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)

BackgroundHaving 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.MethodsData 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.ResultsIn 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).ConclusionsSocial 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.

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Associations Between Social Support, Social Networks, and Financial Exploitation in Older Adults

Journal of Applied Gerontology ◽

10.1177/0733464816642584 ◽

2016 ◽

Vol 37 (8) ◽

pp. 990-1011 ◽

Cited By ~ 7

Author(s):

Scott R. Beach ◽

Richard Schulz ◽

Rodlescia Sneed

Keyword(s):

Social Support ◽

Older Adults ◽

Social Networks ◽

Social Network ◽

Perceived Social Support ◽

Population Based ◽

Network Size ◽

Social Network Size ◽

Financial Exploitation ◽

The Social

Social support and social networks are important correlates of elder mistreatment. This study tests hypothesized associations between perceived social support, social network size, and financial exploitation (FE). A population-based survey of 903 older adults (60+) in Allegheny County (Pittsburgh, Pennsylvania) found that lower perceived social support and larger social networks were simultaneously associated with higher risk for FE since age 60, controlling for known risk factors. The same associations were found for FE in the last 6 months. Older adults with larger social networks combined with lower perceived social support were most likely to report FE. When it comes to the role of social relationships and risk for FE, “more may not always be better.” Encouragement to widen the social network by “making new friends” should be stressed less than making sure these new network members will truly be supportive of the older adult.

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Postdiagnosis social networks and lifestyle and treatment mechanisms in the Ater Breast Cancer Pooling Project (ABCPP).

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.26_suppl.115 ◽

2014 ◽

Vol 32 (26_suppl) ◽

pp. 115-115

Author(s):

Candyce H. Kroenke ◽

Yvonne Michael ◽

Xiao-Ou Shu ◽

Elizabeth Poole ◽

Marilyn L. Kwan ◽

...

Keyword(s):

Breast Cancer ◽

Social Networks ◽

Social Network ◽

Alcohol Consumption ◽

Cancer Survival ◽

Network Size ◽

Cancer Prognosis ◽

Social Network Size ◽

Network Diversity ◽

Socially Isolated

115 Background: Larger social networks have been associated with better breast cancer survival. To investigate potential mediators, we evaluated associations of social network size and diversity with lifestyle and treatment factors associated with prognosis. Methods: We included 9,331 women from the After Breast Cancer Pooling Project who provided data on social networks within two years following diagnosis. A social network index was derived from information about the presence of a spouse or intimate partner, religious ties, community participation, friendship ties, and numbers of relatives. Diversity was assessed as variety of ties, independent of size. We used logistic regression to evaluate associations with outcomes and evaluated whether effect estimates differed using meta-analytic techniques. Results: Associations of social networks and outcomes generally did not differ by cohort. Because of the low prevalence of smoking and alcohol consumption in the Shanghai cohort, however, analyses of smoking and alcohol included US cohorts only. Women who were socially isolated (small networks) were more likely to be obese (body mass index>30 kg/m2, OR=1.21, 95% CI:1.03-1.42) and have low physical activity (<10 MET-h/wk, OR=1.53, 95% CI:1.34-1.75) compared to socially integrated women. Women with low network diversity were more likely to be current smokers (OR=3.68, 95% CI:2.19-6.19) and have high alcohol consumption (>15 g/d alcohol, OR=2.43, 95% CI:1.60-3.69). Among node positive cases, socially isolated women were more likely not to receive chemotherapy (OR=1.52, 95% CI:1.03-2.25). By contrast, low network diversity, but not social network size, was associated with greater odds of not receiving adjuvant hormonal therapy (OR=1.52, 95% CI:1.03-2.23). Associations with surgery were nonsignificant. Conclusions: In a large pooled cohort, small, less diverse social networks measured post-diagnosis were associated with more adverse lifestyle factors and less intensive cancer treatment, which may help to explain poorer breast cancer prognosis in socially isolated women.

