Abstract
Advances in medical technology and improvements in health behavior have greatly increased the proportion of Americans who survive into old age. Consequently, identifying environmental and behavioral factors that enhance or protect the health and functional capacity of older adults is an important goal. This study investigated the extent to which social interactions and physical activity can protect older adults from the declines in functional ability that typically occur with age and the extent to which they buffer the negative effects of widowhood on physical functioning. Data were from the Longitudinal Study of Aging, a six-year follow-up of over 7,000 respondents in the 1984 National Health Interview Survey. Using individual growth curve models which examine the effects of predictor variables on change over time, this study investigated how physical activity, social interactions, and widowhood are related to the rate of change in functional health over a six-year period. Results suggested that physical activity and social interactions each exerted independent effects on functional decline. In addition, physical activity and social interactions buffered the effects of widowhood on functional decline, especially in men who died before the end of the study. Results suggest a need for health promotion programs to encourage both physical and social activities in the elderly.
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References
Fries JF: Aging, natural death, and the compression of morbidity.New England Journal of Medicine. 1980,303: 130–135.
Koplan JP, Livengood JR: The influence of changing demographic patterns on our health promotion priorities.American Journal of Preventive Medicine. 1994,10: 42–44.
United States Department of Health and Human Services:Health United States 1993. DHHS Publication No. (PHS) 94-1232. Hyattsville, MD: U.S. Department of Health and Human Services, 1994, 153.
Wagner EH, LaCroix AZ, Buchner DM, Larson EB: Effects of physical activity on health status in older adults I: Observational studies.Annual Review of Public Health. 1992,13: 451–468.
Bowling A, Browne PD: Social networks, health, and emotional well-being among the oldest old in London.Journals of Gerontology. 1991,46: S20-S22.
Leppin A, Schwarzer R: Social support and physical helath: An updated meta-analysis. In Schmidt LR, Schwenkmezger P, Weinman J, Maes S (eds),Theoretical and Applied Aspects of Health Psychology. Chur: Harwood Academic Publishers, 1990, 185–202.
Berkman L, Breslow L:Health and Ways of Living: Findings from the Alameda County Study. New York: Oxford University Press 1983.
Berkman LF: The role of social relations in health promotion.Psychosomatic Medicine. 1995,57: 245–254.
House J, Robbins C, Metzner H: The association of social relationships and activities with mortality: Prospective evidence from the Tecumseh Community Health Study.American Journal of Epidemiology. 1982,116: 123–140.
Blazer D: Social support and mortality in an elderly community population.American Journal of Epidemiology. 1982,115: 684–694.
Wolinsky FD, Johnson RL, Stump TE: The risk of mortality among older adults over an eight-year period.Gerontologist. 1995:35: 150–161.
Sugisawa H, Liang J, Liu X: Social networks, social support, and mortality among older people in Japan.Journals of Gerontology. 1994,49: S3-S13.
Orth-Gomer K, Johnson JV: Social network interaction and mortality: A six-year follow-up study of a random sample of the Swedish population.Journal of Chronic Diseases. 1987,40:949–957.
Kaplan GA, Wilson TW, Cohen RD, et al: Social functioning and overall mortality: Prospective evidence from the Kuopio Ischemic Heart Disease Risk Factor Study.Epidemiology. 1994,5: 495–500.
Mor V, Murphy J, Masterson-Allen S, et al: Risk of functional decline among well elders.Journal of Clinical Epidemiology. 1989.42: 895–904.
Liu X, Liang J, Muramatsu N, Sugisawa H: Transitions in functional status and active life expectancy among older people in Japan.Journals of Gerontology: Social Sciences. 1995,50B: S383-S394.
Weinberger M, Tierney WM, Booher P, Hiner SL: Social support, stress, and functional status in patients with osteoarthritis.Social Science and Medicine. 1990,30: 503–508.
Falk A, Hanson BS, Isacsson SO, Ostergren PO: Job strain and mortality in elderly men: Social network, support, and influence as buffers.American Journal of Public Health. 1992,82: 1136–1139.
Rosengren A, Orth GK, Wedel H, Wilhelmsen L: Stressful life events, social support, and mortality in men born in 1933.British Medical Journal. 1993,307: 1102–1105.
Johnson JV, Stewart W, Hall EM, Fredlund P, Theorell T: Long-term psychological work environment and cardiovascular mortality among Swedish men.American Journal of Public Health. 1996,86: 324–331.
Schwarzer R, Jerusalem M, Hahn A: Unemployment, social support, and health complaints: A longitudinal study of stress in East German refugees.Journal of Community and Applied Social Psychology. 1994,4: 31–45.
