Aging
Social integration and subsequent disability in older adults from California L. Paloma Rojas-Saunero* L. Paloma Rojas-Saunero Ryo Ikesu Natalie Gradwohl Ruijia Chen Rachel A. Whitmer Paola Gilsanz M. Maria Glymour Elizabeth Rose Mayeda
Background: Understanding the benefits of social integration on health among older adults is important for informing the design of future interventions to prevent isolation and promote healthy aging. The aim of this study is to estimate the association between social integration and subsequent disability in older adults in California. Methods: We used longitudinal data from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study and the Study of Health Aging in African Americans (STAR) and included all participants free of instrumental activities of living (IADL) limitations at baseline. Social integration was defined by the Berkman-Syme Social Network Index (SNI) at baseline and was categorized as least integrated (SNI: 0-2), moderately integrated (SNI: 3-4), and most integrated (SNI: 5-6). The outcome corresponds to having any (versus no) IADL limitations [managing money (keeping track of expenses, paying bills); doing chores at home (vacuuming, sweeping, dusting, straightening up); preparing own meals] on the follow-up visits over 4 years. We fit generalized estimating equation models to estimate the risk of incident disability by social integration category, adjusting for baseline age, sex, and educational attainment. Results: We included 1702 participants (n = 349 “least integrated”, n = 947 “moderately integrated”, n = 406 “most integrated”). Mean baseline age was 73 (SD: 7) years, 60% were women. Median follow-up was 2.3 years. The adjusted risk ratio for newly reported IADL limitations was 1.17 (95% CI: 0.90, 1.52) for participants moderately integrated and 0.65 (95% CI: 0.46, 0.93) for most integrated participants, compared to those least integrated. Discussion: These findings suggest that social integration is associated with lower risk of developing disability in later life. Future work needs to expand on how changes in social integration impact incident disability.