Toni C. Antonucci

An Examination of Sex Differences in Social Support among Older Men and Women.

This paper is designed to empirically investigate sex differences in social support. Several types of sex differences are examined, including quantity and quality of support, the relationship between quantitative and qualitative measures of support, the number and source of support provided and received, and the relative predictive power of quality and quantity of support on well-being. The data are taken from the Supports of the Elderly, a national survey of older people (Kahn and Antonucci, 1984). Included in the present study are 214 men and 166 women ranging in age from 50 to 95 who are married and have at least one child. The analyses reveal that women have larger networks and receive supports from multiple sources, while men tend to rely on their spouses exclusively. Men report greater satisfaction with marriage than women. Quantitative supports are more related to qualitative supports for women than for men. For both sexes, the quality of support rather than the quantity of support has significantly greater effects on well-being; both the quantity and quality of social support have a greater impact on the well-being of women compared to men.

Attachment and close relationships across the life span

The Convoy Model of Social Relations is identified as a unifying conceptual framework within which to consider attachment and other close social relationships across the life span. Convoy data are provided for people aged 8 to 93 in both the United States and Japan. Data from community based representative samples in the Detroit (N = 1703) and Yokohama (N = 1842) metropolitan areas indicate age differences in all close relationships but gender differences only in very close relationships in the two countries. There was only one Age × Gender × Country interaction for number of people in close relations. Examination of role relationships suggest age differences overall but considerable similarities in the two countries.

Social relations and depressive symptomatology in a sample of community-dwelling French older adults.

This study examined the association between social relations and mental health, specifically the relative contribution of social networks and social support to depressive symptomatology. The culturally unique representative sample consisted of 3,777 noninstitutionalized older persons living in southwestern France. The findings indicated that French older adults generally had more than 8 people in their networks, their networks consisted mostly of family members, and they felt understood by most of their network members. These older adults reported being satisfied with their social relations. Sociodemographic variables contribute (R2 = .143) to depressive symptomatology, as did social network (incremented R2 = .033) and social support (incremented R2 = .09) variables. Sociodemographic, social network, and social support variables together increased the variance explained still further (incremented R2 = .108). Results were consistent with similar analyses in the U.S. and indicated that social support variables account for more variance in depressive symptomatology than social network variables.

Marital status and risk of Alzheimer’s disease A French population-based cohort study

Objective: To analyze the relationship between marital status and risk of AD or dementia. Methods: This study was carried out from the Personnes Agées QUID (PAQUID) cohort, an epidemiologic study on normal and pathologic aging after age 65 years. The PAQUID cohort began in 1988. Individuals were followed up at 1, 3, and 5 years, with an active detection of dementia. Marital status was divided into four categories: widowed, never married, divorced or separated, and the reference category, married or cohabitant. The longitudinal relationship between marital status and risk of incident AD or dementia was analyzed by a Cox model with delayed entry. Results: Among the 3,675 individuals initially not demented, 2,106 were married or cohabitants, 1,287 were widowers, 179 were never married, and 103 were divorced or separated. Among the 2,881 individuals reevaluated at least once for the risk of dementia during the 5-year follow-up, 190 incident cases of dementia were identified, including 140 with AD. The relative risks (RRs) of dementia (RR = 1.91, p = 0.018) and of AD (RR = 2.68, p < 0.001) were increased for the never-married individuals compared with those who were married or cohabitants. This excess of risk was specifically associated with AD. Adjustment for other risk factors of dementia (education, wine consumption), or for factors reflecting social environment, leisure activities, and depression, did not modify the risk of AD for never-married individuals (RR = 2.31, p = 0.02). Conclusions: We confirmed an association between marital status and AD, with an excess risk observed among never-married individuals. This association may provide clues about the pathogenesis of AD.

Social Support: Theoretical Advances, Recent Findings and Pressing Issues

The topic of social support has received increased attention over the last several years. At this point in time, with the benefit of much preliminary research, it is possible to move forward considering, and frequently correcting, limitations of the past and delineating the issues which are in most need of attention in the future. With this in mind, the purpose of this chapter is threefold: To outline the convoy model of social support which has benefited from previous theoretical approaches to social support but represents a life span extension of the concept. Second, to present a unique national study of the suppports of older adults which has recently been conducted and which represents the source of much of the data reported in the present chapter. And, finally, to delineate several issues and provide relevant information under a general rubric which can best be summarized as present knowledge/pressing issues. By this is implied some of the intriguing, interesting, puzzling, and/or contradictory findings in the literature. Where possible, relevant data from our national study will be provided which address these issues.

Racial and ethnic variations in knowledge and attitudes about genetic testing.

This study was designed to shed light on whether differences in utilization of genetic testing by African-Americans, Latinos, and non-Hispanic Whites are due primarily to different preferences, or whether they instead reflect other values and beliefs or differential access. It explores the values, attitudes, and beliefs of African-Americans, Latinos, and non-Hispanic Whites with respect to genetic testing by means of a telephone survey of representative samples of these three groups. The study finds clear evidence that Latinos and African-Americans are, if anything, more likely to express preferences for both prenatal and adult genetic testing than White respondents. At the same time, they hold other beliefs and attitudes that may conflict with, and override, these preferences in specific situations. African-Americans and Latinos are also less knowledgeable about genetic testing than non-Hispanic Whites, and they are less likely to have the financial resources or insurance coverage that would facilitate access to testing.

