Close social ties and health in later life: Strengths and vulnerabilities

Patterns of stress and support in social support networks of in-home hospice cancer family caregivers

Family caregivers of home hospice cancer patients often experience burden and distress, which can be mitigated by perceived social support. However, less attention has been paid to the non-family sources of support within social networks, or to how sources of support may also be sources of stress. We describe support and stress in social networks of hospice family caregivers and identify caregiving characteristics associated with classes identified in our data. We collected demographic and psychosocial self-report data from family caregivers providing in-home hospice care for advanced cancer patients (N = 90). Caregivers also reported perceived support and stress from specific family and non-family relationships. We identified three classes with unique patterns of stress and support within caregivers' support networks using a latent class analysis. Classes include: 1) high support, low stress across family and non-family network members ("supportive"; 53% of caregivers); 2) high support, high stress across family and non-family network ("ambivalent maximizers"; 26%); and 3) high support, high stress across family network only ("family-focused ambivalent"; 21%). Caregivers in the ambivalent maximizer class reported more burden than caregivers in the supportive class (p = .024). This is one of the first studies to systematically explore the role of non-family support, as well as how stress and support co-occur within relationships and across networks. As informal support networks of hospice family caregivers are complex and multifaceted, understanding the patterns of support and stress across various network members is essential to offer services to more effectively manage caregiver burden.

Active With Whom? Examining the Social Context of Physical Activity in Individuals After Stroke and Their Partners

Engaging in regular moderate-to-vigorous intensity physical activity (MVPA) is crucial to reduce future health risk for individuals living with the effects of a stroke and their partners. Although numerous studies point to the importance of social factors in physical activity engagement, little is known about with whom individuals after stroke and their partners engage in physical activity with and whether different physical activity companions are uniquely associated with MVPA. Eighty-nine community-dwelling individuals after stroke (M_age = 68.64, SD = 10.44; 74% male) and 83 partners (M_age = 66.04, SD = 9.91; 24% male) completed 14 consecutive days of daily life assessments that included wearing physical activity monitors (accelerometers) and self-reporting physical activity companions (n = 1,961 days). Results show that average levels of MVPA were correlated between partners (r = 0.38), as were day-to-day MVPA fluctuations (r = 0.34). Importantly, for individuals after stroke, being active with their partner, but not with any other physical activity companion, was linked with elevated daily MVPA. In contrast, for partners of individuals after stroke, engaging in physical activity with a variety of different companions (partner, other family member, friend, colleague) was each associated with higher MVPA in daily life. For both individuals after stroke and their partners being active by oneself (without a companion) on a given day was not associated with elevated MVPA. Findings suggest that interventions that promote physical activity engagement should consider the role of meaningful others, with the partner being particularly key for individuals living with chronic health conditions.

Decoupling of Elderly Healthcare Demand and Expenditure in China

This study examined the changing trajectory and factors that influenced the health and medical expenditure of the Chinese elderly population over the past two decades. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018, inferential and multiple linear regression models were constructed. The key finding is that China has experienced a decoupling of healthcare demand (HCD) and healthcare expenditure (HCE) since around 2014, when HCE began to decline despite the fact that HCD continued to rise. This is a promising sign, suggesting that the government's health insurance policy is working. Furthermore, participating in health insurance schemes can significantly reduce the elderly's HCD and HCE, demonstrating that health insurance can effectively affect the elderly's decision to seek medical treatment and improve their health condition. We also found that age, region, basic old-age insurance, and care by the government and institutions were significant factors that influenced the healthcare demand and expenditure of the elderly population.

Psychological and Social Factors Associated with Coexisting Frailty and Cognitive Impairment: A Systematic Review

Those living with coexistent frailty and cognitive impairment are at risk of poorer health outcomes. Research often focuses on identifying biological factors. This review sought to identify the association psychological and social factors have with coexisting physical and cognitive decline. Six databases were systematically searched in July 2020. Studies included individuals aged 60 years or older identified as being both frail and cognitively impaired. A narrative synthesis examined patterns within the data. Nine studies were included, most employed a cross-sectional design. Depression was investigated by all nine studies, those with coexistent frailty and cognitive impairment had higher levels of depressive symptoms than peers. Findings were mixed on social factors, although broadly indicate lower education, living alone and lower material wealth were more frequent in those living with coexistent decline. Further research is needed to explore potentially modifiable psychological and social factors which could lead to the development of supportive interventions.

Qualities of social relationships as mediators of the relationship between future perceptions and health

OBJECTIVES

Foreshortened future perceptions relate to higher mental and physical morbidity. However, socioemotional selectivity theory (SST) maintains that psychological well-being improves as future perceptions narrow due to growing tendency to prioritize meaningful goals and close relationships. The objective of this study was to reconcile this contradiction by examining a model in which the focus on close relationships suppresses the direct relationship between narrow future perceptions and physical/mental morbidity.

