Social engagement and disability in a community population of older adults: the New Haven EPESE.

This paper examines the effect of social engagement on disability among community-dwelling older adults in 1982-1991. Data were collected from the New Haven, Connecticut, site of the Established Populations for Epidemiologic Studies of the Elderly. Baseline social engagement was measured by using 11 items related to social and productive activity. Disability data consisted of a six-item measure of activities of daily living, a three-item measure of gross mobility, and a four-item measure of basic physical functions. Nine waves of yearly disability data were analyzed by using generalized estimating equations models. After adjustment for age, gender, race, and physical activity, significant cross-sectional associations (p's < 0.001) were found between social engagement and all three measures of disability, with more socially engaged older adults reporting less disability. Social engagement also showed small, but negative interaction effects with follow-up-time outcomes (p's < 0.01), indicating that the protective effect of social engagement decreased slightly during follow-up. Results suggest a strong, but not necessarily causal association of social engagement with disability. Promotion of social engagement may still be important for the prevention of disability.

[1]  D. Commenges,et al.  Social and Leisure Activities and Risk of Dementia: A Prospective Longitudinal Study , 1995, Journal of the American Geriatrics Society.

[2]  L. Branch,et al.  A prospective study of functional status among community elders. , 1984, American journal of public health.

[3]  M. Graney.  The Reciprocal Relationship Between Disability and Depression , 2000, Journal of the American Geriatrics Society.

[4]  G. DeFriese,et al.  The economic implications of self-care: the effect of lifestyle, functional adaptations, and medical self-care among a national sample of Medicare beneficiaries. , 2000, American journal of public health.

[5]  J. Schneider,et al.  Participation in cognitively stimulating activities and risk of incident Alzheimer disease. , 2002, JAMA.

[6]  Laura Fratiglioni,et al.  Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. , 2002, American journal of epidemiology.

[7]  N. Nagelkerke,et al.  Baseline and previous physical activity in relation to mortality in elderly men: the Zutphen Elderly Study. , 1999, American journal of epidemiology.

[8]  J. House,et al.  Volunteering and mortality among older adults: findings from a national sample. , 1999, The journals of gerontology. Series B, Psychological sciences and social sciences.

[9]  J P Mullooly,et al.  Social networks as predictors of ischemic heart disease, cancer, stroke and hypertension: incidence, survival and mortality. , 1992, Journal of clinical epidemiology.

[10]  Suzanne G. Leveille,et al.  Smoking, Physical Activity, and Active Life Expectancy , 1999 .

[11]  H. Wahl,et al.  The daily life of elderly Germans: activity patterns, personal control, and functional health. , 1990, Journal of gerontology.

[12]  K. Manton,et al.  Estimates of change in chronic disability and institutional incidence and prevalence rates in the U.S. elderly population from the 1982, 1984, and 1989 National Long Term Care Survey. , 1993, Journal of gerontology.

[13]  Andrew M. Pope,et al.  Disability in America: Toward a National Agenda for Prevention. Summary and Recommendations. , 1991 .

[14]  P. K. Adelmann.  Multiple Roles and Physical Health among Older Adults , 1994 .

[15]  L. Beckett,et al.  Functional disability among elderly blacks and whites in two diverse areas: the New Haven and North Carolina EPESE. Established Populations for the Epidemiologic Studies of the Elderly. , 1995, American journal of public health.

[16]  K. Yano,et al.  Effects of walking on mortality among nonsmoking retired men. , 1998, The New England journal of medicine.

[17]  T. Louis,et al.  Chronic conditions that lead to functional limitation in the elderly. , 1994, Journal of gerontology.

[18]  E B Fisher,et al.  Relationship of activity and social support to the functional health of older adults. , 2000, The journals of gerontology. Series B, Psychological sciences and social sciences.

[19]  L. Verbrugge,et al.  Short-term dynamics of disability and well-being. , 1994, Journal of health and social behavior.

[20]  K Y Liang,et al.  Longitudinal data analysis for discrete and continuous outcomes. , 1986, Biometrics.

[21]  J. Rowe,et al.  Successful aging. , 1998, Aging.

[22]  L. Berkman,et al.  Beyond single indicators of social networks: a LISREL analysis of social ties among the elderly. , 1997, Social science & medicine.

[23]  L. Beckett,et al.  Analysis of change in self-reported physical function among older persons in four population studies. , 1996, American journal of epidemiology.

[24]  D. Clark.  The effect of walking on lower body disability among older blacks and whites. , 1996, American journal of public health.

[25]  D. Blazer.  Social support and mortality in an elderly community population. , 1982, American journal of epidemiology.

[26]  J. Guralnik,et al.  Social network ties and mortality among the elderly in the Alameda County Study. , 1987, American journal of epidemiology.

[27]  H. Krumholz,et al.  Role of exercise stress testing and safety monitoring for older persons starting an exercise program. , 2000, JAMA.

[28]  A M Jette,et al.  The disablement process. , 1994, Social science & medicine.

[29]  S. Willis,et al.  Everyday cognitive competence in elderly persons: conceptual issues and empirical findings. , 1996, The Gerontologist.

