Marjolein Broese van Groenou

Quality of Marriages in Later Life and Emotional and Social Loneliness

OBJECTIVES We examine the extent of emotional and social loneliness among older people and how the evaluation of the functioning and quality of marriages plays a role. METHODS Data on 755 respondents aged 64-92 are taken from the Longitudinal Aging Study Amsterdam (Wave 2001-2002). Hierarchical negative binomial regression analysis is used. RESULTS Between 1 in 4 and 5 older adults who are married exhibit moderate or strong emotional or social loneliness. Stronger emotional and social loneliness is observed in adults whose spouse has health problems, who do not often receive emotional support from the spouse, who have nonfrequent conversations or are in disagreement, or who evaluate their current sex life as not (very) pleasant or not applicable. Emotional loneliness is stronger among women in second marriages, whereas marked social loneliness is especially characteristic of older men with disabled spouses. Moreover, smaller social networks and less contact with children also increase emotional and social loneliness in later life. DISCUSSION Differentiating marital quality and gender provides greater insight into emotional and social loneliness in married older people.

Contacts between elderly parents and their children in four European countries: current patterns and future prospects

Frequency of contacts with the family is an indicator of the strength of intergenerational exchange and potential support for older people. Although the availability of children clearly represents a constraint on potential family support, the extent of interaction with and support received from children depends on factors other than demographic availability alone. This study examined the effects of socio-economic and demographic variables on weekly contacts with children in Great Britain, Italy, Finland and The Netherlands using representative survey data which included information on availability of children and extent of contact. Our results confirm the higher level of parent adult-child contact in Italy than in northern European countries, but levels of contact in all the countries considered were high. Multivariate analysis showed that in most countries characteristics such as divorce were associated with a reduced probability of contact between fathers and children; in Finland this also influenced contact between mothers and children. Analyses are also included of possible future scenarios of contact with children that combine the observed effects of the explanatory variables with hypothetical changes in population distribution.

Network and Health Changes Among Older Dutch Adults

A negative effect of good health on the instrumental support received can be viewed as an effect of the mobilization of helpers. A positive effect of good health on the personal network size and the instrumental support given demonstrates that people in poor health have difficulty actively maintaining their relationships. Furthermore, the support received and given is positively related to the support given and received in the past. In four waves of a seven-year longitudinal study, personal interviews were conducted with 2,302 older Dutch adults (aged 60 to 85) who live on their own. The hypotheses have been confirmed. An implication is that investing in relationships by giving support might pay off in times of need. Individuals enter and leave a variety of roles throughout their lifetime, and each role is accompanied by a specific set of personal relationships as Kahn and Antonucci (1981) have illustrated in their metaphor of the convoy network. In old age, one’s personal network reflects the transitions earlier in life affecting the opportunities and individual choices to maintain and develop relationships. These life course differences not only produce differences in the networks of older adults, they affect the dynamics of these networks as well (Schulz & Rau, 1985; Stueve & Gerson, 1977). In old age, the process of making and losing personal relationships goes on, leading to changes in the size, composition and functioning of the network.

Socio-economic status differences in older people's use of informal and formal help: a comparison of four European countries

This study investigates the variations by older peoples socio-economic status (SES) (i.e. educational level and social class) in the use of informal and formal help from outside the household in Great Britain, Italy, Belgium and The Netherlands. In all these countries, it was older people in low SES groups who mostly used such help. Multinomial logistic regression analyses showed that, in each country and for both types of help, there were SES gradients in the utilisation of both formal and informal care, and that differences in age, health and marital status largely accounted for the former but not the latter. Cross-national differences in the use of both informal and formal help remained when variations in sex, age, SES, health, marital status, home ownership and the use of privately-paid help were taken into account. Significant interaction effects were found, which indicated that older people in low SES groups in Great Britain and The Netherlands had higher odds of using informal help from outside the household than their counterparts in Italy, and similarly that those in The Netherlands were more likely to use formal help than their Italian peers. The results are discussed in relation to the cultural differences and variations in the availability of formal services among the countries.

Explanations of socioeconomic differences in changes in physical function in older adults: results from the Longitudinal Aging Study Amsterdam

BackgroundThis study examines the association between socioeconomic status and changes in physical function in younger- (aged 55–70 years) and older-old (aged 70–85 years) adults and seeks to determine the relative contribution of diseases, behavioral, and psychosocial factors in explaining this association.MethodsData were from 2,366 men and women, aged 55–85 years, participating in the Longitudinal Aging Study Amsterdam (LASA). Two indicators of socioeconomic status were used: education and income. Physical function was measured by self-reported physical ability over nine years of follow-up.ResultsIn older adults, low socioeconomic status was related to a poorer level of physical function during nine years of follow-up. In subjects who were between 55 and 70 years old, there was an additional significant socioeconomic-differential decline in physical function, while socioeconomic differentials did not further widen in subjects 70 years and older. Behavioral factors, mainly BMI and physical activity, largely explained the socioeconomic differences in physical function in the youngest age group, while psychosocial factors reduced socioeconomic status differences most in the oldest age group.ConclusionThe findings indicate age-specificity of both the pattern of socioeconomic status differences in function in older persons and the mechanisms underlying these associations.