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EFFECTS OF SOCIAL SUPPORT NETWORK ON AMERICAN OLDER ADULTS’ MEMORY FUNCTIONS

Innovation in Aging ◽

10.1093/geroni/igz038.3383 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S929-S930

Author(s):

Ethan Siu Leung Cheung ◽

Kedong Ding

Keyword(s):

Social Support ◽

Older Adults ◽

Social Networks ◽

Social Network ◽

Memory Function ◽

Network Size ◽

Support Network ◽

Memory Functions ◽

Social Network Size ◽

The Impact

Abstract Background: Previous studies have found older adults’ cognitive functions are strongly associated with their social networks, including memory. Yet, few studies have explored the influences of specific social network members, such as siblings and children. Further, little studies examined the impact of the size of older adults’ social networks. Hence, this study aimed to investigate how older adults’ relationships with their spouses, siblings, and children, as well as the size of their social networks, affect American older adults’ memory functions. Methods: Using the 2018 data from NHATS, 5547 samples were included. We adopted a multiple logistic regression model to test the impact of social support network sizes, and how associations of social support networks varied between spouses, siblings, and children. All models were calibrated for age, gender, education, income, and race/ethnicity. Results: Analysis showed that higher socioeconomic status (more education and without Medicaid), being female, and younger age were associated with increased odds of having good self-rated memory functions. Older adults with larger social support networks (>=3 individuals) were more likely to have better self-rated memory function (adjusted odds ratio, 1.182, p<0.05), while holding other variables. Having a spouse also increased odds of higher self-rating memory function, in contrast to having children. Conclusion: This study highlighted the importance of having a larger social network size for older adult’s memory function and indicated the necessity of developing intervention programs to expand older adults' social network size, especially for those with lower socioeconomic status.

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1135 Longer And More Frequent Naps Predict Incident Alzheimer’s Dementia In Community-based Older Adults

SLEEP ◽

10.1093/sleep/zsaa056.1129 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A432-A432

Author(s):

P Li ◽

L Gao ◽

A Gaba ◽

L Yu ◽

A S Buchman ◽

...

Keyword(s):

Older Adults ◽

Proportional Hazards ◽

The Elderly ◽

Sleep Time ◽

Cox Proportional Hazards ◽

Alzheimer’S Dementia ◽

Alzheimer's Dementia ◽

Cox Proportional Hazards Models ◽

Motor Activities ◽

Underlying Mechanisms

Abstract Introduction Excessive napping duration has been associated with cognitive decline. The effect of napping frequency is less understood, and little is known about the development of Alzheimer’s dementia associated with napping. We tested whether longer or more frequent naps in the elderly are linked to the development of incident Alzheimer’s dementia. Methods We studied 1,180 older adults (age: 81.0±7.3 [SD]) in the Rush Memory and Aging Project who have been followed for up to 14 years. Motor activities of up to 10 days were recorded at baseline to assess napping characteristics objectively. We defined daytime napping episodes as motor activity segments between 10AM and 7PM with continuous zero-activity for ≥10min but <1h (to avoid off-wrist periods). Segments that were <5min apart were merged. Alzheimer’s dementia diagnosis was determined using the criteria of the National Institute of Neurological and Communicative Disorders and Strone and the Alzheimer’s Disease and Related Disorders Association. Cox proportional hazards models were performed to examine the associations of daily napping duration and frequency with incident AD. Results Of 1,180 non-demented participants at baseline (including 264 with mild cognitive impairment), 277 developed Alzheimer’s dementia within 5.74±3.36 years. On average, participants napped for 38.3±1.0 (SE) min and1.56±0.04 (SE) times per day at baseline. After adjustment for age, sex, and education, every 30-min increase in daily napping duration was associated with a 20% increase in the risk of incident AD (95% confidence interval [CI]: 9%-31%; p=0.0002). One more nap per day was associated with a 19% increase in the risk of AD (95% CI: 8%-30%; p=0.0003). These associations remained after further adjustment for total sleep time. Conclusion Longer and more frequent daytime naps predict a higher risk of incident Alzheimer’s dementia. Future studies are needed to examine specific underlying mechanisms. Support This work was supported by NIH grants RF1AG064312, RF1AG059867, R01AG017917, and R01AG56352.