METHOD

Community-dwelling older adults (N = 249, mean age = 75.60, SD = 7.54) recruited through social clubs and day centers were interviewed at home. They filled self-report questionnaires measuring future time perspective, subjective nearness to death, positivity of relationships with others and inclusion of others in the self, while rating several physical/mental health indices. A structural equation modeling analysis tested direct and indirect effects.

RESULTS

Narrow future perceptions related to higher mental (|β| ranged .28 to .47, p < .001) and physical morbidity (|β| ranged .37 to .45, p < .001) and, surprisingly, also to lower positivity of close relationships (|β| ranged .24 to .31, p < .01) and less inclusion of others (|β| ranged .17 to .21, p < .01). Both social indices mediated the relationship with lower physical health, while positivity of close relationships also mediated the relationship with psychological distress.

CONCLUSION

The findings challenge SST assumptions by underscoring the negative effects of narrow future perceptions on social relationship, making the latter a mediator rather than suppressor in the link between future perceptions and physical/mental morbidity. The findings should be viewed in light of the study's limitations, including convenience sampling and cross-sectional design.

Friendships in Old Age: Daily Encounters and Emotional Well-Being

OBJECTIVES

Having friends in old age is linked to higher levels of happiness and life satisfaction. Yet, we know little about older adults' emotional experiences when they encounter friends throughout the day. This study examined whether older adults reported (a) more pleasantness, (b) fewer conversations about stressful experiences, and (c) better mood when they had contact with friends compared to when they had contact with other social partners or were alone throughout the day. We also examined whether these experiences varied by the friendship closeness.

METHOD

Adults aged 65+ (n = 313) from the Daily Experiences and Well-being Study provided background information and listed and described their close social partners. Participants then completed ecological momentary assessment (EMA) surveys every 3 hr for 5 to 6 days where they reported their encounters with social partners, rated the pleasantness and indicated whether they discussed stressful issues during these encounters, and rated positive and negative mood.

RESULTS

Multilevel models revealed that encounters with friends were more pleasant and were associated with fewer discussions about stressful experiences compared to encounters with romantic partners or family members throughout the day. Encounters with friends were also associated with better mood, though this link only held for encounters with friends who were not considered close.

DISCUSSION

Findings are discussed in terms of functionalist theory, socioemotional selectivity theory, relationship ambivalence, and the benefits of less close ties. This work facilitates the understanding of how daily contact with friends can promote older adults' emotional well-being.

Strength of social ties and perceived tangible support: distinct characteristics and gender differences of older adults' social circles

Social connections have been found to promote wellbeing among older adults. Studies note gender differences in older adults' social network characteristics and aspects of social support. The present study examined gender differences in the association of social network characteristics (number of strong social ties) and perceived tangible support among a sample of elders (n = 278). Older men reported higher levels of perceived tangible support, while older women had more strong social ties. The number of strong social ties was associated with older women's, but not men's, increased sense of tangible support. Implications for cultivating elders' wellbeing respective of gender particularities are discussed.

Changes in family composition and their effects on social capital in old age: evidence from a longitudinal study conducted in Switzerland

Previous studies have shown that family networks evolve over time. Nonetheless, little research has linked family expansion or shrinking to the levels of available family-based social capital in older adults’ family networks. To address this research gap, this paper explores the following question: to what extent are changes in family composition and family-related life events associated with current levels of family-based social capital in later years? We use the two waves of the longitudinal CIGEV-LIVES Vivre-Leben-Vivere study, a large survey addressing the family and health conditions of older people in Switzerland. We combine data on life events occurring during old age and family configurations. We find that family networks are indeed highly dynamic, with distinct patterns of losses and gains observed among respondents. Adding and omitting significant family members has distinct significant effects on social capital, while family-related life events only have marginal effects.

The Relationship Between Loneliness and Psychological Adjustment: Validation of the Italian Version of the Interpersonal Acceptance-Rejection Loneliness Scale

In recent literature, many researchers have highlighted that the feeling of loneliness can be considered a sign of relevant distress with short- and long-term consequences on the health of people who needs to be appropriately monitored and treated. In this view, the Interpersonal Acceptance-Rejection Loneliness Scale (IPARLS) has been developed to evaluate the subjective feelings and distress related to interpersonal loneliness and to overcome the limits of the previous scales; however, its psychometric characteristics have not yet been fully investigated. Starting from these considerations, two studies have been conducted. The first study, involving 688 adults (19-69 years; 51% females), assessed dimensionality, reliability, and validity of and tested the measurement invariance (MI) of the Italian version of the IPARLS. The second study, involving 205 adults (20-69 years; 51% females), investigated the relationship between loneliness and psychological adjustment. Results confirmed the unidimensionality of the scale and showed that it is reliable, valid, and fully invariant as a function of age and gender. Moreover, data showed a strong association between perceived loneliness and psychological adjustment. The IPARLS is confirmed to be a valid and reliable measure to investigate loneliness in the life cycle from clinical and research perspectives.

