Living arrangements, social integration, and change in functional health status

Limited prospective data have examined the association between living arran gements and emotional wellbeing. The authors assessed whether older women l iving with a spouse were less likely to experience a decline in mental heal th, vitality, or physical function compared with women living alone or with nonspouse others. The association between living arrangement and 4-year ch ange in functional health status was examined prospectively among 28,324 wo men aged 60-72 years in the Nurses' Health Study. After adjustment for age, baseline function, comorbid conditions, and health behaviors, women living alone had lower risk of decline in mental health (relative risk (RR) = 0.7 3, 95 percent confidence interval (CI): 0.65, 0.81) and vitality (RR = 0.72 , 95 percent Cl: 0.65, 0.80) compared with those living with a spouse. Cont act with friends and relatives and level of social engagement were signific antly protective against a decline in mental health among women living alon e but not among women living with a spouse. These results suggest that wome n living independently are neither socially isolated nor at increased risk for decline in functional health status. In fact, these women actually fare better on measures of psychologic function than do women living with a spo use.