Longitudinal changes in social networks, health and wellbeing among older Koreans

Exploring social network typologies and their impact on health and mental well-being in older adults: Evidence from JAGES

BACKGROUND

The types of social networks, their prevalence, and their relationship to health outcomes in older age have been different across countries and cultures. Most of the literature has focused on USA or in European countries and little is known about the social network typologies among older adults from Japan. This study aimed to identify these patterns of social network typologies and examine the differences in sociodemographic and related to health variables.

METHODS

23894 participants from the JAGES project (2019), aged 65 or older (M = 74.74, DT = 6.39) from Japan. Statistical analyses included Latent Profile Analysis (LPA) followed by ANOVAs, Chi square and multinomial logistic regressions tests to compare the profiles.

RESULTS

Four profiles were identified: family (66.9%), spouse (16.6%), diverse (14.5%), and neighbor/others (1.9%). The profiles differ statistically (p < 0.001) in all sociodemographic characteristics and in the means of depression, loneliness, self-perceived health, and happiness. Compared with the "family" network, younger men, with fewer chronic illnesses but higher levels of depression and loneliness were more likely to be in the "spouse" profile, older women with lower socioeconomic status, but less lonely and happier in the "diverse" profile and adults who still working, have lower socioeconomic status and are less happy into the "neighbors/others" group.

DISCUSSION

We discuss the differences between the profiles found, the potential differences with previous studies and the specific cultural Japanese nuances that may explain the characteristics of the network types founded.

Social connectedness and mental health before and during the COVID-19 pandemic in a community sample in Korea

This study compared social connectedness patterns and examined the relationships between objective or subjective social connectedness and mental health before and during the COVID-19 pandemic among community dwelling adults in South Korea. An identical online survey was administered at two time points, in 2019 prior to the onset and again in 2021. Objective (network diversity and network size) and subjective (thwarted belongingness and perceived burdensomeness) social connectedness were measured along with positive and negative indices of mental health (depression, suicidal behavior, happiness, and life satisfaction). The results indicated that among social connectedness indices perceived burdensomeness were significantly higher during the COVID-19 pandemic compared to the prior period, while network size was smaller. Subjective social connectedness was associated with all aspects of mental health consequences, either positive or negative. Among objective social connectedness, only network diversity was significantly associated with increased happiness and life satisfaction, and objective social connectedness was not associated with depression and suicidal behavior. These associations did not differ across the two time periods. The findings, both before and during the pandemic, indicated that network diversity is an important factor for positive indices of mental health and that efforts to increase subjective social connectedness are needed to decrease the risk of depression and suicidal behavior.

Transitions in Social Network Types over Time among Older Adults

OBJECTIVE

Network typology studies have identified heterogeneous types of older adults' social networks. However, little is known about stability and change in social network types over time. We investigate transitions in social network types among older adults, aged 60 years and older, and factors associated with such transitions.

METHODS

We used data on 1,305 older adults, participating in 2 waves of a national, longitudinal survey, conducted in 2016-2017 and 2019, in Singapore. Latent transition analysis identified the distinct types of social networks and their transition patterns between the waves. Multinomial logistic regression examined the association of baseline and change in physical, functional, and mental health and baseline sociodemographic characteristics with network transitions into more diverse or less diverse types.

RESULTS

We found 5 social network types at both waves, representing the most to the least diverse types - diverse, unmarried and diverse, extended family, immediate family, and restricted. Between waves, about 57% of respondents retained their social network type, whereas 24% transitioned into more diverse types and 19% into less diverse types. Those who were older and less educated and those with worsening functional and mental health were more likely to transition into less diverse types versus remaining in the same type.

DISCUSSION

The findings capture the dynamics in social network composition among older adults in the contemporary aging society. We highlight sociodemographic and health disparities contributing to later life social network diversity.

Transitions between social network profiles and their relation with all-cause mortality among older adults

BACKGROUND

The importance of social network in mortality among older adults has been acknowledged. However, existing studies typically overlook the interplay among social network indicators, and seldom consider the change in social network over time. We take a person-centered approach to identify transitions between social network profiles, and examine the linkage of such transitions with subsequent mortality risk.

METHODS

Data came from 2738 older Singaporeans enrolled in a longitudinal study. Latent transition analysis examined nine social network indicators assessed at two time points, two years apart to reveal the corresponding transitions between social network profiles. Adjusted Cox regression then associated the identified transitions with all-cause mortality risk in the subsequent four years.

RESULTS

We observed three diverse social network profiles (that featured diversified social interaction and involved both household and non-household members) and three relatively restricted social network profiles (that focused on household or non-household members). Compared to sustained diverse profiles over time, sustained restricted profiles or a transition from diverse to restricted profiles entailed increased mortality risk. The mortality risk following a restricted-to-diverse profile transition could be as low as that associated with sustained diverse profiles.

CONCLUSIONS

Dynamics of social network profiles have implications for mortality risk in later life. To promote longevity, initiatives are needed to help older people to maintain or shift to diverse social network profiles.