Leveraging Daily Social Experiences to Motivate Healthy Aging

Models of healthy aging highlight the motivating influence of social connections. Social experiences constantly shape our thoughts and behaviors throughout daily life, and these daily processes slowly and consistently influence our health and well-being. In this paper, we discuss research that has moved from cross-sectional laboratory designs emphasizing individual behaviors to more naturalistic within-person paradigms linking daily social experiences to emotional, cognitive, and physical well-being. We mention research gaps that need to be filled to advance our knowledge of the powerful forces of the social environment for motivating healthy aging. We also offer future directions to move this research forward. We conclude with an outlook on how to leverage these powerful forces in novel intervention approaches that are sensitive to the constantly changing nature of the person and the environment.

Emotion Recognition and Reactivity in Persons With Neurodegenerative Disease Are Differentially Associated With Caregiver Health

BACKGROUND AND OBJECTIVES

Motivated by the high rates of health problems found among caregivers of persons with neurodegenerative disease, we examined associations between deficits in two aspects of care recipients' socioemotional functioning and their caregivers' health.

RESEARCH DESIGN AND METHODS

In 2 studies with independent samples (N = 171 and 73 dyads), caregivers reported on care recipients' emotion recognition and emotional reactivity. Caregiver health was assessed using both self-report measures (Studies 1 and 2) and autonomic nervous system indices (Study 2).

RESULTS

Lower emotion recognition in care recipients was linearly associated with worse self-reported health, faster resting heart rate, and greater physiological reactivity to an acoustic startle stimulus in caregivers. These effects held after accounting for a variety of risk factors for poor caregiver health, including care recipients' neuropsychiatric symptoms. Emotional reactivity showed a quadratic association with health, such that the lowest and highest levels of emotional reactivity in care recipients were associated with lower self-reported health in caregivers.

DISCUSSION AND IMPLICATIONS

Results shed light on the unique associations between two aspects of care recipients' emotional functioning and caregivers' health. Findings suggest potential ways to identify and help caregivers at heightened risk for adverse health outcomes.

Age Differences in Stress, Life Changes, and Social Ties During the COVID-19 Pandemic: Implications for Psychological Well-Being

BACKGROUND AND OBJECTIVES

Experiences of the coronavirus disease 2019 (COVID-19) pandemic and its implications for psychological well-being may vary widely across the adult life span. The present study examined age differences in pandemic-related stress and social ties, and links with psychological well-being.

RESEARCH DESIGN AND METHODS

Participants included 645 adults (43% women) aged 18-97 (M = 50.8; SD = 17.7) from the May 2020 nationally representative Survey of Consumers. Participants reported the extent to which they felt stress related to the pandemic in the last month, the extent to which their lives had changed due to the pandemic, as well as social isolation, negative relationship quality, positive relationship quality, and frequency of depression, anxiety, and rumination in the past week.

RESULTS

Results showed that older people reported less pandemic-related stress, less life change, less social isolation, and lower negative relationship quality than younger people. Greater pandemic-related stress, life change, social isolation, and negative relationship quality were associated with poorer psychological well-being. Poorer social ties (i.e., greater social isolation and negative quality) exacerbated the effects of the COVID-19 pandemic (stress, life change) on psychological well-being.

DISCUSSION AND IMPLICATIONS

Researchers have indicated that older adults may be more vulnerable to COVID-19 pandemic-related stress and social isolation, but this study indicates that young adults may be relatively more vulnerable. Because isolation and negative relationship quality appear to exacerbate the deleterious effects of the COVID-19 pandemic on psychological well-being, reducing social isolation and negative relations are potential targets for intervention.

The Strength of Weaker Ties: An Underexplored Resource for Maintaining Emotional Well-Being in Later Life

Objectives

The purpose of this study was to examine dynamic links between changes in social ties and changes in emotional well-being.

Method

Trivariate dual-change score models were used to test whether a large number of close ties would be more strongly associated with low levels of depressed affect than a large number of weaker ties, and a large number of weaker ties would be more strongly associated with high levels of positive affect compared to a large number of close ties, across three waves of a large, regionally representative sample of U.S. adults aged 40 and older (N = 802).

Results

We found that a greater number of weaker ties was associated with having more close ties over time, and that the number of weaker ties was more strongly predictive of positive age-related changes in both aspects of well-being (i.e., more positive affect and less depressed affect) than the number of close ties.

Discussion

Contrary to popular theoretical orientations in gerontology, weaker ties may offer older adults a more effective avenue for promoting emotional well-being over time than close ties, and may have the additional benefit of compensating for losses in the number of close ties.

Empathy and Close Social Ties in Late Life

OBJECTIVES

Older adults with stronger social ties often lead longer, healthier, and happier lives, but these ties may differ based on older adults' ability to share and understand others' emotions (i.e., empathy). This study asked how empathy was associated with the way that older adults construct and engage in their social worlds.