[30]  J. Ormel,et al.  The impact of psychological attributes on changes in disability among low-functioning older persons. , 1999, The journals of gerontology. Series B, Psychological sciences and social sciences.

[31]  G. Fillenbaum,et al.  Comparison of Two Brief Tests of Organic Brain Impairment, the MSQ and the Short Portable MSQ , 1980, Journal of the American Geriatrics Society.

[32]  L. Beckett,et al.  Black-white differences in risk of becoming disabled and recovering from disability in old age: a longitudinal analysis of two EPESE populations. , 1997, American journal of epidemiology.

[33]  E. Simonsick,et al.  Risk due to inactivity in physically capable older adults. , 1993, American journal of public health.

[34]  M. Schroll,et al.  All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. , 2000, Archives of internal medicine.

[35]  P. Wolf,et al.  The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. , 1994, American journal of public health.

[36]  P. K. Adelmann,et al.  Multiple roles and psychological well-being in a national sample of older adults. , 1994, Journal of gerontology.

[37]  L. Fried,et al.  Disability in Older Adults: Evidence Regarding Significance, Etiology, and Risk , 1997, Journal of the American Geriatrics Society.

[38]  A. LaCroix,et al.  Intercommunity variations in the association between social ties and mortality in the elderly. A comparative analysis of three communities. , 1993, Annals of epidemiology.

[39]  J. Kohout,et al.  Established populations for epidemiologic studies of the elderly: Study design and methodology , 1993, Aging.

[40]  L. Berkman,et al.  Cognitive functioning and the incidence of limitations in activities of daily living in an elderly community sample. , 1995, American journal of epidemiology.

[41]  G A Colditz,et al.  A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA. , 1996, Journal of epidemiology and community health.

[42]  M. Silverstein,et al.  Does engagement with life enhance survival of elderly people in Sweden? The role of social and leisure activities. , 2001, The journals of gerontology. Series B, Psychological sciences and social sciences.

[43]  L. Berkman,et al.  Social Disengagement and Incident Cognitive Decline in Community-Dwelling Elderly Persons , 1999, Annals of Internal Medicine.

[44]  B. Winblad,et al.  Influence of social network on occurrence of dementia: a community-based longitudinal study , 2000, The Lancet.

[45]  T. Seeman,et al.  Self-efficacy beliefs and perceived declines in functional ability: MacArthur studies of successful aging. , 1999, The journals of gerontology. Series B, Psychological sciences and social sciences.

[46]  S. Z. Nagi.  An epidemiology of disability among adults in the United States. , 1976, The Milbank Memorial Fund quarterly. Health and society.

[47]  E. Pfeiffer.  A Short Portable Mental Status Questionnaire for the Assessment of Organic Brain Deficit in Elderly Patients † , 1975, Journal of the American Geriatrics Society.

[48]  J. House,et al.  Social relationships and health. , 1988, Science.

[49]  D. Gold,et al.  Disability as a Function of Social Networks and Support in Elderly African Americans and Whites. , 2001, The journals of gerontology. Series B, Psychological sciences and social sciences.

[50]  W. Spector,et al.  Combining activities of daily living with instrumental activities of daily living to measure functional disability. , 1998, The journals of gerontology. Series B, Psychological sciences and social sciences.

[51]  R. L. Kane,et al.  Developing a New Metric for ADLs , 1995, Journal of the American Geriatrics Society.

[52]  I. Rosow,et al.  A Guttman health scale for the aged. , 1966, Journal of gerontology.

[53]  H. Cohen,et al.  Does religious attendance prolong survival? A six-year follow-up study of 3,968 older adults. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[54]  H. Agüero-Torres,et al.  Dementia is the major cause of functional dependence in the elderly: 3-year follow-up data from a population-based study. , 1998, American journal of public health.

[55]  L. Beckett,et al.  Social networks and disability transitions across eight intervals of yearly data in the New Haven EPESE. , 1999, The journals of gerontology. Series B, Psychological sciences and social sciences.

[56]  D M Buchner,et al.  Exercise: effects on physical functional performance in independent older adults. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[57]  S. Johansson,et al.  Attendance at cultural events, reading books or periodicals, and making music or singing in a choir as determinants for survival: Swedish interview survey of living conditions , 1996, BMJ.

[58]  L. Wilhelmsen,et al.  PROSPECTIVE STUDY OF SOCIAL INFLUENCES ON MORTALITY The Study of Men Born in 1913 and 1923 , 1985, The Lancet.

[59]  M. Diehl,et al.  Everyday competence in later life: current status and future directions. , 1998, The Gerontologist.

[60]  S. Kasl,et al.  Religion among disabled and nondisabled persons II: attendance at religious services as a predictor of the course of disability. , 1997, The journals of gerontology. Series B, Psychological sciences and social sciences.

[61]  J. Rowe.  The New Gerontology , 1997, Science.

[62]  E D Richardson,et al.  Impairments in physical performance and cognitive status as predisposing factors for functional dependence among nondisabled older persons. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.