Social Support and Reciprocity: A Cross-Ethnic and Cross-National Perspective

This cross-national study examined the perception of reciprocity in support relationships and the degree to which reciprocity predicts life satisfaction. Comparisons of white and black American elderly with elderly from south-western France indicate cultural differences. The French are much more likely to perceive their support relationships as reciprocal and very unlikely to report receiving less support than they provide. Among elderly white Americans, age, lower educational levels and functional limitations are associated with not perceiving support relationships as reciprocal. The pattern is similar but not significant among black Americans. French elderly with more functional limitations report that they receive less than they provide, whereas those who are married are more likely to report that their relations are reciprocal. Comparisons of white and black Americans over the full adult age range reveal that for white Americans, age, education, functional limitations, and marital status are important factors predicting reciprocity in social relations; for black Americans again the pattern is similar, but only functional limitations and marital status significantly predict reciprocity. Generally, reciprocal relationships are most positively related to life satisfaction in comparison to both receiving more or receiving less support in white and black American adults and American and French elderly.

The Convoy Model: Explaining Social Relations From a Multidisciplinary Perspective

PURPOSE OF THE STUDY Social relations are a key aspect of aging and the life course. In this paper, we trace the scientific origins of the study of social relations, focusing in particular on research grounded in the convoy model. DESIGN AND METHODS We first briefly review and critique influential historical studies to illustrate how the scientific study of social relations developed. Next, we highlight early and current findings grounded in the convoy model that have provided key insights into theory, method, policy, and practice in the study of aging. RESULTS Early social relations research, while influential, lacked the combined approach of theoretical grounding and methodological rigor. Nevertheless, previous research findings, especially from anthropology, suggested the importance of social relations in the achievement of positive outcomes. Considering both life span and life course perspectives and grounded in a multidisciplinary perspective, the convoy model was developed to unify and consolidate scattered evidence while at the same time directing future empirical and applied research. Early findings are summarized, current evidence presented, and future directions projected. IMPLICATIONS The convoy model has provided a useful framework in the study of aging, especially for understanding predictors and consequences of social relations across the life course.

Profiles of social relations among older adults: a cross-cultural approach

ABSTRACT This study extends previous research on the profiles of social relations in three ways: (1) by including both functional and qualitative characteristics of social relations; (2) by examining the association of these profiles with mental and physical health and mortality; and (3) by exploring these profiles and associations in two cultures. Using samples of approximately 500 adults aged 60 or more years from the Social Relations and Mental Health over the Life Course studies in both the United States and Japan, separate cluster analyses were conducted for each country. The common or shared network types were labelled ‘diverse’, ‘restricted’, ‘friend-focused’ and ‘family-focused’, but in the US we found two types of ‘friend-focused’ networks (supported and unsupported) and two types of ‘restricted’ networks (structurally- and functionally-restricted). In addition, we found a unique network type in Japan: ‘married and distal’. Multivariate analyses of variance and Cox regressions revealed that whereas individuals in the functionally restricted network type had the worse physical and mental health in the US, Americans in the structurally-restricted network type had the lowest survival rates at a 12-year follow-up. Interestingly, there were no wellbeing differences by network type in Japan. The findings have been interpreted in the light of social relations theories, with special emphasis on the importance of taking a multidimensional perspective and exploring cultural variation.

What aspects of social network are protective for dementia? Not the quantity but the quality of social interactions is protective up to 15 years later.

Objective: To test the association between several social networks variables reflecting both structural characteristics and quality of relationships with the risk of dementia and Alzheimers disease 5 and up to 15 years later. Methods: The study sample is gathered from the Paquid cohort, a French population-based study of 3,777 elderly people evaluated at baseline and regularly revisited during a 15-year interval. The sample consisted of 2,089 subjects who completed the social network questionnaire and were free of dementia at the time of enrollment and also at the next two follow-ups to minimize the problem of reverse causality. The questionnaire collected at baseline included marital status, number of ties, nature of social network, satisfaction, perception of being understood/misunderstood, and reciprocity in relationships. Results: The incident cases of dementia considered were those diagnosed at 5-year and subsequent follow-ups, resulting in 461 dementia and 373 Alzheimers disease cases. The multivariate Cox model, including the six social network variables and adjusted for numerous potential confounders, showed significant associations with satisfaction and reciprocity in relationships. Participants who felt satisfied with their relations had a 23% reduced dementia risk. Participants who reported that they received more support than they gave over their lifetime had a 55% and 53% reduced risk for dementia and Alzheimers disease, respectively. Conclusion: The only variables associated with subsequent dementia or Alzheimers disease were those reflecting the quality of relationships. The delay between social network assessment and dementia diagnosis was from 5 up to 15 years, thus minimizing the problem of reverse causality. MMSE = Mini Mental Status Examination; IADL = Instrumental Activities of Daily Living; RR = relative risk; CI = confidence interval.