METHOD

We drew on the Daily Experiences and Well-being Study to examine how older adults' empathy was associated with the structure (e.g., network size and contact), function (e.g., support), and quality (e.g., affection and conflict) of their close social ties. Participants (N = 333) self-rated empathy and listed their social partners using three concentric convoy circles.

RESULTS

Empathy was not associated with older adults' social network structure, but more empathic older adults exchanged support with more social partners and reported greater affection for their social partners. We did not observe a significant link between older adults' empathy and conflict with social partners.

DISCUSSION

Examining empathy advances our understanding of individual differences in older adults' close social ties. This study suggests that empathy may play a promising role with regard to promoting older adults' social experiences and strengthening their close ties.

Age-related change in self-perceptions of aging: Longitudinal trajectories and predictors of change

Using data from the German Ageing Survey (Deutscher Alterssurvey, DEAS; N = 4,712), this study examined age-related change in three dimensions of self-perceptions of aging (SPA): perceptions of physical losses, social losses, and ongoing development. Participants ranged in age from 40 to 85 years at study entry (1996, 2002, or 2008) and were followed for up to 21 years. Time-invariant, context-specific and time-varying, person-specific predictors of the observed age-related changes were examined. Findings from longitudinal multilevel regression analyses showed significant nonlinear age-related change for all three dimensions. Specifically, starting at about age 65, participants showed age-related increases in perceptions of physical and social losses, with increases getting steeper in old age. Starting at about age 55, participants reported increasingly fewer perceptions related to ongoing development. The decline in perceptions of ongoing development also became increasingly steeper after age 70. Region of residence was a significant context-specific predictor of the intercepts of the three SPA dimensions. Health-related variables (i.e., number of chronic diseases, self-rated health), affective well-being (i.e., positive and negative affect), and measures of social integration (i.e., loneliness) were significant person-specific predictors. Health-related variables had their strongest association with perceptions of physical losses, whereas negative affect and loneliness had their strongest association with perceptions of social losses. Positive affect had its strongest association with perceptions of ongoing development. This study is the first one to describe age-related change trajectories in multiple dimensions of SPA and significant predictors of these change trajectories. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Functional Limitations, Social Integration, and Daily Activities in Late Life

OBJECTIVES

Disability in late life has been associated with increases in receiving care and loss of autonomy. The Disablement Process Model suggests that physical impairments lead to functional limitations that contribute to disabilities in managing household, job or other demands. Yet, we know surprisingly little about how functional limitations are related to activities throughout the day among community-dwelling adults, or the possible moderating role of social integration on these associations.

METHODS

Community-dwelling adults (N = 313) aged 65+ completed a baseline interview assessing their functional limitations, social ties, and background characteristics. Over 5 to 6 days, they answered questions about daily activities and encounters with social partners every 3 hours on handheld Android devices.

RESULTS

Multilevel logistic models revealed that functional limitations are associated with increased likelihood of activities associated with poor health (e.g., TV watching, medical appointments), and reduced likelihood of social activities, or physical activities, chores, or leaving the home. Most moderation analyses were not significant; family and friends did not mitigate associations between functional limitations and daily activities, with the exception of medical appointments. Individuals with functional limitations were more likely to attend medical appointments when with their social partners than when alone.

DISCUSSION

This study provided modest indication that functional limitations in community-dwelling older adults are associated with patterns of activity that may lead to further limitations, disability or loss of autonomy. Findings warrant longitudinal follow-up to establish subsequent patterns of decline or stability.

Loving Others: The Impact of Compassionate Love on Later-Life Psychological Well-being

OBJECTIVES

Existing scholarship in social gerontology has paid relatively little attention to broader loving emotions, such as compassionate and altruistic love, as potentially meaningful mechanisms for improving later-life psychological well-being outside a family framework.

METHOD

Drawing from a 3-wave longitudinal survey of community-dwelling older residents (n = 334) of Miami, Florida, we utilized generalized estimating equation models to examine the influence of changes in compassionate love (i.e., feeling love toward other persons and experiencing love from others) on depressive symptoms over time. We also explored cross-sectional relationship between compassionate love and positive and negative affects.

RESULTS

An increase in the feeling of being loved (β = -0.77, p < .001) and feeling love for others (β = -0.78, p < .001) led to a decline in odds of reporting greater levels of depressive symptoms over time. The odds of reporting higher level of positive affect were significantly greater for older adults who reported feeling loved by others (β = .63, p < .001) and expressed love for other people (β = 0.43, p < .05). Older adults who felt loved and expressed love for other people, respectively, had 0.71 and 0.54-point lower ordered log odds of reporting higher negative affect than those who reported lower levels of love. The statistically significant impact of feeling loved on all well-being outcomes was maintained even after adjustment for altruistic attitudes and emotional support. Except for depressive symptoms, such adjustments explained the positive influence of love for others on well-being outcomes.

DISCUSSION

Our findings underscore the powerful influence of both receiving and giving loving emotions for the maintenance of later-life psychological well-being.