Fried Y, Tiegs RB: The main effect model versus buffering model of shop steward social support: A study of rank-and-file auto workers in the USA.Journal of Organizational Behavior. 1993,14: 481–493.
Fusilier MR, Ganster DC, Mayes BT: Effects of social support, role stress, and locus of control on health.Journal of Management. 1987,13: 517–528.
Rael EGS, Stansfeld SA, Shipley M, et al: Sickness absence in the Whitehall II study, London: The role of social support and material problems.Journal of Epidemiology and Community Health. 1995,49: 474–481.
Norris FH, Murrell SA: Social support, life events, and stress as modifiers of adjustment to bereavement by older adults.Psychology and Aging. 1990,5: 429–436.
Lissner L, Bengtsson C, Bjorkelund C, Wedel H: Physical activity levels and changes in relation to longevity.American Journal of Epidemiology. 1995,143: 54–62.
Rakowski W, Mor V: The association of physical activity with mortality among older adults in the Longitudinal Study of Aging (1984–1988).Journals of Gerontology. 1992,47: M122-M129.
Rehm J, Fichter MM, Elton M: Effects on mortality of alcohol consumption, smoking, physical activity, and close personal relationships.Addiction. 1993,88: 101–112.
Simonsick EM, Lafferty ME, Phillips CL, et al: Risk due to inactivity in physically capable older adults.American Journal of Public Health. 1993,83: 1443–1450.
Paffenbarger RS, Kampert JB, Lee IM, et al: Changes in physical activity and other lifeway patterns influencing longevity.Medicine and Science in Sports and Exercise. 1994,26: 857–865.
Ruigomez A, Alonso J, Anto JM: Relationship of health behaviors to five-year mortality in an elderly cohort.Age and Ageing. 1995,24: 113–119.
Wolinsky FD, Stump TE, Clark DO: Antecedents and consequences of physical activity and exercise among older adults.Gerontologist. 1995,38: 451–462.
Shephard RJ: Exercise and aging: Extending independence in older adults.Geriatrics. 1993,48: 61–64.
Unger JB: Sedentary lifestyle as a risk factor for self-reported poor physical and mental health.American Journal of Health Promotion. 1995,9: 15–17.
Shephard RJ, Montelpare W: Geriatric benefits of exercise as an adult.Journal of Gerontology. 1988,43: M86-M90.
Brown JD: Staying fit and staying well: Physical fitness as a moderator of life stress.Journal of Personality and Social Psychology. 1991,60: 555–561.
Wheeler RJ, Frank MA: Identification of stress buffers.Behavioral Medicine. 1988,14: 78–89.
Havighurst RJ: Successful aging. In Williams RH, Tibbits C, Donahue W (eds),Processes of Aging: Social and Psychological Perspectives. New York: Atherton, 1963, 299.
Strawbridge WJ, Camacho TC, Cohen RD, Kaplan GA: Gender differences in factors associated with change in physical functioning in old age: A 6-year longitudinal study.Gerontologist. 1993,33: 603–609.
Hanson BS, Isacsson SO, Janzon L, Lindell SE: Social network and social support influence mortality in elderly men.American Journal of Epidemiology. 1989,130: 100–111.
Krause N, Goldenhar L, Liang J, Jay G, Maeda D: Stress and exercise among the Japanese elderly.Social Science and Medicine. 1993,36: 1429–1441.
Potts MK, Hurwicz ML, Goldstein MS, Berkanovic E: Social support, health-promotive beliefs, and preventive health behaviors among the elderly.Journal of Applied Gerontology. 1992,11: 425–440.
Holmes TH, Rahe RH: The Social Readjustment Rating Scale.Journal of Psychosomatic Research. 1967,11: 213–218.
Ferraro KF: Widowhood and health. In Markides KS, Cooper CL (eds),Aging, Stress, and Health. New York: Wiley, 1989.
Ben-Shlomo Y, Smith GD, Shipley M, Marmot MG: Magnitude and causes of mortality differences between married and unmarried men.Journal of Epidemiology and Community Health. 1993,47: 200–205.
Elo IT, Preston SH: Educational differences in mortality: United States, 1979–1985.Social Science and Medicine. 1996,42: 47–57.
Jagger C, Sutton CJ: Death after marital bereavement—Is the risk increased?Statistics in Medicine. 1991,10: 395–404.
Kaprio J, Koskenvuo M, Rita H: Mortality after bereavement: A prospective study of 95,647 widowed persons.American Journal of Public Health. 1987,77: 283–287.
Mendes de Leon CF, Fillenbaum GG, Williams CS, et al: Functional disability among elderly Blacks and Whites in two diverse areas: The New Haven and North Carolina EPESE.American Journal of Public Health. 1995,85: 994–998.
