title: Understanding causal associations between self-rated health and personal relationships in older adults: A review of evidence from longitudinal studies.
abstract: BACKGROUND
  As we age we experience many life changes in our health, personal relationships, work, or home life which can impact on other aspects of our life. There is compelling evidence that how we feel about our health influences, or is influenced by, the personal relationships we experience with friends and relatives. Currently the direction this association takes is unclear.
  
  
  OBJECTIVE
  To assess the level of published evidence available on causal links between self-rated health and personal relationships in older adults.
  
  
  METHODS
  MEDLINE, CINAHL, and PsycINFO searches from inception to June 2012 and hand searches of publication lists, reference lists and citations were used to identify primary studies utilizing longitudinal data to investigate self-rated health and personal relationships in older adults.
  
  
  RESULTS
  Thirty-one articles were identified. Only three articles employed methods suitable to explore causal associations between changes in self-rated health and changes in personal relationships. Two of these articles suggested that widowhood leads to a reduction in self-rated health in the short term, while the remaining article suggested a causal relationship between self-rated health and negative emotional support from family or friends, but this was complex and mediated by self-esteem and sense of control.
  
  
  CONCLUSIONS
  While there is an abundance of longitudinal aging cohorts available which can be used to investigate self-rated health and personal relationships over time the potential for these databases to be used to investigate causal associations is currently not being recognized.
authors: Leeds Institute of Health Sciences, Charles Thackrah Building, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, UK. Electronic address: c.l.craigs@leeds.ac.uk.
authors: Cheryl L
authors: CL
authors: Craigs
authors: Leeds Institute of Health Sciences, Charles Thackrah Building, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, UK.
authors: Maureen
authors: M
authors: Twiddy
authors: Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
authors: Stuart G
authors: SG
authors: Parker
authors: Leeds Institute of Health Sciences, Charles Thackrah Building, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, UK.
authors: Robert M
authors: RM
authors: West
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D005190:Family / Q000523:psychology; D033062:Friends / Q000523:psychology; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies
keywords: Aging; Causation; Cohort studies; Longitudinal; Relationships; Self-rated health