title: Diabetes-related support, regimen adherence, and health decline among older adults.
abstract: OBJECTIVES. Social support is generally conceptualized as health promoting; however, there is little consensus regarding the mechanisms through which support is protective. Illness support has been proposed to promote regimen adherence and subsequent prevention of health decline. We hypothesize that (a) support for regimen adherence is negatively associated with self-reported health decline among older diabetic adults and that (b) regimen adherence is negatively associated with health decline among older diabetic adults.
  
  
  METHODS
  We used the Health and Retirement Study data on individuals over the age of 60 years with type 2 diabetes mellitus (n = 1,788), examining change in self-reported health status over a 2-year period using binomial and cumulative ordinal logistic regression models.
  
  
  RESULTS
  Diabetic support is not significantly associated with health decline, but it is strongly associated with adherence to health-promoting activities consisting of a diabetic regimen. Therefore, the extent to which one receives illness support for a given regimen component is highly positively associated with adhering to that component, although this adherence does not necessarily translate into protection against perceived decline in health.
  
  
  CONCLUSIONS
  Illness-related support appears to be a mechanism through which social support matters in the diabetic population. Although this relationship did not extend to prevention of health status decline among diabetics, the relationship between support and illness management is promising.
authors.affiliation: Department of Health Management and Policy, School of Public Health, University of Michigan, 109 South Observatory Street, SPH 2, Ann Arbor, MI 49109-2029, USA. enicklet@umich.edu
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Nicklett
authors.forename: Jersey
authors.initials: J
authors.lastname: Liang
mesh_terms: D000203:Activities of Daily Living / Q000145:classification* / Q000523:psychology*; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy*; D004185:Disability Evaluation; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States