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Social Network Characteristics and Their Associations With Stress in Older Adults: Closure and Balance in a Population-Based Sample

The Journals of Gerontology Series B ◽

10.1093/geronb/gbz035 ◽

2019 ◽

Vol 75 (7) ◽

pp. 1573-1584

Author(s):

Lea Ellwardt ◽

Rafael P M Wittek ◽

Louise C Hawkley ◽

John T Cacioppo

Keyword(s):

Older Adults ◽

Social Networks ◽

Social Network ◽

Perceived Stress ◽

Social Relations ◽

Population Based ◽

Network Size ◽

Future Research ◽

Analytical Strategy ◽

Random Effects Models

Abstract Objectives Integration into social networks reduces stress during adverse life events and improves coping with disability in late life. The aim was to investigate whether social network closure (frequent contact among ties) and balance (positive contact among ties) are associated with perceived stress. We expect lowest stress for older adults with highly closed and balanced networks. Method Panel data on self-reported egocentric networks stem from the population-based Chicago Health, Aging, and Social Relations Study. Five waves were collected between 2002 and 2006, with 708 observations from 160 participants aged 50–68 years at baseline. Data include information on the participants’ social relationships, that is, interaction frequency and relationship quality, for ego–alter ties and alter–alter ties, and participants’ perceived stress. The analytical strategy used fixed- and random-effects models. Results Participants reporting the highest number of balanced relationships (positive ties among alters) experience least stress. This effect holds independently of sociodemographic confounders, loneliness, and network size. Discussion The absence of a stress-reducing effect from network closure suggests that balance matters more. Future research would benefit from considering balance when examining the characteristics of social networks that impinge on mental health outcomes in older adults.

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Impact of anemia on hospitalization and mortality in older adults

Blood ◽

10.1182/blood-2005-10-4308 ◽

2006 ◽

Vol 107 (10) ◽

pp. 3841-3846 ◽

Cited By ~ 193

Author(s):

Bruce F. Culleton ◽

Braden J. Manns ◽

Jianguo Zhang ◽

Marcello Tonelli ◽

Scott Klarenbach ◽

...

Keyword(s):

Older Adults ◽

Proportional Hazards ◽

Prognostic Significance ◽

The Elderly ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Normal Kidney ◽

Increased Risk ◽

All Cause Mortality ◽

Community Dwelling Older Adults

Although anemia is common in older adults, its prognostic significance is uncertain. A total of 17 030 community-dwelling subjects 66 years and older were identified between July 1 and December 31, 2001, and followed until December 31, 2004. Cox proportional hazards analyses were performed to determine the associations between anemia (defined as hemoglobin < 110 g/L) and hemoglobin and all-cause mortality, all-cause hospitalization, and cardiovascular-specific hospitalization. Overall, there were 1983 deaths and 7278 first hospitalizations. In patients with normal kidney function, adjusting for age, sex, diabetes mellitus, and comorbidity, anemia was associated with an increased risk for death (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.55-5.12), first all-cause hospitalization (HR, 2.16; 95% CI, 1.88-2.48), and first cardiovascular-specific hospitalization (HR, 2.49; 95% CI, 1.99-3.12). An inverse J-shaped relationship between hemoglobin and all-cause mortality was observed; the lowest risk for mortality occurred at hemoglobin values between 130 to 150 g/L for women and 140 to 170 g/L for men. Anemia is associated with an increased risk for hospitalization and death in community-dwelling older adults. Consideration should be given to redefine “normal” hemoglobin values in the elderly. Clinical trials are also necessary to determine whether anemia correction improves quality or quantity of life in this population.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111175 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11175

Author(s):

Kyung-Won Choi ◽

Gyeong-Suk Jeon

Keyword(s):

Older Adults ◽

Social Networks ◽

Social Network ◽

Depressive Symptoms ◽

Living Arrangements ◽

Network Size ◽

Multivariable Logistic Regression Analysis ◽

Men And Women ◽

The Social ◽

The Impact

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.

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The Modified Healthy Ageing Index Is Associated with Mortality and Disability: The Rugao Longevity and Ageing Study

Gerontology ◽

10.1159/000513931 ◽

2021 ◽

pp. 1-9

Author(s):

Hui Zhang ◽

Yinsheng Zhu ◽

Meng Hao ◽

Jiucun Wang ◽

Zhengdong Wang ◽

...

Keyword(s):

