Social Support and Functional Decline in the Oldest Old

Abstract

<b><i>Objective:</i></b> Longitudinal studies investigating the link between social support and functional decline are limited among the oldest old. Thus, the aim of this study was to examine whether changes in social support are associated with functional decline among the oldest old longitudinally using panel regression models. <b><i>Methods:</i></b> Longitudinal data from 3 waves (waves 7, 8, and 9) of a multicenter prospective cohort study covering primary care patients aged ≥85 years were used. In the analytical sample, <i>n</i> equaled 624 individuals. The validated Lawton and Brody Instrumental Activities of Daily Living (IADL) scale and the well-established Barthel Index (ADL) were used to quantify functional status. The psychometrically sound Lubben Social Network Scale was used to measure social support. Several potential confounders such as age, marital status, cognitive decline, or depressive symptoms were included in the fixed effects (FE) regression models. <b><i>Results:</i></b> Linear FE regressions showed that a decrease in social support is associated with functional decline (IADL: β = 0.03, <i>p</i> < 0.05; ADL: β = 0.27, <i>p</i> < 0.05) in men but not in women. With IADL as outcome measure, the interaction term (sex × social support) achieved statistical significance (<i>p</i> < 0.01). With regard to covariates, functional decline (IADL and ADL) was consistently associated with increasing age, an increase in the number of chronic conditions (except for women [ADL]), and cognitive decline (except for men [ADL]). Furthermore, functional decline (ADL) was associated with an increase in depressive symptoms. <b><i>Discussion:</i></b> Our findings highlight the meaning of social support for functional status among the oldest old. Finding ways to sustain social support in highest age may be a promising approach in order to postpone functional decline.

Social Isolation and Loneliness among Near-Centenarians and Centenarians: Results from the Fordham Centenarian Study

“…When we consider levels of social isolation and loneliness separately, our findings are consistent with those regarding the oldest-old [53,73]. In the present sample, nearcentenarians and centenarians tended, on average, to have a number of meaningful social relationships just above the risk threshold and to report loneliness rarely.…”

Social Isolation and Incident Dementia in the Oldest-Old—A Competing Risk Analysis

“…Moreover, there was no association between social isolation and incident dementia in men or women. There are a few studies that have also examined the association between social isolation and dementia or cognitive functioning in the oldest old (23,36,37). A study also based on AgeCoDe/AgeQualiDe data examined oldest-old, healthy individuals over a period of 4.7 years with regards to social isolation and cognitive function.…”

“…It was shown that smaller social networks, measured with the LSNS-6, were associated with lower cognitive function (23). In addition, Hajek et al (37) studied oldest-old individuals based on AgeCoDe/AgeQualiDe data with the LSNS-6 over a 2-year period and found that a social network size was associated with functional deterioration in men. The different findings in comparison to our study could be explained by varying methodological approaches.…”

“…For this study, however, a defined clinical disease (dementia) was used as outcome. In addition, in contrast to Röhr et al ( 23) and Hajek et al (37), our analyses was adjusted for mortality risk by performing a competing risk analyses.…”

Determinants of Physical Functioning and Health-Related Quality of Life among Sexual and Gender Minority Older Adults with Cognitive Impairment

“…The results from the NHANES also suggest that poor sleep quality is associated with lower physical functioning among older adults, and the association is stronger among those with cognitive impairment and other chronic conditions (Puri et al, 2017). Previous research studies also suggest that lack of a support network might have negative impact over time on physical functioning among older adults (Hajek et al, 2021).…”