Exploring cause of death as a factor in social convoy membership: the case of Pauline

Research integrating social convoy and continuing bonds frameworks suggests that deceased individuals can be included in convoys as connections may carry on after death. Building on this, we present a qualitative case study that explores whether such relationships are influenced by the way people die. Pauline, 67, compares the "natural" deaths of relatives to her husband's suicide. Analysis of Pauline's interview revealed that the unexplained death of her husband impacted her identity and contributed to his continued existence within her convoy. Consequently, the cause of death may be an important consideration for researchers integrating the social convoy and continuing bonds frameworks.

Friends, family, and romantic partners: Three critical relationships in older women's lives

How are different social relationships jointly and uniquely associated with older women's health and well-being, and what is the directionality of these associations? We address these questions using longitudinal data from the Midlife in the United States study. We find that relationship quality with romantic partners, family, and friends is positively linked with better health and well-being concurrently and longitudinally. Cross-lagged analyses indicate that romantic relationships are more predictive of than predicted by health and well-being, family relationships are more predicted by than predictive of health and well-being, and friendships are both predicted by and predictive of health and well-being.

For better and worse? The roles of closeness, marital behavior, and age in spouses' cardiometabolic similarity

Spouses share common risks for cardiometabolic diseases: a person's diabetes or hypertension raises the partner's odds of developing the same condition. The mechanisms responsible for this disease concordance remain poorly understood. To examine three factors that may modulate partners' cardiometabolic similarity-closeness, hostile marital behavior, and age-and to explore whether health behavior concordance plays a role, on two separate occasions 43 healthy couples ages 24-61 provided fasting glucose, metabolic data (fat and carbohydrate oxidation), and resting blood pressure before discussing one of their most severe marital disagreements. Accounting for the fixed effects of sex, age, study visit, and abdominal fat on cardiometabolic levels, we found that aspects of health behavior concordance were associated with greater similarity in glucose, diastolic blood pressure (DBP), and carbohydrate and fat metabolism. Independent of health behavior concordance, partners who felt closer and behaved in a less hostile way had more similar rates of fat oxidation; less hostile partners also shared greater overlap in carbohydrate oxidation. Likewise, fasting glucose and DBP were more similar within older couples compared to younger pairs, beyond the effects of health behavior concordance. In sum, our data captured preclinical similarities in cardiometabolic health among disease-free couples, which may form the basis for their long-term overlapping disease risks. Closer, less hostile, and older couples shared more similar fasting glucose, metabolic data, and blood pressure; importantly, health behavior concordance did not explain all associations. These novel data suggest that multiple paths may lead to couples' shared disease risks.

Variety Is the Spice of Late Life: Social Integration and Daily Activity

OBJECTIVES

Social integration (involvement with a diverse array of social ties) has been linked to positive outcomes including better physical health. Research has not investigated whether encounters with diverse social ties enhance individuals' daily behaviors. The objectives of this study were to assess whether social ties connect individuals to more diverse daily behaviors, physical activity, and nonsedentary time as well as more positive mood.

METHOD

Older adults (aged 65+, n = 313) provided information about their 10 closest social ties. Then they completed ecological momentary assessment (EMA) surveys every 3 hr for 5-6 days where they reported on social encounters and behaviors. They also wore Actical accelerometers to objectively measure physical activity.

RESULTS

Multilevel models revealed that encounters with a greater variety of social ties was associated with engaging in a greater variety of behaviors, more objectively measured physical activity, and a smaller proportion of time spent sedentary. Encounters with weak ties/peripheral social ties accounted for this increased activity (compared to being alone or with close friends or family). Moreover, involvement with diverse ties or diverse behaviors was associated with better mood.

DISCUSSION

Findings are discussed in terms of social engagement theory, network diversity, and the benefits of weak ties.

Emotions, relationships, health and illness into old age

There is strong evidence linking relationships and emotions to physical health outcomes. What is critically missing is a more comprehensive understanding of how these important psychosocial factors influence disease over the lifespan. In this narrative review, existing lifespan models of social support and emotion regulation are reviewed and integrated into a general conceptual framework in the health domain. This integrated model takes into account bidirectional links between relationships and emotions, as well as health behaviors, biological pathways, and health. Evidence is consistent with the utility of an integrative model attempting to understand its links to health-relevant pathways and outcomes in older adults. Future work that examines multiple pathways using prospective designs will be necessary for this work to reach its full potential, including intervention and policy opportunities.

"They're in My Heart, Mind, and Cells": What Continuing Bonds Reveal About Social Networks

BACKGROUND AND OBJECTIVES

Research suggests that robust social networks have positive effects on peoples' well-being. An instrumental methodology for studying networks is the social convoy model, a diagram of concentric circles that illustrate network size, structure, and satisfaction. Convoys have been described as dynamic. Specifically, as people age, their convoys become stronger and smaller due to focusing on what matters most and accumulating losses. Therefore, convoys only include meaningful, living persons. The continuing bonds model posits that it is normal for people to maintain connections with the deceased. The objective of the current study was to integrate the social convoy and continuing bonds models in order to examine the presence of deceased loved ones in convoys.

