The importance of maintaining strong interpersonal relationships well into older adulthood is reinforced by new data from two longitudinal studies--one of them spanning 70 years in the lives of participants--that link mortality risk and social ties to the community. One study, which involved rural Iowans, demonstrated a significant decrease in mortality for older adults who were very involved in church activities.

Presented at the 106th Annual Meeting of the American Psychological Association (APA) held this summer in San Francisco, the research highlights a newfound reliance on longitudinal data not commonly available to gerontologists 10 years ago. Karen Hooker, associate professor in the department of human development and family sciences at Oregon State University, called this change a "major advance." She explained during a symposium on social relationships and health among elders, "In order for us to explain where you end up in later life, it's important for researchers to be able to trace within individuals the trajectories of change."

In the last decade, Hooker said, numerous studies have shown that as people age, those having close relationships with friends or family and holding membership in clubs or organizations tend to have better health and well-being than older adults who are less involved in the community.

During the symposium, psychologist Daniel Russell presented research exploring whether certain types of social contact have unique effects on mortality risk. The study, "Social Contact and Mortality Among Rural Older Adults," found that among participants, "the better the social relationships (at the beginning of the study), the less likely they were to die over the course of the (12-year) study."

The most specific correlation in the data was between church involvement and low mortality risk. "Individuals who reported attending church more frequently" at the beginning of the study "were less likely to die over the next 12 to 13 years" (the period studied) even after researchers filtered out the possible effects of factors, such as subjects' physical health, which could limit their church attendance, and social support, which could be a benefit of going to church.

Russell, a psychology professor at the Institute for Social and Behavioral Research, Center for Family Research in Rural Mental Health, at Iowa State University, and coauthors based their research on a 12-year study of nearly 2,000 rural Iowans whose average age was 74. Initial interviews were collected in 1981 and 1982 from Iowa participants of the Established Populations for Epidemiologic Studies of the Elderly (epese).

Study subjects were asked about their levels of stress, mental status, physical health, morale and extent of loneliness. Also measured was the extent of their participation in clubs; church involvement; their number of living children, close relatives and friends; and how comfortable they felt relying on their children, close relatives or friends in an emergency.

"In measuring loneliness, we never explicitly used the word lonely," Russell said. "Other research has shown, for example, that men will rarely admit to being lonely, and we feel that the same might be true with elders. Loneliness is not the same as being alone. Some people don't have a lot of contact with other people, and they're quite happy; others have lots of contact and are still quite lonely. So, instead, we measured loneliness based on questions, such as, 'How often do you feel isolated?' Or, 'How often do you feel in tune with other people?'"

Forty-four percent of the participants died during the study years. The primary and secondary causes of death were identified so the researchers could determine whether evidence connected different types of social contact to particular causes of death. The most frequent reasons for mortality among participants was cardiac disease, cancer and respiratory illness.

Not surprisingly, he said, the lonely individuals tended to have a higher mortality risk than those who were not lonely. Previous research has shown that lonely people have lowered immune systems, which affects mortality. However, lonely individuals in the Iowa study were less likely to die of cancer. Russell called the finding "counterintuitive" and said future research might consider if there is indeed a relationship between loneliness and cancer.

Also under further examination, Russell said, is how church-going and religiosity affect mortality.

Brandeis University psychologist Joan Tucker presented research analyzing data from the earliest continuous U.S. study of a single population, begun at Stanford University in 1921. Researcher Lewis Terman interviewed approximately 1,500 bright schoolchildren (mostly white and from middle-class families) from the San Francisco and Los Angeles areas, and his successors followed this group with questions about their lives every 5to 10 years through 1991. The Terman Life-Cycle Study set the pace for longitudinal research that is becoming increasingly important to an aging society.

For example, Tucker and her colleagues from the State University of New York at Stony Brook and the University of California at Riverside are among many investigators who have analyzed this data. She said that her research team's findings "provide the strongest evidence to date that the health consequences of [having strong social relationships] change as individuals get older." The researchers relied on data from four assessments of the study group taken in 1940, 1950, 1960 and 1977. Social ties were based on evaluations of marital status, number of living children and siblings and the number of organizations to which the subjects belonged.

Tucker said that the evidence strongly suggested that as the usually positive effect of marriage on health declined as survey subjects age, "other social ties may compensate by having a stronger influence on health and longevity."

The data also showed that men had a significantly higher mortality risk if they were divorced or widowed, even if they later remarried. Men who had two or more children had a marginally lower risk of mortality, as did those men who belonged to more clubs and organizations. However, after age 70, men who had remarried had a lower mortality rate than those who remained single.

Tucker suggested that the results might show that men whose marriage ended may suffer "short- and long-term detrimental effects on health [which could] partially explain the link between marital status and mortality risk. . . . This suggests that remarriage may eventually have beneficial health effects for men."

For women, marital status was not a significant factor, but having more children and belonging to more clubs and organizations were associated with a lower mortality risk. Among women age 70 or older, children and social clubs became more significantly related to lower mortality risk. Tucker said that perhaps as women age and "experience widowhood or are themselves caring for an aging spouse, their children and the relationships they establish through participation in clubs and organizations become more important sources of companionship, social support . . . which, in turn, have health-promotive effects for these older women."

Next, she said, "We need to replicate these findings and then think about what they mean. What does this tell us about growing older?"

For more information, contact Daniel Russell, Institute for Social and Behavioral Research, Center for Family Research in Rural Mental Health, Iowa State University, 2625 N. Loop Dr., Suite 500, Ames, IA 50010-8296; (515) 294-4518; fax (515) 294-3613; e-mail: drussell@iastate.edu; Joan Tucker, Department of Psychology, Brandeis University, Waltham, MA 02254-9110; (781) 736-3300; fax (781) 736-3247; e-mail: tucker@binah.cc.brandeis.edu.

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