European Journal of Ageing

, Volume 2, Issue 1, pp 40–47 | Cite as

Disability and social ties: comparative findings of the CLESA study

  • M. V. ZunzuneguiEmail author
  • A. Rodriguez-Laso
  • A. Otero
  • S. M. F. Pluijm
  • S. Nikula
  • T. Blumstein
  • M. Jylhä
  • N. Minicuci
  • D. J. H. Deeg
  • CLESA Working Group
Original Investigation


The associations between prevalence, incidence and recovery from activities of daily living (ADL) disability and social ties among community-dwelling persons over 65 in Finland, The Netherlands and Spain are examined. Data were harmonized in the CLESA study. The baseline sample was composed of 3,648 subjects between 65 and 85 years old, living in Finland, The Netherlands and Spain. Disability in four activities of daily living was determined at baseline and at follow-up. Social participation, number of family ties and presence of friends were added to obtain a social ties index. Logistic regressions were fitted to the prevalence, incidence and recovery data to estimate the associations between disability and social ties, adjusting for education, co-morbidity and self-rated health. The modifying effects of country, age and sex were tested in all models. For every country, the social ties index, having friends and social participation were negatively associated with ADL disability prevalence. ADL incidence was negatively related to the number of family ties, with a stronger relationship in Spain than in The Netherlands or Finland. ADL recovery was associated with the social ties index. No age or gender differences in these associations were found. Social ties appear to generate a beneficial effect on the maintenance and restoration of ADL function. While social ties play an important role in maintaining and restoring function in all three countries, family ties appear to generate a stronger effect on protection from disability incidence than does social participation, and the strength of this effect varies by culture.


Longitudinal studies Aging Disability Social ties 



The CLESA Working Group: Finland M. Jylhä (Principal Investigator), S. Nikula, V. Autio; Israel J. Gindin (Principal Investigator; First Principal Investigator—the late Modan Baruch of the Chaim Sheba Medical Center), T. Blumstein, A. Chetrit, A. Walter-Ginzburg, K. Shamay; Italy S. Maggi (Project Leader), N. Minicuci, M. Noale, C. Marzari; The Netherlands D.J.H. Deeg (Principal Investigator), S.M.F. Pluijm; Spain A. Otero (Principal Investigator), M.J. Garcia de Yebenes, A. Rodríguez-Laso, M.V. Zunzunegui; Sweden N.L. Pedersen (Principal Investigator), C. Bardage. The CLESA Project is supported by EU QoL2000-00664. LASA is supported by The Netherlands Ministry of Health, Welfare and Sports and the Vrije Universiteit. ILSA was supported by the CNR (National Research Council) and the Italian Department of Health–National Institutes of Health. Aging in Leganés is supported by the Spanish Health Research Fund (FIS), the Madrid Regional Research Fund and Private Foundations (La Caixa, BBVA). CALAS was supported by the US National Institute on Aging Grants R01-5885-03 and R01-5885-06. The TamELSA is supported by the Academy of Finland, the Juho Vainio Foundation, the Yrjö Jahnsson Foundation and the Medical Research Fund of Tampere University Hospital. SATSA is supported by the US National Institute on Aging (AG 04563, 10175) and the Swedish Social Research Council.


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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • M. V. Zunzunegui
    • 1
    Email author
  • A. Rodriguez-Laso
    • 2
  • A. Otero
    • 2
  • S. M. F. Pluijm
    • 3
  • S. Nikula
    • 4
  • T. Blumstein
    • 5
  • M. Jylhä
    • 4
  • N. Minicuci
    • 6
  • D. J. H. Deeg
    • 3
  • CLESA Working Group
  1. 1.Département de Médecine Sociale et Préventive, Faculté de MédecineUniversité de MontréalMontréalCanada
  2. 2.Centro Universitario de Salud PúblicaUniversidad Autonoma de MadridMadridSpain
  3. 3.Institute for Research in Extramural Medicine (EMGO Institute)VU University Medical Center (VUMC)AmsterdamThe Netherlands
  4. 4.School of Public HealthUniversity of TampereTampereFinland
  5. 5.The Gertner Institute for Epidemiology and Health Policy ResearchChaim Sheba Medical CenterTel HashomerIsrael
  6. 6.Institute of Neuroscience, Aging UnitNational Council ResearchPadovaItaly

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