Objective Although the link between enhanced social relationships and better health has generally been well established, few studies have examined the role of leisure activity in this link. This study examined how leisure influences the link between social relationships and health in older age. Methods Using data from the 2006 and 2010 waves of the nationally representative U.S. Health and Retirement Study and structural equation modelling analyses, we examined data on 2,965 older participants to determine if leisure activities mediated the link between social relationships and health in 2010, controlling for race, education level, and health in 2006. Results The results demonstrated that leisure activities mediate the link between social relationships and health in these age groups. Perceptions of positive social relationships were associated with greater involvement in leisure activities, and greater involvement in leisure activities was associated with better health in older age. Discussion & Conclusions The contribution of leisure to health in these age groups is receiving increasing attention, and the results of this study add to the literature on this topic, by identifying the mediating effect of leisure activity on the link between social relationships and health. Future studies aimed at increasing leisure activity may contribute to improved health outcomes in older adults.

These findings suggest that interventions to increase the number of geriatric-oriented physicians should focus on influencing learners' attitudes through experiences in the care of older adults.

One of the most challenging diabetes-related behavior changes is adhering to a healthful diet. Drawing on the social cognitive theory and social support literature, this qualitative study explores how spousal support influences dietary changes following a diagnosis of type 2 diabetes in middle-aged and older adults. The purpose of this study was to determine how aspects of the spousal relationship translate into behavior changes, specifically adherence to a healthful diet. Analyses revealed five core themes related to dietary adherence: control over food, dietary competence, commitment to support, spousal communication, and coping with diabetes. The themes can be categorized within two key social cognitive theory constructs: reinforcement and self-efficacy. Implications from the focus group data can inform the development of more effective, targeted nutrition messages and programs to provide specific knowledge and skills.

The effect of sex on ADL difficulty is largely explained by social and health-related covariates in middle-aged and older adults. In contrast, the independent association of female sex with decreased strength and mobility in both groups cannot be explained by our models' social or health-related variables. In addition, the positive association of BMI with mobility difficulty is significantly worse for women than for men.

Aims To explore older patients’ perceived impact of chronic co-morbid conditions on Type 2 diabetes self-management. Methods We used purposive sampling to select 32 mentally alert community-dwelling adults, aged 60 years or older, diagnosed with Type 2 diabetes and at least one other chronic health condition to participate in focus groups. We summarized the discussions following each focus group and identified codes to describe the overarching themes. Results We conducted eight 90-min focus groups, each consisting of two to six patients. Three themes emerged. (i) Diabetes complications as a motivator: managing co-morbid conditions made health an important focal point in the lives of older patients. Most patients acknowledged the positive effect complications had on their diabetes self-management by motivating them to pay greater attention to their diabetes to diminish the progression of these complications. (ii) Prioritizing health conditions: patients reported prioritizing health conditions and selectively attending to the management of those conditions based on perceived severity or importance. Further, many patients perceived some conditions as more serious than others and admitted to prioritizing another health condition over their diabetes. (iii) Emotional impact of co-morbidity management: patients described feeling frustrated, confused, and overwhelmed in response to conflicting treatment recommendations, particularly for diet, physical activity and medication regimens. Conclusions Complications and co-morbidities may have differential impacts on the diabetes self-management of older patients. Addressing the perceived impact of co-morbidity on diabetes self-management may improve patients’ outcomes; however, the most effective method of utilizing this information in clinical practice needs to be examined.

This article presents a life-span developmental (LSD) perspective on the linkages between social status and health. The objective is to develop a conceptual framework that is useful in understanding why people are differentially exposed to risks of disease or protective factors and the social conditions that link the effects of risk and protective factors to the social environment over the life span. The discussion distinguishes between the complementary concepts of "life span," "life cycle," and "life course," critical theoretical distinctions that may help refine hypotheses about the relationship between health and social status. We argue that life-cycle and life-course concepts can be viewed as embedded in a more general LSD perspective. Using the theoretical principles derived from this perspective, the review examines (a) gender differences, (b) race-ethnic experiences, (c) childhood experiences, (d) educational levels, (e) socioeconomic differences, and (f) age differences. The emphasis in the review is to highlight the value of a broader LSD perspective in the study of health inequalities. The article ends with a brief summary of where future research is headed and novel developments in the study of social status and health.

Adhering to increased exercise is often reported as one of the greatest challenges facing adults living with diabetes, a perception shared by the married middle-aged and older adults living with diabetes who participated in this study. Understanding how that challenge can best be met is both research and program relevant. Drawing on the social cognitive theory and social support literature, this qualitative study explored the powerful couple relationship in Type 2 diabetes management. The overarching goal of this paper was to illuminate the potentially key role of collective efficacy in exercise adherence in order to develop and test interventions that provide more effective supports for adults living with diabetes. Analyses revealed three core themes used by the couples to describe their perceived beliefs: 'Collective support', 'Collective motivation' and 'Collective responsibility'. Our findings provide insights regarding how collective beliefs of spousal support may influence the adoption and maintenance of an exercise program. As health educators look for approaches to improve exercise adherence in diabetes management, it is important to understand how couples can be empowered to assume responsibility for their management.

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