RESEARCH DESIGN AND METHODS

Eighteen individuals (M = 66 years), recruited via fliers and snowball sampling, participated in one semistructured interview regarding the death of a loved one and their convoy. Participants also completed a convoy model, identifying where the deceased fit (if anywhere) when they were alive and at present. Interviews were transcribed, coded, and analyzed for themes.

RESULTS

Three themes emerged: communication (i.e., writing or speaking to the deceased), continuity (i.e., a continuing relationship), and reciprocity (i.e., perceived exchange of support(s)). Eighty-nine percent of participants felt their loved one's death did not change their convoy presence and 88% reported that their positioning in the convoy remained unchanged.

DISCUSSION AND IMPLICATIONS

This research offers a new way to think about convoys and may prompt the development of supportive interventions for bereaved individuals.

Social support as a protective factor against the effect of grief reactions on depression for bereaved single older adults

This study tested the main effect model and the stress-buffering model of the mechanisms by which social support affects bereaved single older adults' depression. Data from the National Social Life, Health, and Aging Project (Wave 2; N = 621) were used to test a latent moderated structural equation model that explores the interaction between grief reactions and social support on bereaved single older adults' depression in the US. The findings provide evidence for the stress-buffering model (i.e., the relationship between grief reactions and depression, which was strongly positive when social support was low, turned negative when social support was high).

Better Off Alone: Daily Solitude Is Associated With Lower Negative Affect in More Conflictual Social Networks

BACKGROUND AND OBJECTIVES

Older adults are often considered at risk for social isolation. Little is known, however, about how often older adults lack social contact (in person, phone, electronic) throughout the day, the implications of lacking contact (i.e., solitude), and whether the effects of solitude vary by the broader social context.

RESEARCH DESIGN AND METHODS

Participants were from the Daily Experiences and Well-being Study (DEWS) which included 313 older adults (aged 65+) who completed baseline interviews followed by 5-6 days of ecological momentary assessments approximately every 3 hr.

RESULTS

Individuals reported having no social contact (i.e., solitude) on 11% of the occasions. Solitude predicted lower negative and positive affect on those occasions. The solitude-negative affect link varied by social network quality. Solitude predicted lower negative affect among individuals with more conflictual social networks but not among those with less conflictual networks.

DISCUSSION AND IMPLICATIONS

Overall, solitude may serve as an adaptive strategy for individuals embedded in demanding or irritating social contexts.

Cultural Dimensions of Diabetes Management: a Qualitative Study of Middle Eastern Immigrants in the U.S

This study examined how aspects of culture, social support, isolation, and loneliness are perceived as influences in chronic illness management by pre-diabetic (Glycated hemoglobin A_1c levels between 5.7 and 6.4) or Type 2 diabetic patients (A_1c levels between 6.4 and 8). Twenty-eight Middle Eastern immigrants in the greater Philadelphia area were interviewed using a semi-structured approach. Results were consistent with other research which suggests that patients benefit from family and community support in the management of their illness. However, findings also suggest that even in the presence of strong family and social support, patients report increased feelings of isolation and loneliness because they have to manage a complex illness that requires many lifestyle changes. For immigrant suffering from chronic illnesses, social gatherings, especially those that center on the consumption of traditional ethnic food, can be highly stressful because they need to avoid such foods as part of their daily treatment regimen. The results of this study have significant implications for patients, physicians, and psychologists who can benefit from an increased sensitivity to patients' challenges in illness management by understanding how cultural factors affect compliance in diabetes treatment regimens.

Interpersonal Tensions and Pain Among Older Adults: The Mediating Role of Negative Mood

OBJECTIVES

To examine whether (a) negative social encounters and physical pain are linked throughout the day, (b) negative mood mediates these associations, and (c) these associations vary by closeness with social partners.

METHOD

Adults aged 65+ (n = 313) completed ecological momentary assessments and reported their negative social encounters, physical pain, and mood every 3 hr throughout the day for 5-6 days.

RESULTS

Multilevel models revealed that negative social encounters were associated with greater pain at each 3-hr interval and that this association was mediated by negative mood during the same interval. Negative encounters with less close partners were associated with pain, but negative encounters with close partners were not.

DISCUSSION

Regulating older adults' negative emotions may be crucial to improving their daily pain. Further, interventions focusing on negative encounters with less close partners in daily life may help mitigate older adults' experiences of pain throughout the day.

