Abstract
Background and aims: There has long been speculation that socially-involved individuals suffer less illness, overcome sickness more readily, and experience better health outcomes than more socially isolated persons. This study describes social network characteristics, and determines whether social network affects health outcomes in the geriatric population. Methods: Data from 1270 consecutive patients seen in the outpatient Geriatric Assessment Clinic (GAC) of the University of Nebraska Medical Center between August 1988 and May 1999 were analyzed. Social network was measured by the Social Network Index (SNI). Results: Younger age, higher income and higher education were related to a broader social network. A larger social network was generally associated with lower caregiver burden, higher functional status and better cognition. Men with the smallest social networks were found to be at significantly higher risk of death than women with larger social networks (HR 4). After adjusting for age (HR 1.04, CI 1.03-1.06), income (HR 1.00, CI 1-1), education (HR, NS), IADL (HR 0.97, CI 0.95-0.99), CIRS (HR 1.08, CI 1.05-1.10) and informal service use (HR, NS), the risk of death for subjects based on SNI is only significant in the comparison between SNI III and SNI I (HR 0.67, CI 0.50-0.91). Conclusions: SNI I males are at significantly increased risk of death compared with all other groups. The average number of years from initial visit to death for SNI I males is only 2.8 years. These results are consistent with the literature, which suggests men are more affected by social isolation and have decreased survival compared with females. The influence of SNI on mortality in this frail, elderly group appears to be diluted by the presence of functional disability and a high degree of comorbid illness.
Similar content being viewed by others
References
Berkman L. Social networks, support, and health: Taking the next step forward. Am J Epidemiol 1986; 123: 559–62.
Berkman L, Syme SL. Social networks, host resistance, and mortality: A nine-year follow-up of Alameda County residents. Am J Epidemiol 1979; 109: 186–204.
Cassel J. The contribution of social environment to host resistance. Am J Epidemiol 1976; 104: 107–23.
Garrison JE, Howe J. Community intervention with the elderly: A social network approach. J Am Geriatr Soc 1976; 24: 329–33.
Hedblad B, Ostergren PO, Hanson BS, et al. Influence of social support on cardiac event rate in men with ischemic type ST segment depression during ambulatory 24-h long-term EKG recording. Eur Heart J 1992; 13: 433–9.
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: 659–66.
Welin L, Larsson B, Svardsudd K, et al. Social network and activities in relation to mortality from cardiovascular diseases, cancer and other causes: A 12-year follow-up of the study of men born in 1913 and 1923. J Epidemiol Community Health 1992; 46: 127–32.
Berkman L. Assessing the physical health effects of social networks and social support. Ann Rev Public Health 1984; 5: 413–32.
Amman G. Social network and social support deficits in depressed patients: A result of distorted perceptions? Eur Arch Psychiatry Clin Neurosci 1991; 241: 49–56.
George LK, Blazer DG, Hughes DC, et al. Social support and the outcome of major depression. Br J Psychiatry 1989; 154:478–85.
Schoenbach VJ, Kaplan BH, Fredman L, et al. Social ties and mortality in Evans County, Georgia. Am J Epidemiol 1986; 123: 577–91.
Seeman TE, Kaplan GA, Knudson L, et al. Social network ties and mortality among the elderly in the Alameda County study. Am J Epidemiol 1987; 126: 714–23.
Welin L, Svardsuud K, Ander-Perciva S, et al. Prospective study of social influences on mortality: The study of men born in 1913 and 1923. Lancet 1985; 8434: 915–8.
Felton BJ, Berry C. Groups as social network members: Overlooked sources of social support. Am J Commun Psychol 1992; 20: 253–61.
Oxman TE, Berkman LF. Assessment of social relationships in elderly patients. Int J Psychiatry Med 1990; 20: 65–84.
Simons RL. Specificity and substitution in the social networks of the elderly. Int J Aging Hum Dev 1983-84; 18: 121–39.
