Social networks and their influences on nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults: a mixed-methods longitudinal study

Evans A Asamane,Janice L Thompson,Carolyn A Greig

doi:10.1186/s12889-020-09153-y

Abstract

BackgroundThe United Kingdom population is ageing and becoming increasingly diverse; thus, it is vital to develop and implement interventions supporting this population shift. Social networks (SN) significantly impact health outcomes in later life, however relatively little is known about SN of community-dwelling ethnically diverse older adults. This study aimed to: 1) profile SN and changes in SN in this population over 8 months; 2) examine associations between SN, dietary intake, nutritional status, and physical function.MethodsSN were assessed using the Wenger Practitioner Assessment of Network Type. Energy and nutrient intakes were measured using multiple-pass 24-h recalls. The Mini Nutritional Assessment-Short Form (MNA-SF) assessed nutritional status. Physical function was measured using the Short Physical Performance Battery (SPPB) and handgrip strength. Data were collected at baseline and 8-months. Correlation and regression analyses examined relationships between SN, physical function, nutrient intake and nutritional status. Semi-structured interviews were conducted at baseline (n = 92) and follow-up (n = 81) to identify potential influences of SN. Interviews were transcribed verbatim and analysed using directed content analysis.ResultsQuantitative data were obtained from 100 participants at baseline and 81 at follow-up. Mean (SD) age was 70.8 (8.1) years (59% male), comprising African/Caribbean (60%), South Asian (34%), and other ethnicities (6%). Five SN typologies were identified under two broad areas: integrated-SN consisting of locally integrated (44%) and wider community (8%); and non-integrated-SN consisting of family dependent (25%), local self-contained (17%), and private restricted (6%). At follow-up, 37% remained in non-integrated networks, 19% transitioned to non-integrated networks, 11% transitioned to, and 33% remained in, integrated networks. Participants within integrated networks at baseline had higher SPPB scores at follow-up. Compared to the private restricted, local self-contained SN significantly predicted zinc, riboflavin and vitamin B6 intakes. Participants remaining in, or transitioning to, non-integrated networks had low MNA-SF scores. Qualitative findings indicate that participants with reductions in SN perceived it as causing poorer physical function and eating behaviours.ConclusionIn the present study, integrated SN were associated with higher physical function and nutritional status at 8-month’s follow-up. These results can inform the design of interventions to improve social networks, physical function and healthy nutrition within this population.

Highlights

The United Kingdom population is ageing and becoming increasingly diverse; it is vital to develop and implement interventions supporting this population shift
Qualitative findings indicate that participants with reductions in social networks (SN) perceived it as causing poorer physical function and eating behaviours
In the present study, integrated SN were associated with higher physical function and nutritional status at 8month’s follow-up

Summary

Introduction

The United Kingdom population is ageing and becoming increasingly diverse; it is vital to develop and implement interventions supporting this population shift. Social networks are unstable, often with severe disruptive changes such as bereavement, and are more likely to become smaller as compared to middle life [5] These disruptions, as explained by the convoy model of social networks, are mainly caused by situational and personal characteristics such as retirement, ill-health, loss of a spouse, residential changes and other life events primarily associated with ageing [5, 6]. A study examining the influence of social networks on health outcomes among 4170 Korean adults aged 65 years and older found that individuals with more extensive social networks had higher levels of life satisfaction and lower depressive symptoms than those with restricted networks [11]. It is necessary to understand the types of social networks among diverse populations living in diverse communities, and how these social networks influence healthy lifestyle choices over time

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