JAH25610.1177/0898264313497510Journal of Aging and HealthPhongsavan et al.
Age, Gender, Social Contacts, and Psychological Distress: Findings From the 45 and Up Study
Journal of Aging and Health 25(6) 921–943 © The Author(s) 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0898264313497510 jah.sagepub.com
Philayrath Phongsavan, PhD1, Anne C. Grunseit, PhD1, Adrian Bauman, PhD1, Dorothy Broom, PhD2, Julie Byles, PhD3, Judith Clarke, PhD4, Sally Redman, PhD1,5, and Don Nutbeam, PhD6, for the SEEF Project
Abstract Objective: The study examined the relationships between social contact types and psychological distress among mid-older adults. Method: Selfcompleted data from 236,490 Australian adults aged 45+ years. Results: There was a consistent relationship between increased frequency in phone contacts, social visits, and social group contacts and reduced risk of psychological distress adjusted for demographic and health factors. However, stratified analyses by age showed, with one exception, that no significant associations were found between social group contact frequency and risk of psychological distress for those aged 85 years and older. Furthermore, significant interaction terms revealed that women experience a steeper reduction in risk than men at age 65 to 74 years and 75 to 84 years compared 1University
of Sydney, Australia National University, Canberra, Australia 3University of Newcastle, Australia 4Southern Cross Care, Sydney, Australia 5Sax Institute, Sydney, Australia 6University of Southampton, UK 2Australian
Corresponding Author: Philayrath Phongsavan, PhD, Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, NSW 2006, Australia. Email: [email protected]
Journal of Aging and Health 25(6)
with those aged 45 to 64 years. Discussion: Social contacts have age and gender differential effects on psychological distress of mid-older Australian adults. Interventions addressing social interaction need to be sensitive to gender and age differences. Keywords psychological distress, social interaction, social contacts, social support, middle age, older adults
A large body of research suggests that as people move from middle age to older age, they can experience more psychological distress, a nonspecific state of negative mood associated with anxiety and/or depression (Charles & Carstensen, 2010; Dohrenwend, Shrout, Ergi, & Mendelsohn, 1980). In this study, we refer to middle age and older age as “mid-older” and define this group as those aged 45 years and older (over 85 years). While there is continuing debate about age differences in distress during mid-older period (Jorm et al., 2005; Mirowski & Ross, 1992; Snowdon, 2001), there is consensus that social factors have a significant influence on the mental health of individuals. Social interactions are considered a key component in healthy aging (World Health Organization [WHO], 2002). The expansive research in this area shows consistent evidence of an association between higher social engagement with others and lower psychological distress levels (Berkman, Glass, Brissette, & Seeman, 2000; Holt-Lundstad, Smith, & Layton, 2010; Phongsavan, Chey, Bauman, Brooks, & Silove, 2006). Participating in a meaningful social context can provide psychological fulfillment (Berkman et al., 2000; Piliavin & Siegl, 2007) and enhance personal well-being (Morrow-Howell, Hinterlong, Rozario, & Tang, 2003), regardless of how social participation is defined or measured. Social participation is also relevant for cardiovascular health (Ellaway & Macintyre, 2007), physical functioning (Kondo, Minai, Imai, & Yamagata, 2007), independence in daily living, and survival and longevity in older populations (Giles, Glonek, Luszcz, & Andrews, 2005; Rubio, Lázaro, & Sánchez-Sánchez, 2009). Studies have found that social participation or social interaction patterns, network composition, and functionality vary qualitatively across adulthood (Lang & Carstensen, 2002), with middle-aged adults having frequent interactions and larger social networks across the home and social and
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work settings, while this may decline in older age. Reduced interactions and isolation can place elderly individuals at increased risks for depression (Cacioppe & Hughes, 2006; Heikkinen & Kauppinen, 2004), poor self-rated physical health (Cornwell & Waite, 2009), and mortality (Luo, Hawkley, Waite, & Cacioppo, 2012). It has been suggested that while younger people and middle-aged adults tend to draw support from relatively larger and socially diverse networks (including family, friends, and acquaintances), older adults place importance on the quality of social interactions, rather than the size of the networks (Carstensen, Isaacowitz, & Charles, 1999). However, most of what is known about the relationships between social interactions and mental health comes from research involving adults aged