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Quality of Life Research

, Volume 8, Issue 8, pp 711–722 | Cite as

Health behaviors, social networks, and healthy aging: Cross-sectional evidence from the Nurses' Health Study

  • Yvonne L. Michael
  • Graham A. Colditz
  • Eugenie Coakley
  • Ichiro Kawachi
Article

Abstract

Physical function is a significant component of health-related quality of life among older adults. Potential correlates of healthy aging, including health behaviors and social network characteristics, were examined among 56,436 US women aged 55–72 in 1992. Healthy aging was assessed by maintenance of physical function measured by four sub-scales of the Medical Outcomes Study Short Form (SF)-36 Health Survey: physical functioning; role limitations; freedom from bodily pain; and vitality. Individual health behaviors, defined as current smoking, alcohol consumption, sedentary behavior, and being overweight each contributed to significant decrements in functioning across all age-groups. After controlling for these health behaviors and other confounders (age, race, education, and co-morbid conditions), elements of a woman's social network were significantly correlated with functional status. Strong predictors of high functioning among older women were having close friends and relatives and presence of a confidant. For example, the absence of a confidant was associated with a 4.44 point reduction in physical functioning (95% CI: −7.0, −1.9), and a 5.68 point reduction in vitality (95% CI: −7.9, −3.4). These effects were comparable in magnitude to those observed among heavy smokers, or women in the highest category of body mass index.

Health-related quality of life Life-course SF-36 Social networks Successful aging 

