ARE SOCIAL SUPPORTS IN LATE MIDLIFE A CAUSE OR A RESULT OF SUCCESSFULPHYSICAL AGING

Background. Many studies have noted a strong association between poor social support and premature mortality. A limitation of such studies h as been their failure to control adequately for confounders that damag e both social supports and physical health. Methods. A 50-year prospec tive multivariate study of 223 men was used to examine the possible ca usal relationships between social supports and health. Alcohol abuse, prior physical health and mental illness prior to age 50 were controll ed. Relative social supports were quantified over the period from age 50 to 70. Results. Adequacy of social supports from age 50 to 70 was p owerfully correlated with physical health at age 70 (P < 0.001). Howev er, such social supports were also powerfully predicted by alcohol abu se (P < 0.001), smoking (P < 0.001) and indicators of major depressive disorder (P < 0.01) assessed at age 50. When prior smoking, depressio n and alcohol abuse were controlled, then the association of physical health with social supports was very much attenuated. Some facets of s ocial support like religion and confidantes were unassociated with hea lth even at a univariate level. Surprisingly, in this sample friends s eemed more important for sustained physical health than closeness to s pouse and to children. Conclusions. While social supports undoubtedly play a significant role in maintaining physical wellbeing in late life , much of the association between poor social supports and mortality m ay be mediated by alcoholism, smoking and pre-morbid psychopathology.