Social networks and disability transitions across eight intervals of yearly data in the New Haven EPESE

Objectives. There is considerable evidence that social networks are strongl y related to survival and other health outcomes. However, findings regardin g the effect of social networks on disability outcomes have been inconsiste nt. This study examines this relationship with respect to the risk of devel oping disability and recovering from disability. Methods. Data come from a community-based sample of the New Haven populatio n aged 65 years and older, with nine annual interviews conducted between 19 82 and 1991. Disability was measured by a 6-item index of activities of dai ly living (ADL), and a 3-item Rosow-Breslau index, with disability defined as impairment in one or more tasks on each measure. Social network variable s were constructed for each of four domains of ties: children, relatives, f riends, and a confidant, and a summary measure of total social networks. A Markov model was used to estimate one-year disability transitions averaged across all 8 intervals, after controlling for sociodemographic and health-r elated variables. Results. Total social networks was associated with a significantly reduced risk of developing ADL disability (beta = -0.009, p <.01), and a significan tly increased likelihood of ADL recovery (beta = 0.017, p <.01). Emotional and instrumental support did not affect the protective effect of social net works against disability, but partially accounted for their effect on enhan ced recovery. Network variables related to relatives and friends were signi ficantly associated with disability and recovery risks, but these related t o children or a confidant were not. The associations with disability transi tions as measured by the Rosow-Breslau index were generally smaller and non significant. Discussion. The findings lend further support for the role of social relati onships in important health outcomes in old age. They suggest that being "e mbedded" in a social network of relatives and friends reduces risk for ADL disability, and enhances recovery from ADL disability.