Mineau GP, Smith KR, Bean LL. Historical trends of survival among widows and widowers. Soc Sci Med 2002; 54: 245–54.
Avlund KM, Damsgaard T, Holstein BE. Social relations and mortality. An eleven year follow-up study of 70-year-old men and women in Denmark. Soc Sci Med 1998; 47: 635–43.
Broadhead WE, Kaplan BH, James SA, et al. The epidemiological evidence for a relationship between social support and health. Am J Epidemiol 1983; 117: 521–37.
Altkorn DL, Ramsdell JW, Jackson JE, et al. Recommendations for a change in living situation resulting from an outpatient geriatric assessment: Associations between referral sources and assessment findings. J Am Geriatr Soc 1991; 39: 267–72.
Heath JM, Gant WD, Kamps CA, et al. Outpatient geriatric assessment: Associations between referral sources and assessment findings. J Am Geriatr Soc 1985; 33: 602–6.
Martin DC, Moryca RK, McDowell J, et al. Community-based geriatric assessment. J Am Geriatr Soc 1984; 32: 900–5.
Keller BK, Potter JF. Predictors of mortality in outpatient geriatric evaluation and management clinic patients. J Gerontol 1994; 49: M246–51.
Lawton MP, Brody EH. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–86.
Folstein MF, Elstein SE, McHugh PR. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.
Zarit S, Zarit J. Subjective burden of husbands and wives as caregivers: A longitudinal study. Gerontologist 1986; 26: 260–5.
Sheikh JI, Yesavage JA. Geriatric depression scale (GDS): Recent evidence and development of a shorter version. Clin Gerontol 1986; 5: 165–73.
Linn BS, Linn MW, Gurel L. Cumulative illness rating scale. J Am Geriatr Soc 1968; 16: 622–6.
Waldman E, Potter JF. A prospective evaluation of the cumulative illness rating scale. Aging Clin Exp Res 1992; 4: 171–8.
Berkman LF. Social networks, host resistance, and mortality: A follow-up study of Alameda County residents. Berkeley: University of California, 1977 (Ph.D. thesis).
SAS Institute. SAS Procedures Guide, Version 6, 3rd ed. Cary, NC: SAS Institute, 1990: 401.
Gottlieb NH, Green LW. Life events, social network, lifestyle, and health: An analysis of the 1979 National Survey of Health Practices and Consequences. Health Educ Q 1984; 11: 91–105.
Kassner E, Jackson B. Determining comparable levels of functional disability. Publication ID # IB32, AARP, April 1998. Accessed November 27, 2001: http://research.aarp.org/health/ib32_disability.html
Robinson K. The relationships between social skills, social support, self-esteem and burden in adult caregivers. J Adv Nurs 1990; 15: 788–95.
Haley WE, Levine EG, Brown SL, et al. Psychological, social and health consequences of caring for a relative with senile dementia. J Am Geriatr Soc 1987; 35: 405–11.
Deronesne C, Alperovich A, Arvay N, et al. Memory complaints in the elderly: A study of 367 community-dwelling individuals from 50 to 80 years old. Arch Gerontol Geriatr (Suppl) 1989; 1: 151–63.
Bowling A. Associations of life satisfaction among the very elderly people living in a deprived part of inner London. Soc Sci Med 1990; 31: 1003–11.
Auslander GK, Litwin H. Social support networks and formal help-seeking differences between applicants to social services and a non-applicant sample. J Gerontol 1990; 45: S112–9.
O’Reilly P. Methodological issues in social support and social network research. Soc Sci Med 1988; 26: 863–73.
Orth-Gomer K, Unden AL. The measurement of social support in population surveys. Soc Sci Med 1987; 24: 83–94.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Keller, B.K., Magnuson, T.M., Cernin, P.A. et al. The significance of social network in a geriatric assessment population. Aging Clin Exp Res 15, 512–517 (2003). https://doi.org/10.1007/BF03327375
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03327375