physical and mental health. However, there has been a lack of research on the hopelessness among Chinese older adults. The aims of this study were to explore factors associated with hopelessness and the moderating role of social networks among Chinese older adults.MethodWe conducted a cross-sectional study among older adults (n = 837) from nine communities in Xi’an and Beijing in China, and collected the participants’ levels of hopelessness, demographic information (age and gender), socioeconomic status (marital status, education, monthly income, living status, and alimony), life satisfaction, health information (self-rated health and sleep quality), and quality of social networks.ResultsOf the participants, 61.9% reported different levels of hopelessness symptoms; 71.2% reported poor sleep quality, and 21.1% reported low levels of social networks. A hierarchical multiple regression analysis showed that marital status, monthly income, alimony, life satisfaction, and sleep quality were significantly associated with hopelessness. A PROCESS analysis demonstrated that social networks played a moderating role in the relationship between sleep quality and hopelessness.ConclusionChinese older adults who had no spouse, had lower incomes, and were dissatisfied with life were more likely to have higher levels of hopelessness. Furthermore, older adults who did not receive financial support from their children reported higher levels of hopelessness. In addition, the worse the sleep quality the higher levels of hopelessness in older adults. However, high levels of social networks could weaken the negative effect of sleep quality on hopelessness.     

Close ties,near and far away: patterns and predictors of geographic network range among older Europeans

A growing number of older adults maintain connections in their core discussion networks at variant distances, raising concerns about the lack of discussants in proximity and the consequences on their social life. This study examines the typical geographic layouts for aging Europeans' core discussion networks and their implications for network function and quality. With a sample of community-dwelling respondents aged 50 and above from the Survey of Health, Aging, and Retirement in Europe, the present research identifies seven geographic layouts that extend previously identified family and diverse network types by adding spatial nuance. Individuals in mid-range and distant-family networks typically lack a discussant nearby but sustain high emotional closeness with family discussants at a distance and express high overall satisfaction with their network. Proximate-diverse networks with a strong representation of non-kin members nearby turn out to be less advantageous than prior research might suggest, providing relatively frequent contact but the lowest level of network satisfaction. Results also identify how individual characteristics link to the geographic layouts and describe their prevalence across European regions. Overall, relatively dispersed layouts are common for older adults across multiple countries and do not necessarily indicate lower emotional closeness and network satisfaction. The present study highlights the importance of looking beyond the mere presence of proximate connections in older adults’ core networks.

     

Urinary incontinence: a treatise on gender, sexuality, and culture

Attitudes toward older adults with incontinence vary significantly between societies and cultures. Intangible consequences arising from such attitudes may exert enormous psychosocial strain on affected older adults, caregivers, family members, and social networks.Health providers should consider psychologic, gender based,and sociocultural differences in formulating efficient screening and therapeutic strategies for older adults who have UI.     

Altruism relates to health in an ethnically diverse sample of older adults

The existing literature indicates links between aspects of social network functioning and health outcomes. It is generally believed that networks that are larger or provide greater instrumental and emotional support contribute to improved health and, perhaps, greater longevity. Recently, it has been suggested that giving as well as receiving social support may be of benefit. On the basis of evolutionary theories of emotion and altruism, the current study sought to test this thesis in a large, ethnically diverse sample of community-dwelling older adults. As expected, levels of social support given were associated with lower morbidity, whereas levels of receiving were not. It is important that these relations held even when (a) socioeconomic status, education, marital status, age, gender, ethnicity, and (b) absolute network size and activity limitation were controlled for. Results are discussed in terms of their implications for theory regarding the relations among social exchanges, giving, and later life adaptation among older adults.     

Social network changes among older Europeans: the role of gender

This study examined changes in the social networks of older Europeans. It utilizes the framework of the socioemotional selectivity theory and the convoy model to explore the social networks’ changes over time, as well as the turnover of specific social network members. Furthermore, the study analyzed gender as a predictor of these transformations. The inquiry focused on older adults aged 65+ who participated in the fourth and sixth waves of the Survey of Health, Ageing, and Retirement in Europe (n = 13,938). The findings reveal a general trend of network expansion over time, with addition of new members and a higher proportion of family ties. These trends mask considerable individual variability in change trajectories, however. A series of OLS and Poisson regressions revealed that women were more likely to report network growth via addition of new social network members, and lower family involvement. These findings underscore the dynamic nature of older Europeans’ interpersonal milieu. They also underscore the role of gender in social network transformations and show that the dynamics of older Europeans’ personal networks differ for men and women.     

