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Structural and functional measures of social relationships and quality of life among older adults: does chronic disease status matter?

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Abstract

Purpose

To evaluate the relative importance of structural and functional social relationships for quality of life (QoL) and the extent to which diagnosed chronic disease modifies these associations.

Methods

Multivariate linear regression was used to investigate time-lagged associations between structural and functional measures of social relationships and QoL assessed 5 years apart by CASP-19, in 5925 Whitehall II participants (mean age 61, SD 6.0). Chronic disease was clinically verified coronary heart disease, stroke, diabetes or cancer.

Results

Social relationships–QoL associations were consistent across disease status (P-values for interaction: 0.15–0.99). Larger friend network (β = 1.9, 95 % CI 1.5–2.3), having a partner (β = 1.2, 95 % CI 0.5–1.7), higher confiding support (β = 2.2, 95 % CI 1.8–2.7) and lower negative aspects of close relationships (β = 3.3, 95 % CI 2.8–3.8) were independently related to improved QoL in old age. The estimated difference in QoL due to social relationships was equivalent to up to 0.5 SD of the CASP-19 score and was stronger than the effect of chronic disease (coronary heart disease β = 2.0, 95 % CI 1.4–2.6).

Conclusions

We found that beneficial aspects of social relationships in relation to QoL were, in order of importance: avoiding negative aspects of close relationships, having confiding support, having a wide network of friends and having a partner. These associations were not modified by chronic disease. Thus, despite inevitable physical deterioration, we may be able to enhance a satisfying late life by optimizing our social relationships.

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Acknowledgments

We thank all participating civil service departments and their welfare, personnel and establishment officers; the Occupational Health and Safety Agency; the Council of Civil Service Unions; all participating civil servants in the Whitehall II study; and all members of the Whitehall II study team. Whitehall II data, protocols and other metadata are available to bona fide researchers for research purposes. Please refer to the Whitehall II data sharing policy at http://www.ucl.ac.uk/whitehallII/data-sharing.

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Correspondence to Jing Liao.

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Funding

The Whitehall II study is also supported by a grant from the British Medical Research Council (K013351), the British Heart Foundation (RG/13/2/30098) and National Institute on Aging, US National Institutes of Health (AG13196). The funding bodies did not play a role in the study design, the collection, analysis and interpretation of data, the writing and the decision to submit the paper.

Ethical Standards

The authors have no conflicts of interests to declare. Ethical approval for the Whitehall II study was obtained from the University College London Medical School Committees on the Ethics of Human Research. The study procedures are in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All participants were asked to give written informed consent at each phase.

Appendix

Appendix

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Table 4 Phase 9 CASP-19 score (2007/09) by chronic disease status and phase 7 (2002/04) social relationships levels a

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Liao, J., Brunner, E.J. Structural and functional measures of social relationships and quality of life among older adults: does chronic disease status matter?. Qual Life Res 25, 153–164 (2016). https://doi.org/10.1007/s11136-015-1052-1

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