Older Adults ◽

Proportional Hazards ◽

Predictive Ability ◽

The Elderly ◽

Cox Proportional Hazards ◽

Adverse Outcomes ◽

Healthy Ageing ◽

Sensitivity Analyses ◽

Logistic Regression Models ◽

Ageing Study

Introduction: The Healthy Ageing Index (HAI) has been shown not only to have wider applicability and predictive ability but also to adequately predict mortality in Western populations. There is still a lack of studies validating the applicability of the HAI in China. Objective: To evaluate the applicability of the HAI and validate whether the HAI is suitable for monitoring ageing in the elderly population in China. Methods: Data were obtained from the Rugao Longevity and Ageing Study. The modified HAI was constructed based on systolic blood pressure, chronic pulmonary diseases, cognitive function, fasting glucose, and kidney function. It was calculated in 1719 individuals aged 70–84 years at baseline. The adverse outcomes were mortality and disability. Demographic, physiologic, and clinical data were collected. Cox proportional hazards and logistic regression models were used to analyze the relationship between the modified HAI and adverse outcomes. Results: A total of 1,719 older adults were analyzed in our study. A total of 793 (46.13%) males were recruited. The mean age was 75.69 ± 3.93 years. At the 5-year follow-up, there were 266 deaths and 275 individuals with disabilities. In the multivariable models, the modified HAI was associated with mortality (hazard ratio = 1.11, 95% confidence interval [CI]: 1.03–1.20) and disability (odds ratio = 1.11, 95% CI: 1.05–1.18). In the sensitivity analyses, similar associations remained after imputing missing data using multiple imputation and excluding participants with major cardiovascular disease at baseline. Conclusion: The modified HAI was a robust and independent predictor of adverse outcomes. It is a valid and feasible tool for monitoring ageing in older adults.

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The Effect of Social Network Size and Composition on the Link Between Discrimination and Health Among Sexual Minorities

Journal of Aging and Health ◽

10.1177/0898264320908982 ◽

2020 ◽

Vol 32 (9) ◽

pp. 1214-1221

Author(s):

Katelin E. Leahy ◽

William J. Chopik

Keyword(s):

Older Adults ◽

Social Networks ◽

Social Network ◽

Health Outcomes ◽

Well Being ◽

Network Size ◽

Negative Effects ◽

Social Network Size ◽

Stress And Health ◽

Lgbt Individuals

Objectives: Previous research has examined the link between discrimination and health in lesbian, gay, bisexual, and/or transgender (LGBT) individuals. The purpose of this study was to examine if health-promoting variables, like social networks, might disrupt this association. Method: Participants were 2,560 LGBT older adults who reported on the composition of their social network, level of discrimination, stress, and health/well-being. Results: Moderated mediation results indicated that social network size disrupted the associations between discrimination, stress, and health outcomes when social networks were (a) larger and (b) comprised of LGBT individuals (but not straight individuals), regardless of age. Discussion: Larger social networks that include fellow LGBT individuals helped buffer experiences of stress and discrimination on health outcomes among LGBT older adults. Implications for how protective factors can reduce the negative effects of discrimination and stress are discussed.

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Social Network Mapping and Functional Recovery Within 6 Months of Ischemic Stroke

Neurorehabilitation and Neural Repair ◽

10.1177/1545968319872994 ◽

2019 ◽

Vol 33 (11) ◽

pp. 922-932 ◽

Cited By ~ 5

Author(s):

Amar Dhand ◽

Catherine E. Lang ◽

Douglas A. Luke ◽

Angela Kim ◽

Karen Li ◽

...

Keyword(s):

Social Networks ◽

Social Network ◽

Physical Function ◽

Assessment Tool ◽

Network Size ◽

Stroke Recovery ◽

Measurement Information ◽

Health Habits ◽

Patient Reported ◽

Network Composition

Objective. Stroke recovery is a multidimensional process influenced by biological and psychosocial factors. To understand the latter, we mapped the social networks of stroke patients, analyzing their changes and effects on physical function at 3 and 6 months after stroke. Methods. We used a quantitative social network assessment tool to map the structure and health habits embedded in patients’ personal social networks. The physical function outcome was determined using the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Scale (0-100, mean 50 for US general population). We used mixed-effects models to assess changes in social network metrics. We used multivariable models to test the association between social networks and physical function, independent of demographics, socioeconomic status, clinical characteristics, comorbidities, cognition, and depression. Results. The cohort consisted of 172 patients, with mostly mild motor-predominant stroke (median NIH Stroke Scale of 2) with retention of 149 at 3 months and 139 at 6 months. An average patient’s network over 6 months contracted by 1.25 people and became denser and family oriented. Network composition also became healthier with pruning of ties with people who smoked or did not exercise. The baseline network size, and not density or health habits in the network, was independently associated with 3- and 6-month physical function PROMIS scores. Patients embedded in small kin-based networks reported more negative social interactions. Conclusions. Despite social networks becoming smaller and close-knit after stroke, they also become healthier. Larger baseline social networks are independently associated with better patient-reported physical function after stroke.

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