A comprehensive overview of social network measures for older adults: A systematic review

ObjectivesThe size and type of older adults’ social networks is associated with health, mental and social outcomes. Investigators within many disciplines are now measuring social networks, but it is not always clear what they are assessing, or which measures may best meet their objectives. To undertake a systematic review to identify (i) social network measures used for older adults, (ii) variety of social network dimensions and (iii) how measures have developed over time.Materials and MethodsThe MEDLINE, EMBASE, CINAHL, PsycInfo and Cochrane Library databases were systematically searched to identify social network instruments, followed by categorization of the domains into quantitative, qualitative and alter domains.ResultsA total of 229 studies and 21 social network measures were included, with 11 quantitative dimensions (e.g., size, frequency), 5 qualitative dimensions (e.g., support satisfaction, emotional bond) and 7 alter members (e.g., family, neighbours) of social networks identified. Measures commonly clustered on quantifiable network size (n = 19), availability of supportive networks (n = 14) and presence of family ties (n = 21). The period between 1985 and 1995 produced the greatest number of newly developed social network measures (n = 10) with a stronger focus on qualitative features.Discussion and ImplicationsThis review provides researchers with an organized summary of measures and dimensions for consideration when appraising social connections in older adults. This can enable better study design through providing information that makes explicit inevitable trade-offs between survey length, comprehensiveness of dimension coverage, and utilization of the measure for researchers.PROSPERO Registration number: CRD42016043089     

The Informal Networks in Food Procurement by Older People—A Cross European Comparison

Healthy dietary profiles contribute to successful aging, and dietary intake is dependent upon food procurement capabilities. Both formal and informal social networks can contribute to grocery shopping capabilities and methods of food procurement. This investigation explores the role of informal networks in food procurement methods among adults aged 65 years and older, and compares differences across eight European countries. Food shopping ways (FSW), identified by quantitative analysis (cluster analysis and correspondence analysis), guided the content qualitative analysis which was carried out addressing three main research questions addressing food shopping routines, feelings of dependency and needs of informal support for shopping, and differences between past and present food shopping behaviours. Living circumstances influence food shopping habits. Informal networks differed between two groups of individuals: those living alone and those living with others. Gender differences emerged in shopping pleasure. Geographical factors were associated with preference for shopping companions, attitudes toward receiving support, and availability of a car for shopping. The importance of living circumstances (i.e., alone vs. with others) in FSW was revealed. Informal social networks may play an important role in public health and welfare policies, particularly given the increase in this demographic group. Assistance with grocery shopping and the availability of trained personnel could widen informal networks, and effective informal networks may be an important supportive service for older adults. The comparison across countries highlighted relationships between food procurement capabilities and social networks. These findings may be used to develop resources to better meet the nutritional needs of older adults.     

The association between social support and cognitive function in Mexican adults aged 50 and older

Social support networks are crucial for the health of older adults; however, personal characteristics and time of life may diminish the protective effect of social support.Objectiveto determine if the presence of social support networks were associated with cognitive impairment among Mexican adults aged 50 or older and if this relationship was different based on age.MethodThis study analyzed data from the National Representation Survey performed in Mexico, Study on Global Ageing (SAGE) wave 1. Cognitive function was evaluated by a standardized test, social support was evaluated through latent class analysis (LCA). The LCA was run to obtain three subgroups of different Social Support Levels (SSL): low, medium, and high. Logistic regression models, stratified by age, were performed to analyze the association between SSL and cognitive function.ResultsFor respondents ages 71–80 y/o, there was an inverse relationship with cognitive impairment for those with medium (OR 0.23, p = 0.020) and high (OR 0.07, p = 0.000) SSL in comparison with low SSL. While social support helped to improve cognitive function in older adults aged 71–80, this same association was not observed in adults of other ages. Those younger than 70 y/o may not need such a strong support network as a result of being more self-sufficient. After 80, social networks were not enough to help diminish the negative impact of cognitive impairment.ConclusionSocial support could improve the cognitive function of adults ages 71 and 80; suggesting there could be a window of opportunity to improve cognitive functioning for this group.     

Stability and change in older adults' social contact and social support: the Cardiovascular Health Study.

OBJECTIVES: The aim of this study was to examine the degree of individual change in structural indicators of social support (family network contact and close friend network contact) and functional indicators of social support (belonging, appraisal, and tangible support) during late life. METHODS: Using a large population-based sample of older adults, hierarchical linear modeling was applied to examine the extent of change in social contact and support as well as sociodemographic characteristics (age, race, gender, and education) that might explain individual variability in contact and support at baseline and over time. RESULTS: Consistent with predictions, small yet significant increases were observed in belonging support and tangible support. Contrary to predictions, no evidence was found for significant individual change in family network contact, close friend network contact, or appraisal support. Sociodemographic characteristics were more consistent predictors of variability in contact and support at baseline than variability over time. DISCUSSION: The findings of this study add to a growing literature suggesting that late life is not typically characterized by a decline in important social resources.     

