title: Structural and functional measures of social relationships and quality of life among older adults: does chronic disease status matter?
abstract: OBJECTIVE
  To evaluate the relative importance of structural and functional social relationships for quality of life (QoL) and the extent to which diagnosed chronic disease modifies these associations.
  
  
  METHODS
  Multivariate linear regression was used to investigate time-lagged associations between structural and functional measures of social relationships and QoL assessed 5 years apart by CASP-19, in 5925 Whitehall II participants (mean age 61, SD 6.0). Chronic disease was clinically verified coronary heart disease, stroke, diabetes or cancer.
  
  
  RESULTS
  Social relationships-QoL associations were consistent across disease status (P-values for interaction: 0.15-0.99). Larger friend network (β = 1.9, 95% CI 1.5-2.3), having a partner (β = 1.2, 95% CI 0.5-1.7), higher confiding support (β = 2.2, 95% CI 1.8-2.7) and lower negative aspects of close relationships (β = 3.3, 95% CI 2.8-3.8) were independently related to improved QoL in old age. The estimated difference in QoL due to social relationships was equivalent to up to 0.5 SD of the CASP-19 score and was stronger than the effect of chronic disease (coronary heart disease β = 2.0, 95% CI 1.4-2.6).
  
  
  CONCLUSIONS
  We found that beneficial aspects of social relationships in relation to QoL were, in order of importance: avoiding negative aspects of close relationships, having confiding support, having a wide network of friends and having a partner. These associations were not modified by chronic disease. Thus, despite inevitable physical deterioration, we may be able to enhance a satisfying late life by optimizing our social relationships.
authors.affiliation: Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK. jing.liao.11@ucl.ac.uk.
authors.forename: Jing
authors.initials: J
authors.lastname: Liao
authors.affiliation: Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Brunner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002908:Chronic Disease / Q000523:psychology*; D003327:Coronary Disease / Q000523:psychology; D003920:Diabetes Mellitus / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D020521:Stroke / Q000523:psychology
keywords: Ageing; Chronic disease; Quality of life; Social relationships