Network size and support in old age: differentials by socio-economic status in childhood and adulthood

This paper examines the impact of childhood and adulthood socio-economic status (SES) on personal network characteristics in later life. Data are derived from 2,285 married older adults (born between 1903 and 1937) who participated in face-to-face interviews for the Dutch survey on ‘Living arrangements and social networks of older adults’ conducted in 1992. Childhood and adulthood SES were indicated by the fathers and own level of education and occupation. Multivariate analyses showed that SES in adulthood has more impact on network features in old age than fathers SES. People with low lifetime SES or with downward SES mobility had small networks, low instrumental and emotional support from non-kin, but high instrumental support from kin, when compared with the upwardly mobile or those with high lifetime SES. The level of education was a better indicator of network differences than occupational prestige. It is concluded that obtaining a high SES during life pays off in terms of having more supportive non-kin relationships in old age. The small networks and less supportive non-kin relationships of low-status older adults make them more vulnerable to situations in which kin are unavailable or less willing to provide support. This study underscores the distinction between types of support and types of relationships in the SES–network association. Further research on the social pathways of socio-economic inequality in health and wellbeing should take these distinctions into account.

Network dynamics in the long-term period after divorce:

This study first identified types of change in the size of the personal network over a period of 12 years following divorce. Second, differences in network change were explained by taking into account divorce characteristics, personal capacities, and structural conditions. Personal interviews were conducted in three waves of a 12-year longitudinal study with 40 men and 64 women who divorced in 1987 or 1988. Most divorcees experienced network losses shortly after the divorce and in half of the cases these losses were not compensated for in the later years after divorce. For some, divorce brought merely network gains, albeit in the longer term. Personal capacities and structural conditions did not differ significantly across participants in different types of network change. Characteristics of the divorce (attitude toward divorce and conflicts with the ex-partner after divorce) partly explained differences in network change after divorce.

Explaining the association between educational level and frailty in older adults: results from a 13-year longitudinal study in the Netherlands

PURPOSE The aim of this study was to examine the longitudinal association between educational level and frailty prevalence in older adults and to investigate the role of material, biomedical, behavioral, social, and mental factors in explaining this association. METHODS Data over a period of 13 years were used from the Longitudinal Aging Study Amsterdam. The study sample consisted of older adults aged 65 years and above at baseline (n = 1205). Frailty was assessed using Frieds frailty criteria. A relative index of inequality was calculated for the level of education. Longitudinal logistic regression analyses based on multilevel modeling were performed. RESULTS Older adults with a low educational level had higher odds of being frail compared with those with a high educational level (relative index of inequality odds ratio, 2.94; 95% confidence interval, 1.84-4.71). These differences persisted during 13 years of follow-up. Adjustment for all explanatory factors reduced the effect of educational level on frailty by 76%. Income, self-efficacy, cognitive impairment, obesity, and number of chronic diseases had the largest individual contribution in reducing the effect. Social factors had no substantial contribution. CONCLUSIONS Our findings highlight the need for a multidimensional approach in developing interventions aimed at reducing frailty, especially in lower educated groups.

Informal and formal home-care use among older adults in Europe: can cross-national differences be explained by societal context and composition?

ABSTRACT Cross-national comparisons employed welfare state classifications to explain differences in care use in the European older population. Yet these classifications do not cover all care-related societal characteristics and limit our understanding of which specific societal characteristics are most important. Using the Survey of Health, Ageing and Retirement (second wave, 2006–07), the effect of societal determinants relating to culture, welfare state context and socio-economic and demographic composition on informal and formal care use of older adults in 11 European countries was studied. Multinomial multi-level regression analyses showed that, in addition to individual determinants, societal determinants are salient for understanding care use. In countries with fewer home-based services, less residential care, more informal care support and women working full time, older adults are more likely to receive informal care only. Older adults are more likely to receive only formal home care or a combination of formal and informal care in countries with more extensive welfare state arrangements (i.e. more home-based services, higher pension generosity), whereas the odds of receiving a combination of informal and formal care are also larger in countries that specify a legal obligation to care for parents. We tentatively conclude that the incorporation of societal determinants rather than commonly used welfare state classifications results in more understanding of the societal conditions that determine older adults’ care use.

Continued and new personal relationships in later life: differential effects of health.

Objectives: The aim of this study is to increase our understanding of declining network size with aging by differentiating between processes of loss and gain and studying the associations with various health problems. Methods: Six observations of the Longitudinal Aging Study Amsterdam (LASA) across a time period of 16 years are used to study detailed network changes in a large sample of Dutch older adults aged 55 to 85 at baseline. Results: Results from multilevel regression analyses show that network size declines with aging, in particular for the oldest old. The decline in network size is to a large degree due to a lack of replacement of lost relationships with new relationships. Results show differential effects of health. Discussion: The older old and people in poor health have limited possibilities to compensate for network losses and may have a serious risk of declining network size in later life.