SOCIAL ROLES FOR OLDER WOMEN

This article addresses a concern with the lack of real life positions for older adults. It suggests that, unlike other real life positions, older adult has not been sufficiently defined in a normative sense. Consequently there are few established or structural roles for the aged. Four broad social role categories are proposed for older adults and possible activities described within each. Also identified are the particular theories on ageing which support each role category, and the implications of each are discussed for social work practice.     

Five-year alcohol and drug treatment outcomes of older adults versus middle-aged and younger adults in a managed care program

AIMS: This study compared 5-year treatment outcomes of older adults to those of middle-aged and younger adults in a large managed care chemical dependency program. We examined age group differences in individual, treatment and extra-treatment factors, which may influence long-term outcome. DESIGN: Seventy-seven per cent of original study participants completed a telephone interview 5 years after out-patient chemical dependency treatment at Kaiser Permanente. This sample (N = 925) included 65 patients aged 55-77, 296 patients aged 40-54 and 564 patients aged 18-39 (age at baseline). MEASUREMENTS: Measures at follow-up included alcohol and drug use, Addiction Severity Index (ASI), Alcoholics Anonymous Affiliation Scale, social resource and self-reported health questions. Mortality data were obtained from contact with family members of patients as well as automated health plan records. FINDINGS: Older adults were less likely to be drug-dependent at baseline than younger and middle-aged adults, and had longer retention in treatment than younger adults. At 5 years, older adults were less likely than younger adults to have close family or friends who encouraged alcohol or drug use. Fifty-two per cent of older adults reported total abstinence from alcohol and drugs in the previous 30 days versus 40% of younger adults. Older women had higher 30-day abstinence than older men or younger women. Among participants dependent only on alcohol, there were no significant age differences in 30-day abstinence. In logistic regression analysis, age group was not significant. Variables associated with greater age that independently predicted 30-day abstinence in the logistic regression model included longer retention in treatment and having no close family or friends who encouraged alcohol or drug use at 5 years; female gender was also significant. CONCLUSIONS: Results indicate that older adults have favorable long-term outcome following treatment relative to younger adults, but these differences may be accounted for by variables associated with age such as type of substance dependence, treatment retention, social networks and gender. Age differences in these characteristics inform intervention strategies to support long-term recovery of older adults and provide direction for investigation of how age affects outcome.     

Aging in Southeast and East Asia: Issues and Policy Directions

Population aging is unique in Asia given the speed at which it is occurring and the immense social and economic changes that the region is experiencing at the same time. Compared to their Western counterparts, Asian governments have much less time to prepare for population aging. Asian countries that have traditionally relied on family-based support for older family members are worried that increased numbers of older adults may stress these family systems. At the same time, information concerning the effectiveness of formal programs for older adults is scarce. This paper reviews current research on informal support versus formal support of older adults in Southeast and East Asia, with a larger aim of assessing the current well-being of older Asians and suggesting areas of policy concern. Current research reveals that formal programs in the majority of Southeast and East Asian countries have very low coverage of today's older adults, and the figures for future generations are not that much higher. However, family support of older persons may not be deteriorating as predicted by modernization theory. Asian families continue to play a major role in supporting older members, thus policies should focus on enabling Asian families to provide this support.     

Social networks and mental health among people living with human immunodeficiency virus (HIV) in Johannesburg,South Africa

People living with human immunodeficiency virus (PLHIV) in developing countries can live longer due to improved treatment access, and a deeper understanding of determinants of their quality of life is critical. This study assessed the link between social capital, operationally defined in terms of social networks (group-based and personal social networks) and access to network resources (access to material and non-material resources and social support) and health-related quality of life (HRQoL) among 554 (55% female) adults on HIV treatment through South Africa's public health system. Female study participants were involved with more group-based social networks but had fewer personal social networks in comparison to males. Access to network resources was higher among females and those from larger households but lower among older study participants. Experience of social support significantly increased with household economic status and duration at current residence. Social capital indicators were unrelated to HIV disease status indicators, including duration since diagnosis, CD4 count and viral load. Only a minority (13%) of study participants took part in groups formed by and for predominantly PLHIV (HIV support groups), and participation in such groups was unrelated to their mental or physical health. Personal rather than group-linked social networks and access to network resources were significantly associated with mental but not physical health, after controlling for sociodemographic characteristics. The findings of limited participation in HIV support groups and that the participation in such groups was not significantly associated with physical or mental health may suggest efforts among PLHIV in South Africa to normalise HIV as a chronic illness through broad-based rather than HIV-status bounded social participation, as a strategy for deflecting stigma. Further research is required to examine the effects of HIV treatment on social networking and participation among PLHIV within both rural and other urban settings of South Africa.