Gender differences in the effect of social support on health-related quality of life: results of a population-based prospective cohort study in old age in Germany.
OBJECTIVE
The causality between social predictors and HRQoL in old age remains almost unclear as only a few studies have examined the influence of social support on HRQoL in a longitudinal setting. Moreover, available studies investigating gender differences in the effect of social support on HRQoL in old age have been solely cross-sectional. Consequently, the aim of this study was to examine whether social support affects health-related quality of life (HRQoL) in old age and whether this effect is moderated by gender.


METHODS
In a population-based cohort (N = 2443) of people aged 75 years and older in Germany, the development of HRQoL was prospectively observed over a 3-year period. Quality of life was quantified by using the visual analogue scale of the EQ-5D instrument. Social support was assessed by using the 14-item form of the questionnaire for social support (F-SozU K-14). In order to control for unobserved heterogeneity, fixed-effects regression analysis was used.


RESULTS
In the total sample (β = 0.55, p < 0.05) and in men (β = 1.39, p < 0.001), a strong positive impact of social support on HRQoL was found. There was no significant effect of social support on HRQoL in women. The effect of social support on HRQoL was significantly moderated by gender (p < 0.05).


CONCLUSIONS
Findings accentuate the fundamental role of social support in HRQoL in old age. Particularly in men, it is therefore crucial to strengthen the social ties in old age.
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. a.hajek@uke.de.
André
A
Hajek
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Christian
C
Brettschneider
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Carolin
C
Lange
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Tina
T
Posselt
WG Medical Statistics and IT-Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
Birgitt
B
Wiese
WG Medical Statistics and IT-Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
Susanne
S
Steinmann
Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Siegfried
S
Weyerer
Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Jochen
J
Werle
Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Michael
M
Pentzek
Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Angela
A
Fuchs
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Janine
J
Stein
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Tobias
T
Luck
Department of Psychiatry, Technical University of Munich, Munich, Germany.
Horst
H
Bickel
Department of Psychiatry, Technical University of Munich, Munich, Germany.
Edelgard
E
Mösch
Department of Psychiatry, University of Bonn, Bonn, Germany.
Steffen
S
Wolfsgruber
Department of Psychiatry, University of Bonn, Bonn, Germany.
Kathrin
K
Heser
Department of Psychiatry, University of Bonn, Bonn, Germany.|German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Wolfgang
W
Maier
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Martin
M
Scherer
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Steffi G
SG
Riedel-Heller
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Hans-Helmut
HH
König
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006296:Health Services; D006304:Health Status; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D057566:Self Report; D012737:Sex Factors; D012944:Social Support
Gender differences; Health-related quality of life; Interaction; Longitudinal; Older people; Social support