Personal Networks and Mortality Risk in Older Adults: A Twenty-Year Longitudinal Study

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.

Types of Non-kin Networks and Their Association With Survival in Late Adulthood: A Latent Class Approach

“…Over the last four decades, social epidemiologists have convincingly demonstrated positive effects of integration into social networks on survival (Berkman & Syme, 1979;Ellwardt, van Tilburg, Aartsen, Wittek, & Steverink, 2015;Holt-Lunstad, Smith, & Layton, 2010; Litwin & ShiovitzEzra, 2006), with evidence being relatively congruent across general and specific populations, countries, time, and gender. At the same time, social isolation has been argued to be a chronically stressful condition contributing to the accumulation of age-related morbidity and functional decline over the life course, thereby bearing the risk of accelerated aging (Berkman, 1988).…”

“…Diversity, here defined as enacting various social roles in a network, has been positively associated with health and survival (Barefoot, Grønbaek, Jensen, Schnohr, & Prescott, 2005;Cohen, Doyle, Skoner, Rabin, & Gwaltney, 1997;Ellwardt, van Tilburg, Aartsen, Wittek, et al, 2015). Non-kin relations likely add diversity to the overall network, as they vary in their social roles (e.g., being friend, neighbor, former colleague), intensity, and resourcefulness.…”

Autism Characteristics in Older Adults with Depressive Disorders

“…For example, low perceived social support, inadequacy of social activity as well as actual low social participation status, loneliness, high number of negative life events, and multi-morbidity (i.e., having more than one psychiatric diagnosis) are known vulnerability factors for developing late-life depressive symptoms 19,20 . Similar psychosocial factors are thought to be common in individuals with ASD 21,22 .…”

Exploring the impact of social network change: Experiences of older adults ageing in place

“…Other common findings include a loss of friends and a relatively increasing share of family members within networks (Bowling et al, ; Conway et al, ; Fuller‐Iglesias et al, ; Reinhardt et al, ) and the ending of relationships without frequent contact or with little support (‘peripheral relations’) (Kahn & Antonucci, ; Klein Ikkink & van Tilburg, ). These changes in social networks, some of which can be interpreted as life events, challenge ageing in place because they are negatively associated with older adults’ health and well‐being (Ellwardt, van Tilburg, Aartsen, Wittek, & Steverink, ; Ellwardt, van Tilburg, & Aartsen, ; Kelly et al, ; Krause, ) and they affect support needs and resources (Guiaux, van Tilburg, & Broese van Groenou, ; Tomassini et al, ). The current literature contains many studies of change in older adults’ social networks, but leaves older adults’ experiences underexposed.…”