Family versus intimate partners: Estimating who matters more for health in a 20-year longitudinal study

This study tested the extent to which the emotional climate (positive and negative relationship quality) in family relationships and intimate partnerships are each uniquely linked to specific domains of aging health outcomes, over and above the impact of earlier health. Data included partnered participants who completed all three waves of the Midlife Development in the United States (MIDUS). We used measures of family and intimate partner strain and support, at MIDUS 1, 2, and 3, and estimated the effects of each on subsequent morbidity and health appraisal (i.e., 10 and 20 years later). Autoregressive cross-lagged paths were modeled using maximum likelihood estimation with robust standard errors. Family strain was associated with later health in both the morbidity, χ²(35) = 411.01, p < .001; root mean square error of approximation (RMSEA) = .062, comparative fit index (CFI) = .952; standardized root-mean-square residual (SRMR) = .034 and health appraisal, χ²(35) = 376.80, p < .001; RMSEA = .058, CFI = .956; SRMR = .032 models. Morbidity and health appraisal also predicted later family emotional climate, reciprocally. Intimate partner emotional climate-health pathways were nonsignificant at each wave, in both models. Results are novel and may be the first to indicate the quality of family relationships are a more powerful predictor of aging health than the quality of intimate partnerships. Findings implicate the health of adults should be considered in the systemic context of families. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Convoys of social relations: Cohort similarities and differences over 25 years

Longer life expectancies and declining fertility rates suggest changes in connectedness among older adults. This study examines cohort patterns in the links between age and social relations by testing the Convoy Model of Social Relations among 2 adult cohorts in 1980 and 2005. We hypothesize that despite societal changes, connectedness remains fundamental in later life. The data are drawn from a regionally representative sample (N = 543) aged 50 to 100 collected in 2005 and a nationally representative sample (N = 718) aged 50 to 95 collected in 1980. We use multilevel-modeling to update the preliminary examination of how network characteristics vary by age and emotional closeness (Antonucci & Akiyama, 1987) with data collected 25 years later. Findings indicate that network size, gender composition, and years known were similar in both cohorts. Changes are also evident. In 2005, network members were older, had more frequent contact, and lived closer to their network members than in 1980. There was 1 cohort difference in network composition, the proportion of other family was smaller in 2005 compared with 1980. Finally, cohorts differed in the effects of age (e.g., on contact frequency), closeness (e.g., on network size), and Age × Closeness interactions (e.g., on sibling composition). In sum, overall patterns of network structure and composition are largely similar in the 2 cohorts. The effects of age and emotional closeness were largely consistent over 25 years. Although caution is warranted, these findings provide continued support for the importance of close relations in later life across historical periods. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Loneliness Following Widowhood: The Role of the Military and Social Support

Objectives

Increased loneliness is a common consequence of widowhood in later life. However, individuals with high levels of perceived social support from friends tend to cope more effectively following major social losses like widowhood. Military service is associated with cultivation of strong social support structures. This effect may not only influence those who serve, but also their spouses. Roughly half of older women today are married to veterans, which could shape how they cope with widowhood. We tested two hypotheses: (a) widows of veterans will be less lonely following widowhood compared to their nonveteran counterparts, and (b) this effect will be explained by perceived social support from friends.

Methods

We used the Health and Retirement Study (HRS) to examine changes in loneliness following widowhood among wives of veterans and nonveterans. We used Ordinary Least Squares regression and mediation tests to address our hypotheses.

Results

Net of baseline differences, widows of veterans reported statistically lower levels of loneliness (p &lt; .05) following widowhood compared to widows of nonveterans. Widows of veterans retained the same level of perceived social support from friends pre- and postwidowhood, whereas nonveteran wives experienced a loss. Perceived social support from friends mediated the association between veteran status of the deceased spouse and loneliness.

Discussion

Our findings suggest wives of veterans may have more resilient social support structures than nonveteran spouses, helping them cope at widowhood. Future research should explore whether these effects persist in association with other major stressful events in later life.

Personal networks and associations with psychological distress among young and older adults

OBJECTIVE

The aim of the study was to provide new tests of the argument that aspects of personal networks affect psychological distress and moderate the effects of negative life events, leveraging new, rich data on two different cohorts.

METHOD

The UCNets project measured psychological distress, life events, and various dimensions of personal networks for 673 50- to 70-year old adults and 485 21- to 30-year old adults. The project used stratified random address based sampling for all the older adults. Such sampling, supplemented with Facebook advertisement and referral sampling, yielded the young adult sample. Networks were measured using several name-eliciting questions and several name descriptors.

RESULTS

The findings differed for younger versus older adults. Among young adults, personal network characteristics were not directly associated with, nor did they moderate the effect of negative life events on psychological distress. Unlike younger adults, the presence of supportive network ties, including social companions and emergency helpers, were directly associated with lower distress among older adults, while difficult and demanding ties as well as advisors were directly associated with higher distress. There was limited evidence of buffering among older adults, albeit through the presence of difficult and demanding ties.

CONCLUSIONS

In the current sample, network exchange roles (i.e., specific types of network support and burden) were associated with psychological distress among older adults while other characteristics of the network, including size, multiplexity, and social participation were not. Further, network support may be best positioned to have direct, as opposed to buffering, effects on psychological well-being.

