Abstract
BackgroundResearch on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investigate whether effects on and pathways to mortality risk differ between functional and structural characteristics of the personal network. The objective is to inquire which personal network characteristics are the best predictors of mortality risk after adjustment for mental, cognitive and physical health.Methods and FindingsEmpirical tests were carried out by combining official register information on mortality with data from the Longitudinal Aging Study Amsterdam (LASA). The sample included 2,911 Dutch respondents aged 54 to 85 at baseline in 1992 and six follow-ups covering a time span of twenty years. Four functional characteristics (emotional and social loneliness, emotional and instrumental support) and four structural characteristics (living arrangement, contact frequency, number of contacts, number of social roles) of the personal network as well as mental, cognitive and physical health were assessed at all LASA follow-ups. Statistical analyses comprised of Cox proportional hazard regression models. Findings suggest differential effects of personal network characteristics on survival, with only small gender differences. Mortality risk was initially reduced by functional characteristics, but disappeared after full adjustment for the various health variables. Mortality risk was lowest for older adults embedded in large (HR = 0.986, 95% CI 0.979—0.994) and diverse networks (HR = 0.948, 95% CI 0.917—0.981), and this effect continued to show in the fully adjusted models.ConclusionsFunctional characteristics (i.e. emotional and social loneliness) are indirectly associated with a reduction in mortality risk, while structural characteristics (i.e. number of contacts and number of social roles) have direct protective effects. More research is needed to understand the causal mechanisms underlying these relations.
Highlights
A vast body of research in social epidemiology has established a substantial impact of social integration on health and survival [1,2,3]
We investigate whether effects on and pathways to mortality risk differ between functional and structural characteristics of the personal network
The objective of the present study is to examine the association between mortality risk and both functional and structural network characteristics, after adjustment for mental, cognitive and physical health, and accounting for changes in the personal network
Summary
A vast body of research in social epidemiology has established a substantial impact of social integration on health and survival [1,2,3]. Personal networks are a source of fulfillment of basic human attachment needs, positive psychological states and social pressure to take care of oneself, all of which directly—and independently of the former stress-buffering effects—induce health-promoting physiological responses [3, 11, 12]. Quantitative aspects of social relationships, most importantly number and diversity of an individual’s contacts (i.e. with a partner, friends, relatives, colleagues or neighbors), denote structural characteristics of the personal network. Based on these arguments, the question arises whether and how social integration reduces the risk of mortality. We investigate whether effects on and pathways to mortality risk differ between functional and structural characteristics of the personal network. The objective is to inquire which personal network characteristics are the best predictors of mortality risk after adjustment for mental, cognitive and physical health
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call