Social Network Types and Depressive Symptoms among Older Korean Men and Women

This study explores the social network types of older Korean men and women, and the relationship of those networks to depressive symptoms. A population of 4608 older adults who participated in the Living Profiles of Older People Survey (LPOPS) were included in the study. Seven criterion variables-marital status, living arrangements, frequency of contact with children, close friends, and close relatives, participation in social activities, and total network size-were included in a K-means cluster analysis. Multivariable logistic regression analysis of the impact of social network type on depressive symptoms was conducted. We identified two "diverse type" social networks (diverse-married and diverse-unmarried) in women, and one diverse type and one "social-activity-focused type" network in men. Family focused type and two "restricted type" social networks (restricted-couple-focused, and restricted-unmarried) were identified in both men and women. The restricted-unmarried and restricted-couple-focused networks were associated with more depressive symptoms in both men and women. However, the family focused type was associated with more depressive symptoms only in women. The results indicated that social network types, and their impact on depressive symptoms, differ by gender. There is a need for further research on gender differences in the social network types of older adults across diverse cultures.

Social participation and self-assessment of health status among older people in Brazil

To estimate the prevalence of social participation (exposure) and its association with positive self-assessment of overall health status (SAH) (outcome) among 7,712 Brazilian elderly interviewed in the National Health Survey 2013. A cross-sectional study that used Propensity Score (PS) to improve comparability between the group exposed and no exposed to social participation. Poisson regression was performed to determine the prevalence and association of interest using crude and adjusted by inverse probability of selection of PS. Social participation was reported by 25.1% (CI95%: 23.4-26.9) and was lower among poor older people, who depend on public transportation and live in more precarious contexts. Most did not SAH positively, but the proportion was higher when they had social participation (48.0%; CI95%: 46.0-51.0). There was a positive association of social participation with SAH positive. The association using the adjusted model (PR: 1.15; CI95%: 1.08-1.22) attenuated the estimated in the crude model. Elderly exposed were 15% more likely to provide a positive SAH. Despite low levels in Brazil, there was a positive association between of social participation and SAH, confirming that engagement in such activities provides important gains for the health and quality of life.

Social networks and their influences on nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults: a mixed-methods longitudinal study

Background

The United Kingdom population is ageing and becoming increasingly diverse; thus, it is vital to develop and implement interventions supporting this population shift. Social networks (SN) significantly impact health outcomes in later life, however relatively little is known about SN of community-dwelling ethnically diverse older adults. This study aimed to: 1) profile SN and changes in SN in this population over 8 months; 2) examine associations between SN, dietary intake, nutritional status, and physical function.

Methods

SN were assessed using the Wenger Practitioner Assessment of Network Type. Energy and nutrient intakes were measured using multiple-pass 24-h recalls. The Mini Nutritional Assessment-Short Form (MNA-SF) assessed nutritional status. Physical function was measured using the Short Physical Performance Battery (SPPB) and handgrip strength. Data were collected at baseline and 8-months. Correlation and regression analyses examined relationships between SN, physical function, nutrient intake and nutritional status. Semi-structured interviews were conducted at baseline (n = 92) and follow-up (n = 81) to identify potential influences of SN. Interviews were transcribed verbatim and analysed using directed content analysis.

Results

Quantitative data were obtained from 100 participants at baseline and 81 at follow-up. Mean (SD) age was 70.8 (8.1) years (59% male), comprising African/Caribbean (60%), South Asian (34%), and other ethnicities (6%). Five SN typologies were identified under two broad areas: integrated-SN consisting of locally integrated (44%) and wider community (8%); and non-integrated-SN consisting of family dependent (25%), local self-contained (17%), and private restricted (6%). At follow-up, 37% remained in non-integrated networks, 19% transitioned to non-integrated networks, 11% transitioned to, and 33% remained in, integrated networks. Participants within integrated networks at baseline had higher SPPB scores at follow-up. Compared to the private restricted, local self-contained SN significantly predicted zinc, riboflavin and vitamin B6 intakes. Participants remaining in, or transitioning to, non-integrated networks had low MNA-SF scores. Qualitative findings indicate that participants with reductions in SN perceived it as causing poorer physical function and eating behaviours.

Conclusion

In the present study, integrated SN were associated with higher physical function and nutritional status at 8-month’s follow-up. These results can inform the design of interventions to improve social networks, physical function and healthy nutrition within this population.

Receipt of Emotional Support among Rural South African Adults

As the world undergoes rapid ageing, informal support from friends and relatives is becoming especially important among older adults in middle and low income countries, where formalized social protections may be limited. We use new data from a cohort of adults ages 40 and older in rural South Africa to explore how receipt of emotional support differs by gender and marital status. Our findings suggest that women are more likely to get emotional support than men and have more sources of support. Moreover, women are more likely to get emotional support from relatives, whereas men are more likely to get support from friends. In regard to marital status, married people are more likely to get emotional support and have more sources of support than people who are not married. However, separated/divorced and widowed people are more likely to get emotional support from relatives and have more sources of non-spousal support than married people. These findings point toward gaps in informal systems of support, and the particular importance of considering men and unmarried (especially never married) people when designing policies to offer social protections to older populations.