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References

  1. 1.
    Rowe JW, Kahn RL. Human aging: Usual and successful. Science 1987; 237: 143–149.Google Scholar
  2. 2.
    Beckett LA, Brock DB, Lemke JH, et al. Analysis of change in self-reported physical function among older persons in four population studies. Am J Epidemiol 1996; 143: 766–778.Google Scholar
  3. 3.
    Guralnik JM, Kaplan GA. Predictors of healthy aging: Prospective evidence from the Alameda County Study. Am J Public Health 1989; 79: 703–708.Google Scholar
  4. 4.
    Berkman LF, Seeman TE, Albert M, et al. High, usual and impaired functioning in community-dwelling older men and women: Findings from the MacArthur Foundation Research Network on Successful Aging. J Clin Epidemiol 1993; 46: 1129–1140.Google Scholar
  5. 5.
    Seeman TE, Charpentier PA, Berkman LF, et al. Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur Studies of Successful Aging. J Gerontol 1994; 49: M97–108.Google Scholar
  6. 6.
    Guralnik JM, LaCroix LA, Abbott RD, et al. Maintaining mobility in late life. I. Demographic characteristics and chronic conditions. Am J Epidemiol 1993; 137: 845–857.Google Scholar
  7. 7.
    LaCroix AL, Guralnik JM, Berkman LF, Wallace RB, Satterfield S. Maintaining mobility in late life. II. Smoking, alcohol consumption, physical activity, and body mass index. Am J Epidemiol 1993; 137: 858–869.Google Scholar
  8. 8.
    Strawbridge WJ, Cohen RD, Shema SJ, Kaplan GA. Successful aging: predictors and associated activities. Am J Epidemiol 1996; 144: 135–141.Google Scholar
  9. 9.
    House JS, Robbins C, Metzner HL. The association of social relationships and activity with mortality: prospective evidence from the Tecumseh Community Health Study. Am J Epidemiol 1992; 116: 123–140.Google Scholar
  10. 10.
    Berkman LF, Syme SL. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. Am J Epidemiol 1979; 109: 186–204.Google Scholar
  11. 11.
    Orth-Gomer K, Johnson JV. Social network interaction and mortality. A six-year follow-up study of a random sample of the Swedish population. J Chronic Dis 1987; 40: 949–957.Google Scholar
  12. 12.
    Schoenbach VJ, Kaplan BH, Fredman L, et al. Social ties and mortality in Evans County, Georgia. Am J Epidemiol 1986; 123: 577–591.Google Scholar
  13. 13.
    Kaplan GA, Salonen JT, Cohen RD, Brand RJ, Syme SL, Puska P. Social connections and mortality from all causes and from cardiovascular disease: Prospective evidence from Eastern Finland. Am J Epidemiol 1988; 128: 370–380.Google Scholar
  14. 14.
    Welin L, Tibblin G, Svardsudd K, et al. Prospective study of social influences on mortality. Lancet 1985; 1: 915–918.Google Scholar
  15. 15.
    Blazer DG. Social support and mortality in an elderly community population. Am J Epidemiol 1982; 115: 684–694.Google Scholar
  16. 16.
    Seeman TE, Berkman LF, Kohout F, LaCroix A, Glynn R, Blazer D. Inter-community variations in the association between social ties and mortality in the elderly: A comparative analysis of three communities. Annals of Epidemiol 1993; 3: 325–335.Google Scholar
  17. 17.
    Hanson BS, Issacson SO, Janzon L, Lindell SE. Social network and social support influence mortality in elderly men. Am J Epidemiol 1989; 130: 100–111.Google Scholar
  18. 18.
    Kawachi I, Colditz GA, Ascherio A, et al. A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA. J Epidemiol and Community Health 1996; 50: 245–251.Google Scholar
  19. 19.
    Goodwin JS, Hunt WC, Key CR, et al. The effect of marital status on stage, treatment, and survival of cancer patients. J Am Med Assoc 1987; 258: 3125–3130.Google Scholar
  20. 20.
    Vogt TM, Mullooly JP, Ernst D, et al. Social networks as predictors of ischemic heart disease, cancer, stroke, and hypertension: incidence, survival, and mortality. J Clin Epidemiol 1992; 45: 659–666.Google Scholar
  21. 21.
    Berkman LF, Leo-Summers L, Horwitz RI. Emotional support and survival after myocardial infarction: A prospective, population-based study of the elderly. Annals of Internal Med 1992; 117: 1003–1009.Google Scholar
  22. 22.
    Funch DP, Mettlin C. The role of support in relation to recovery from breast surgery. Social Science Med 1982; 16: 91–188.Google Scholar
  23. 23.
    Speigel D, Bloom JR. Pain in metastatic breast cancer. Cancer 1983; 52: 149–153.Google Scholar
  24. 24.
    Hunt WC, Key CR, Samet JM. The effect of marital status on stage, treatment, and survival of cancer patients. Journal of the Am Med Association 1987; 258: 3125–3130.Google Scholar
  25. 25.
    Mor V, Murphy J, Masterson-Allen S, et al. Risk of functional decline among well elders. J Clin Epidemiol 1989; 42: 895–904.Google Scholar
  26. 26.
    Seeman TE, Bruce ML, McAvay GJ. Social network characteristics and onset of ADL disability: MacArthur Studies of Successful Aging. J Gerontol 1996; 51: S191–200.Google Scholar
  27. 27.
    Seeman TE, Berkman LF. Structural characteristics of social support and their relationship with social support in the elderly: Who provides support. Social Sci Med 1988; 26: 737–749. 721Google Scholar
  28. 28.
    Connidis IA, Davies L. Confidants and companions in later life: The place of family and friends. J Gerontol 1990; 45: S141–149.Google Scholar
  29. 29.
    Ware JE Jr. SF-36 Health Survey. Manual and Interpretation Guide. Boston, Massachusetts: The Health Institute of Boston, 1993.Google Scholar
  30. 30.
    Brazier JE, Harper R, Jones NMB, et al. Validating the SF-36 health survey questionnaire: New outcome measures for primary care. Br Med J 1992; 305: 160–164.Google Scholar
  31. 31.
    McHorney CA, Ware Jr JE, Raczek AE. The MOS 36-item short form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247–263.Google Scholar
  32. 32.
    McHorney CA, Ware Jr JE, Lu RJF, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994; 32: 40–66.Google Scholar
  33. 33.
    Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). Conceptual framework and item selection. Med Care 1992; 30: 473–483.Google Scholar
  34. 34.
    Berkman LF. Social networks, host resistance, and mortality: A follow-up study of Alameda County residents. Ph.D. Thesis. Berkeley: University of California, Berkeley, 1977.Google Scholar
  35. 35.
    Wolf AM, Hunter DJ, Colditz GA, et al. Reproducibility and validity of a self-administered physical activity questionnaire. Int J Epidemiol 1994; 23: 991–999.Google Scholar
  36. 36.
    Rimm EB, Stampfer MJ, Coldtitz GA, et al. Validity of self-reported waist and hip circumferences in men and women. Epidemiol 1990; 1: 466–473.Google Scholar
  37. 37.
    Giovannucci E, Colditz GA, Stampfer MJ, et al. The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol 1991; 133: 810–817.Google Scholar
  38. 38.
    Coakley EH, Kawachi I, Speizer FE, et al. Body weight and risk of reduced physical functioning in middle-aged and older women. Am J Epidemiol 1996; 143: S16 (Abstract).Google Scholar
  39. 39.
    World Health Organization. Physical Status:Use and Interpretation of Anthropometry. Geneva; World Health Organization, 1995.Google Scholar
  40. 40.
    Stampfer MJ, Rimm EB, Walsh DC. Commentary: Alcohol, the Heart, and Public Policy. Am J Public Health 1993; 83: 801–804.Google Scholar
  41. 41.
    Mackenbach JP, Ben Den Bos J, Joung IM, et al. Determinants of Excellent Health: Different from the determinants of ill-health. Int J Epidemiol 1994; 23: 1273–1281.Google Scholar
  42. 42.
    Roos NP, Havens B. Predictors of successful aging: a twelve-year study of Manitoba elderly. Am J Public Health 1991; 81: 63–68.Google Scholar
  43. 43.
    Hennessy CH, Moriarty DG, Zack MM, Scherr PA, Brackbill R. Measuring Health-Related Quality of Life for Public Health Surveillance. Public Health Reports 1994; 109(5): 665–672.Google Scholar
  44. 44.
    Lerner DJ, Levine S. Health-related Quality of Life: Origins, Gaps, and Directions. Adv Med Sociol 1994; 5: 43–65.Google Scholar

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • Yvonne L. Michael
    • 1
  • Graham A. Colditz
    • 1
  • Eugenie Coakley
    • 1
  • Ichiro Kawachi
    • 1
  1. 1.Department of Medicine, Channing LaboratoryHarvard Medical School and Brigham and Women's HospitalBostonUSA

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