Schaefer C, Quesenberry Jr. CP, Wi S: Mortality following conjugal bereavement and the effects of a shared environment.American Journal of Epidemiology. 1995,141: 1142–1152.
Roos NP, Havens B: Predictors of successful aging: A twelve-year study of Manitoba elderly.American Journal of Public Health. 1991,81: 63–68.
Katz S, Branch LG, Branson MH, et al: Active life expectancy.New England Journal of Medicine. 1983,309: 1218–1224.
Cox HG:Later Life: The Realities of Aging. Englewood Cliffs, NJ: Prentice Hall, 1993.
Penning MJ, Strain LA: Gender differences in disability, assistance, and subjective well-being in later life.Journals of Gerontology. 1994,49: S202-S208.
Barer BM: Men and women aging differently.International Journal of Aging and Human Development. 1994,38: 29–40.
Ducharme F: Longitudinal change in conjugal support and coping behaviors of elderly marital partners.Journal of Family Nursing. 1995,1: 281–302.
Lubben JE, Weiler PG, Chi I: Gender and ethnic differences in the health practices of the elderly poor.Journal of Clinical Epidemiology. 1989,42: 725–733.
O’Brien SJ, Vertinsky PA: Unfit survivors: Exercise as a resource for aging women.Gerontologist. 1991,31: 347–357.
Berkman LF, Leo-Summers L, Horwitz RI: Emotional support and survival following myocardial infarction: A prospective population-based study of the elderly.Annals of Internal Medicine. 1992,117: 1003–1009.
Seeman TE, Berkman LF, Blazer D, Rowe JW: Social ties and support and neuroendocrine function: The MacArthur studies of successful aging.Annals of Behavioral Medicine. 1994,16: 95–106.
Rowe JW, Kahn RL: Human aging: Usual and successful.Science. 1987,237: 143–149.
Umberson D, Wortman CB, Kessler RC: Widowhood and depression: Explaining long-term gender differences in vulnerability.Journal of Health and Social Behavior. 1992,33: 10–24.
United States Department of Health and Human Services, National Center for Health Statistics: National Health Interview Survey: Longitudinal Study of Aging, 70 Years and Over, 1984–1990 (computer file) (5th Release). Hyattsville, MD: U.S. Department of Health and Human Services, National Center for Health Statistics (producer). Ann Arbor, MI: Inter-University Consortium for Political and Social Research (distributor), 1991.
Ainsworth BE, Montoye HJ, Leon AS: Methods of assessing physical activity during leisure and work. In Bouchard C, Shephard RJ, Stephens T (eds),Physical Activity, Fitness, and Health, Champaign, IL: Human Kinetics Publishers 1994.
Schectman KB, Barzilai B, Rost K, Fischer EB: Measuring physical activity with a single question.American Journal of Public Health. 1991,81: 771–773.
Stewart AL, Greenfield S, Hays RD, et al: Functional status and well-being of patients with chronic conditions.Journal of the American Medical Association. 1989,262: 907–913.
Kosorok MR, Omenn GS, Diehr P, Koepsell TD, Patrick DL: Restricted activity days among older adults.American Journal of Public Health. 1992,82: 1263–1267.
Kim J, Mueller CW:Factor Analysis: Statistical Methods and Practical Issues. Newbury Park, CA: Sage Publications, 1978.
Willett JB: Questions and answers in the measurement of change. In Rothkopf E (ed),Review of Research in Education, Washington, DC: AERA, 1988, 345–422.
Leigh JP, Fries JF: Health habits, health care use, and costs in a sample of retirees.Inquiry. 1992,29: 44–54.
Osler M: Social network and lifestyle in Danish adults.Journal of Epidemiology and Community Health. 1995,49: 327–328.
Heitzmann CA, Kaplan RM: Assessment of methods for measuring social support.Health Psychology. 1988,7: 75–109.
Thoits PA: Stress, coping, and social support processes: Where are we? What next?Journal of Health and Social Behavior. 1995,Extra Issue: 53–79.
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Preparation of this manuscript was supported in part by a National Cancer Institute predoctoral fellowship presented to the first author.
The authors wish to thank Chih-Ping Chou, Margaret Gatz, Leslie Bernstein, and Victoria Fortunato for their helpful suggestion and the Inter-University Consortium for Political and Social Research for providing the LSOA dataset.
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Unger, J.B., Johnson, C.A. & Marks, G. Functional decline in the elderly: Evidence for direct and stress-buffering protective effects of social interactions and physical activity. ann. behav. med. 19, 152–160 (1997). https://doi.org/10.1007/BF02883332
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DOI: https://doi.org/10.1007/BF02883332
Keywords
- Social Support
- Social Interaction
- Physical Functioning
- Stressful Life Event
- Behavioral Medicine