Always alone? Network transitions among detached older Europeans and their effects

The present study investigated the changes that occurred within the interpersonal environments of a sample of socially isolated older Europeans after four years. Based upon data from the Survey of Health, Ageing and Retirement in Europe (SHARE), the inquiry looked at 834 older people who were socially detached at baseline, at follow-up or at both time-points. The analysis traced changes in relation to the social network types that they acquired or left. The findings indicate that respondents more frequently moved from no-network status at baseline to close family-based social network types at follow-up than to other network types. In comparison, the loss of a network at follow-up was seen to originate from close networks and from other network types alike. Multivariate analysis revealed that those who moved from socially detached status to close-family networks had fewer depressive symptoms compared to those who moved to other network types. However, the move from a close-family network to the no-network status was about as depressing as was being chronically isolated. The effects of network transitions were more varied in relation to the life satisfaction outcome. In sum, the findings suggest that a transition out of social isolation in late life is possible and it may be beneficial as well.

Network type, transition patterns and well-being among older Europeans

Using SHARE data, this study was based on an earlier analysis that derived social network types among adults aged 65 and over in Europe. The current effort investigated the transitions that occurred across these network types after 4 years (N = 13,767). Four general network transition patterns were identified according to network type (close-family networks and other networks) and whether a network transition occurred. The associations between network type, network transitions and well-being (depression and life satisfaction) were examined. We regressed depressive symptoms and a life satisfaction measure on the network transition patterns, controlling for socio-demographic background, health and country. The results revealed that a majority of older Europeans experienced a range of network transition, while close-family-based networks tended to prevail over time. Moreover, respondents who remained in or transitioned to close-family networks had fewer depressive symptoms and better life satisfaction than those in other network types. The study, thus, underscores the varied effects of network types and network changes on emotional well-being in late life. It also demonstrates that beneficial changes can be made in one's social network in old age, especially with regard to greater family closeness.

Social Network Types and Health among Older Adults in Rural China: The Mediating Role of Social Support

This study aimed to identify social network types among older adults in rural China, to explore the relationship between social network types and the health of the older adults, and further, to examine the mediating role of social support in this relationship. A cross-sectional survey method was employed to investigate the health of adults aged 60 or older in rural areas of Hubei Province from 5 September 2018 to 15 October 2018; 405 samples were obtained. First, using k-means clustering analysis, we found five robust network types: diverse, restricted, family, friends and a specific type—family-restricted. Second, the results of multiple linear regression analysis showed that social network types were significantly associated with depressive symptoms and self-rated health in older adults. Older people with diverse friend networks were significantly associated with lower levels of depressive symptoms, whereas those with restricted and family-restricted networks were significantly associated with higher levels of depressive symptoms and lower levels of self-rated health. Finally, the results of multiple linear regression analysis confirmed that social support partially mediated the association of the identified social network types with depressive symptoms and self-rated health. Enriching the social network relationships of older adults and providing them with more social support should be conducive to promoting their mental and physical health.

A 10-Year Follow-Up Study of Social Ties and Functional Health among the Old: The AGES Project

In Asian nations, family ties are considered important. However, it is not clear what happens among older people with no such ties. To investigate the association, we used longitudinal data from the Aichi Gerontological Evaluation Study (AGES) project. Functionally independent older people at baseline (N = 14,088) in 10 municipalities were followed from 2003 to 2013. Social ties were assessed by asking about their social support exchange with family, relatives, friends, or neighbors. Cox proportional hazard models were employed to investigate the association between social ties and the onset of functional disability adjusting for age, health status, and living arrangement. We found that social ties with co-residing family members, and those with friends or neighbors, independently protected functional health with hazard ratios of 0.81 and 0.85 among men. Among women, ties with friend or neighbors had a stronger effect on health compared to their male counterparts with a hazard ratio of 0.89. The fact that social ties with friends or neighbors are associated with a lower risk of functional decline, independent of family support, serves to underscore the importance of promoting social ties, especially among those lacking family ties.

Aging in Place of Vulnerable Older Adults: Person-Environment Fit Perspective

Based on the premise that the experience of aging in place is different for vulnerable subgroups of older adults compared with less vulnerable subgroups, we focus on low-income older adults as a vulnerable subgroup and senior housing as an alternative to a conventional, private home environment. Using the 2008 and 2010 waves of the Health Retirement Study, regression models determined the impact of person-environment (P-E) fit between poverty status and residence in senior housing on self-rated health. Consistent with the environmental docility hypothesis, findings show that, among low-income individuals, the supportive environment of senior housing plays a pronounced compensating role and may be a key to successful adaptation in aging. As the first research effort to empirically demonstrate the positive health effects of senior housing among socioeconomically vulnerable elders, our findings provide a much-needed theoretical and practical underpinning for policy-making efforts regarding vulnerable elders.