Disability as a function of social networks and support in elderly AfricanAmericans and Whites: The duke EPESE 1986-1992

Objectives. We examined the association of structural and functional aspect s of social relationships with change in disability, and the degree to whic h race modifies these associations. Methods. Data ore From a population-based sample of 4,136 African Americans and Whites aged greater than or equal to 65 living in North Carolina. Disa bility data were collected during seven consecutive yearly interviews and s ummarized in two outcome measures. Measures of social relationships include d five measures representing network size. extent of social interaction, an d specific type of relationships, as well as instrumental and emotional sup port. Weighted proportional odds models were fitted to model disability as a function of baseline social network and support variables, and the intera ction of each variable with follow-up time. Results. Network size and social interaction showed significant negative as sociations with disability risks. which did not vary by race, or as a funct ion of time. Social interaction with friends was associated with a reduced risk for disability but social interaction with children or relatives was n ot related to disability. Instrumental support was associated with a signif icantly increased disability risk, with a greater adverse effect among Whit es than African Americans. Emotional support was not associated with disabi lity. but a protective effect for ADL disability was found after controllin g for its intercorrelation with instrumental support. Discussion. The findings provide further evidence for the role of social re lationships in the disablement process, although not all types of social re lationships may be equally beneficial. Furthermore. these associations may be more complex than simple causal effects. There were few racial differenc es in the association of social relationships with disability, with the pos sible exception of instrumental support. Which may allude to possible socio cultural differences in the experience of instrumental support exchanges.