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Effects of social network diversity on mortality, cognition and physical function in the elderly: a longitudinal analysis of the Chicago Health and Aging Project (CHAP)
  1. Talha Ali1,
  2. Charlotte Juul Nilsson2,
  3. Jennifer Weuve3,
  4. Kumar B Rajan4,
  5. Carlos F Mendes de Leon1
  1. 1 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
  2. 2 Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  3. 3 Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
  4. 4 Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
  1. Correspondence to Talha Ali, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI – 48109, USA; talhaali{at}


Background Having a larger social network has been shown to have beneficial effects on health and survival in adults, but few studies have evaluated the role of network diversity, in addition to network size. We explore whether social network diversity is associated with mortality, cognition and physical function among older black and white adults.

Methods Data are obtained from the Chicago Health and Aging Project, a longitudinal, population-based study of adults aged 65 years and older at baseline. Using Cox proportional hazards regression, we estimate the hazard of mortality by network diversity (n=6497). The association between network diversity and cognition (n=6560) and physical function (n=6561) is determined using generalised estimating equations. Models were adjusted for age, gender, race, socioeconomic status, marital status and health-related variables.

Results In fully adjusted models, elderly with more diverse social networks had a lower risk of mortality (HR=0.93, p<0.01) compared with elderly with less diverse networks. Increased diversity in social networks was also associated with higher global cognitive function (coefficient=0.11, p<0.001) and higher physical function (coefficient=0.53, p<0.001).

Conclusions Social networks are particularly important for older adults as they face the greatest threats to health and depend on network relationships, more than younger individuals, to meet their needs. Increasing diversity, and not just increasing size, of social networks may be essential for improving health and survival among older adults.

  • social epidemiology
  • mortality
  • cognition
  • physical function
  • epidemiology of ageing

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  • Contributors TA contributed to the literature review, interpretation of data and prepared the complete manuscript (which involved drafting the first article and revising it based on feedback from the coauthors); CJN contributed to the conception and design of the study and revised the article critically; JW contributed to the analysis and interpretation of data and revised the article critically; KBR contributed to the analysis of the data; CFMdL conceived and designed the study, contributed to study analysis, interpretation of data and revised the article critically. All authors approved the final version.

  • Funding Research reported in this article was supported by National Institute of Aging on the National Institutes of Health under award number R01AG032247 and R56AG048937.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Institutional Review Board of Rush University Medical Center approved the data collection.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at A working version of this article was presented as a poster at the 21st IAGG World Congress of Gerontology and Geriatrics, San Francisco, California, USA in July 2017.