title: Living arrangements, social integration, and change in functional health status.
abstract: Limited prospective data have examined the association between living arrangements and emotional wellbeing. The authors assessed whether older women living with a spouse were less likely to experience a decline in mental health, vitality, or physical function compared with women living alone or with nonspouse others. The association between living arrangement and 4-year change in functional health status was examined prospectively among 28,324 women 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) = 0.73, 95 percent confidence interval (CI): 0.65, 0.81) and vitality (RR = 0.72, 95 percent CI: 0.65, 0.80) compared with those living with a spouse. Contact with friends and relatives and level of social engagement were significantly protective against a decline in mental health among women living alone but not among women living with a spouse. These results suggest that women 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 spouse.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Y L
authors.initials: YL
authors.lastname: Michael
authors.forename: L F
authors.initials: LF
authors.lastname: Berkman
authors.forename: G A
authors.initials: GA
authors.lastname: Colditz
authors.forename: I
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D015999:Multivariate Analysis; D009726:Nurses / Q000523:psychology / Q000706:statistics & numerical data; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012934:Social Isolation / Q000523:psychology*; D018454:Spouses / Q000523:psychology; D014481:United States / Q000453:epidemiology; D016387:Women's Health