Social Ambivalence and Disease (SAD): A Theoretical Model Aimed at Understanding the Health Implications of Ambivalent Relationships

The protective influence of social relationships on health is widely documented; however, not all relationships are positive, and negative aspects of relationships may be detrimental. Much less is known about the relationships characterized by both positivity and negativity (i.e., ambivalence). This article provides a theoretical framework for considering the influence of ambivalent relationships on physical health, including reasons why ambivalence should be considered separately from relationships characterized as primarily positive (supportive) or primarily negative (aversive). We introduce the social ambivalence and disease (SAD) model as a guide to understanding the social psychological antecedents, processes, and consequences of ambivalent relationships. We conclude by highlighting gaps in the literature and features of the SAD model that may serve as a guide to future research on potential health-relevant pathways of ambivalent relationships.

Emotion, Social Relationships, and Physical Health: Concepts, Methods, and Evidence for an Integrative Perspective

Emotional characteristics and processes are robust predictors of the development and course of major medical illnesses and premature mortality, as are a variety of indicators of the presence and quality of personal relationships. Despite clear evidence of close interconnection between these two domains of risk and protection, affective characteristics and relationships have largely been studied separately as influences on health. After a recent conference on integrative perspectives on emotions, relationships and health co-sponsored by the American Psychosomatic Society and the Society for Affective Science, the present review builds on prior calls for integration, related theory, and current research to outline what is known about the interconnection of these domains as it specifically relates to their overlapping influences on health. Areas of interest include the following: their interconnected roles over the course of development, which may inform current efforts to understand the influence of early life events on adult health; the parallel positive and negative factors in both domains that could have distinct influences on health; the role of emotion regulation in relationship contexts; and measurement, design, and analysis approaches to capture the dyadic and dynamic aspects of these interconnected influences on health. We conclude with a discussion of an emerging research agenda that includes the following: common biological foundations of affective and relationship processes, the cultural embeddedness of affective and relationship processes, the potential contribution of affective-relational processes to health disparities, and implications for intervention research.

Marriage and Gut (Microbiome) Feelings: Tracing Novel Dyadic Pathways to Accelerated Aging

Within a couple, partners influence each other's mental and physical health. This review focuses on how couples' relationships, the partners' individual and joint vulnerabilities, and their health behaviors influence health through changes in the gut microbiota, metabolism, and immune function. Couples' shared stressors and emotions and their intertwined lifestyles and routines serve to promote common disease risks in part through parallel changes in their gut microbiotas. Marital discord, stress, and depression have strong bidirectional links, fueling one another. Chronic marital stress and depression can elevate the risk for obesity, metabolic syndrome, and cardiovascular disease by altering resting energy expenditure, insulin production, and triglyceride responses after unhealthy meals. During stressful times, health behaviors typically suffer-and sleep disturbances, poor diets, and sedentary behavior all influence these metabolic pathways while also promoting gut dysbiosis. Dysbiosis increases intestinal permeability (gut leakiness), providing a mechanistic pathway from marital distress and depression to heightened inflammation and accelerated aging. Age-related changes in the gut microbiota's composition and gut leakiness foster immunosenescence, as well as the progression of inflamm-aging; these age-related risks may be altered by stress and depression, diet, sleep, exercise habits, and developmental shifts in emotion regulation strategies. Consideration of the strong mutual influences that partners have on each other's mood and health behaviors, as well as the biological pathways that underlie these influences, provides a new way to view marriage's health implications.

An examination of objective social disconnectedness and perceived social isolation among persons with spinal cord injury/dysfunction: a descriptive cross-sectional study

PURPOSE

To describe objective social disconnectedness and perceived social isolation post-spinal cord injury/dysfunction (SCI/D), and to examine associations among social disconnectedness and social isolation by sociodemographic and clinical characteristics.

MATERIALS AND METHODS

A telephone-based questionnaire was administered to 170 community dwelling individuals with a SCI/D. Social disconnectedness was measured by social network size, composition, and frequency of contact. Social isolation was measured using the revised three item UCLA Loneliness Scale.

RESULTS

Of the 170 participants, the majority were men (n = 136, 80%), had a traumatic injury (n = 149, 87.6%), and had incomplete tetraplegia (n = 58, 34%). The mean network size was 3.86 (SD = 2.0) of a maximum seven. The mean loneliness score for the sample was 4.93 (SD = 1.87). Factors associated with lower feelings of loneliness included being married, living with a higher proportion of network members, and being employed. Size of networks was not significantly associated with feelings of loneliness.

CONCLUSIONS

This study highlights the vulnerability for perceived social isolation among persons with SCI/D. The size of network does not seem to matter as much as the frequency and quality of social interactions. Findings reinforce the complexity of social disconnectedness and the importance in understanding the various indicators of social disconnectedness as they relate to social isolation. IMPLICATIONS FOR REHABILITATION Social relationships have been shown to be a vital component of optimal health and well-being. Individuals with a spinal cord injury/dysfunction are faced with a number of challenges in developing and maintaining social relationships and community participation. Rehabilitation professionals should encourage opportunities for social inclusion, employment and community participation to optimize health and well-being for this population.