Latham Kenzie, Clarke Philippa J, Pavela Greg
Department of Sociology, Indiana University-Purdue University Indianapolis, Indianapolis.
Institute for Social Research, University of Michigan, Ann Arbor.
J Gerontol B Psychol Sci Soc Sci. 2015 Sep;70(5):769-81. doi: 10.1093/geronb/gbu181. Epub 2015 Jan 12.
Evidence suggests social relationships may be important facilitators for recovery from functional impairment, but the extant literature is limited in its measurement of social relationships including an over emphasis on filial social support and a paucity of nationally representative data.
Using data from Waves 4-9 (1998-2008) of the Health and Retirement Study (HRS), this research examines the association between social relationships and recovery from severe mobility limitation (i.e., difficulty walking one block or across the room) among older Americans. Using a more nuanced measure of recovery that includes complete and partial recovery, a series of discrete-time event history models with multiple competing recovery outcomes were estimated using multinomial logistic regression.
Providing instrumental support to peers increased the odds of complete and partial recovery from severe mobility limitation, net of numerous social, and health factors. Having relatives living nearby decreased the odds of complete recovery, while being engaged in one's neighborhood increased the odds of partial recovery. The influence of partner status on partial and complete recovery varied by gender, whereby partnered men were more likely to experience recovery relative to partnered women. The effect of neighborhood engagement on partial recovery also varied by gender. Disengaged women were the least likely to experience partial recovery compared with any other group.
The rehabilitative potential of social relationships has important policy implications. Interventions aimed at encouraging older adults with mobility limitation to be engaged in their neighborhoods and/or provide instrumental support to peers may improve functional health outcomes.
有证据表明社会关系可能是功能障碍恢复的重要促进因素，但现有文献在社会关系测量方面存在局限性，包括过度强调子女的社会支持且缺乏全国代表性数据。
利用健康与退休研究（HRS）第4 - 9轮（1998 - 2008年）的数据，本研究考察了美国老年人的社会关系与从严重行动不便（即行走一个街区或穿过房间困难）中恢复之间的关联。使用一种更细致入微的恢复测量方法，包括完全恢复和部分恢复，通过多项逻辑回归估计了一系列具有多个竞争恢复结果的离散时间事件史模型。
在排除众多社会和健康因素后，向同龄人提供工具性支持增加了从严重行动不便中完全恢复和部分恢复的几率。有亲属住在附近会降低完全恢复的几率，而参与社区活动则会增加部分恢复的几率。伴侣状态对部分恢复和完全恢复的影响因性别而异，相对于有伴侣的女性，有伴侣的男性更有可能恢复。社区参与对部分恢复的影响也因性别而异。与其他任何群体相比，不参与社区活动的女性最不可能经历部分恢复。
社会关系的康复潜力具有重要的政策意义。旨在鼓励行动不便的老年人参与社区活动和/或向同龄人提供工具性支持的干预措施可能会改善功能健康状况。
