Social Networks in the NSHAP Study: Rationale, Measurement, and Preliminary Findings

Cornwell, Benjamin; Schumm, L. Philip; Laumann, Edward O.; Graber, Jessica

doi:10.1093/geronb/gbp042

Cited by 271 publications

(232 citation statements)

References 38 publications

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“…The interviews were comprised of a personal interview; anthropometric, clinical, and physiological measures; and a self-administered questionnaire (27,40,45). The study was approved by the Institutional Review Boards of The University of Chicago and NORC of The University of Chicago; all respondents provided written informed consent.…”

Section: Discussionmentioning

confidence: 99%

Empirical redefinition of comprehensive health and well-being in the older adults of the United States

McClintock

Dale

Laumann

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

114

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The World Health Organization (WHO) defines health as a "state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Despite general acceptance of this comprehensive definition, there has been little rigorous scientific attempt to use it to measure and assess population health. Instead, the dominant model of health is a disease-centered Medical Model (MM), which actively ignores many relevant domains. In contrast to the MM, we approach this issue through a Comprehensive Model (CM) of health consistent with the WHO definition, giving statistically equal consideration to multiple health domains, including medical, physical, psychological, functional, and sensory measures. We apply a data-driven latent class analysis (LCA) to model 54 specific health variables from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative sample of US community-dwelling older adults. We first apply the LCA to the MM, identifying five health classes differentiated primarily by having diabetes and hypertension. The CM identifies a broader range of six health classes, including two "emergent" classes completely obscured by the MM. We find that specific medical diagnoses (cancer and hypertension) and health behaviors (smoking) are far less important than mental health (loneliness), sensory function (hearing), mobility, and bone fractures in defining vulnerable health classes. Although the MM places two-thirds of the US population into "robust health" classes, the CM reveals that one-half belong to less healthy classes, independently associated with higher mortality. This reconceptualization has important implications for medical care delivery, preventive health practices, and resource allocation.comprehensive health | aging | disease | well-being | health policy I n 1946, the World Health Organization (WHO) defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (1). In 1977, George Engel (2) built on this definition, calling for a new biopsychosocial model. It integrated traditional medicine with psychosocial factors, which stimulated the field of psychosomatic medicine. These ideas have been honored more as an ideal than in practice.Here, we seek to apply this comprehensive definition to characterize the health of US older adults living in their homes. Studying a representative sample of the US population ages 57-85 y old [the National Social Life, Health and Aging Project (NSHAP)], we gathered wide-ranging information on the diseases of the traditional "Medical Model" (MM) and also, psychological well-being and physical function in a "Comprehensive Model" (CM) informed by the approach by Engel (2, 3). We empirically determined if these health measures formed distinct constellations, characterizing groups of people with different patterns of health and well-being. Our large survey of 3,005 community-dwelling older adults ages 57-85 y old was not a clinical sample or a sample of con...

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Section: Discussionmentioning

confidence: 99%

Empirical redefinition of comprehensive health and well-being in the older adults of the United States

McClintock

Dale

Laumann

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

114

View full text Add to dashboard Cite

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“…35 This method elicits the number of influential individuals in respondents' lives. 36 Density describes the overall degree of involvement of all members of the network and how close-knit a respondent's social context is. It was calculated as a respondent's frequency of interaction with each network member plus the frequency of interactions among each possible pair of network members, divided by network size.…”

Section: Methodsmentioning

confidence: 99%

“…Density values are continuous between a range of 0 and 1, where a value of 1 indicates that all possible pairs of network members have the maximum contact, and a value of 0 indicates no contact between any of the possible pairs of network members. 36 Second, we examined social resources and demands that accompany social relationships: perceived social support and perceived social strain. Perceived social support was measured by asking whether the respondent could (independently): 1) rely on and 2) open up to their spouse, family, or friends.…”

Section: Methodsmentioning

confidence: 99%

Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults

et al. 2016

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BACKGROUND: An early sign of cognitive decline in older adults is often a disruption in social function, but our understanding of this association is limited. OBJECTIVE: We aimed to determine whether those screening positive for early stages of cognitive impairment have differences across multiple dimensions of social function and whether associations differ by gender. DESIGN: United States nationally representative cohort (2010), the National Social life, Health, and Aging Project (NSHAP). PARTICIPANTS: Community-dwelling adults aged 62-90 years (N = 3,310) with a response rate of 76.9 %. MAIN MEASURES: Cognition was measured using a survey adaptation of the Montreal Cognitive Assessment categorized into three groups: normal, mild cognitive impairment (MCI), and dementia. We measured three domains of social relationships, each comprised of two scales: network structure (size and density), social resources (social support and social strain), and social engagement (community involvement and socializing). We used multiple linear regression to characterize the relationship of each social relationship measure to cognition. KEY RESULTS: Individuals screened as at risk for MCI and early dementia had smaller network sizes by 0.3 and 0.6 individuals (p < 0.001), and a 10 % and 25 % increase in network density (p < 0.001), respectively. For social resources, individuals at risk for MCI and dementia had 4 % and 14 % less social strain (p = 0.01), but only women had 3 % and 6 % less perceived social support (p = 0.013), respectively. For social engagement, individuals screened positive for MCI and dementia had 8 % and 19 % less community involvement (p = 0.01), but only men had 8 % and 13 % increased social involvement with neighbors and family members (p < 0.001), respectively. CONCLUSION: Changes in social functioning provide an early indication to screen for cognitive loss. Recognition that early cognitive loss is associated with differences in social function can guide counseling efforts and help identify social vulnerabilities to ease the transition to overt dementia for both patients and caregivers.

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“…In general, the size of the social network decreases with age (Cornwell et al, 2008(Cornwell et al, , 2009). Family plays a central role in the social relations of the elderly.…”

Section: Brand Relationsmentioning

confidence: 99%

Brand relations and life course: Why old consumers love their brands

Sikkel¹

2013

J Market Anal

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Dirk Sikkelis a Statistician and Market Researcher. He has worked for different market research agencies and as a professor in methodology. During the last 12 years, he has specialized in marketing to older consumers. Currently, he is a Professor at the University of Amsterdam in the department of communication sciences and has his own company Sixtat.Correspondence: Dirk Sikkel, Sixtat, Schout van Eijklaan 98, Leidschendam, 2262 XV, The Netherlands E-mail: d.sikkel@sixtat.nl ABSTRACT The relationship between age and the importance of brand relation is investigated. In a first exploratory survey, this relation appeared to be U-shaped. Brand relations are relatively strong for both consumers under 30 and those over 60. In a second survey, a theory-based explanation is sought as to why the importance of brand relation increases with age over 50. The answer lies in a decreased tolerance of ambiguity, consistent with low cognitive-affective complexity. Given hedonic innovativeness and future time perspective, the relation between age and brand relation becomes stronger. The results imply that brands should communicate to older consumers: 'we have a long future together, our new products are attractive and we don't take you out of your comfort zone'.

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Social Networks in the NSHAP Study: Rationale, Measurement, and Preliminary Findings

Abstract: The data reiterate the relevance of social networks to older adults' health. We close by discussing how the NSHAP measures might be employed in future analyses of health.

Cited by 271 publications

References 38 publications

Empirical redefinition of comprehensive health and well-being in the older adults of the United States

Empirical redefinition of comprehensive health and well-being in the older adults of the United States

Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults

Brand relations and life course: Why old consumers love their brands

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