Another study finds institutionalization especially common after the death of a spouse
THURSDAY, May 29 (HealthDay News) -- People who keep up active social lives as they age may be doing their brain a favor, a new study finds.
Being socially active may increase feelings of self-worth and emotional validation that could end up helping maintain memory, researchers say. Social interaction may also present older minds with new challenges, keeping the brain more agile.
"We assessed social integration by marital status, volunteer activities and frequency of contact with children and neighbors," explained lead researcher Karen Ertel, a postdoctoral fellow in the Department of Society, Human Development and Health at the Harvard School of Public Health, Boston.
Her team found that "people who were most socially integrated had memory decline of less than half the rate compared with those who were the least socially integrated," Ertel said.
The report is published in the May 29 online edition of the American Journal of Public Health.
In the study, Ertel's team collected data on almost 17,000 Americans, 50 and older, who participated in the Health and Retirement Study. To test memory, the researchers had participants memorize a list of 10 words. Over six years, researchers tested recall of the word list to assess any decline in immediate and delayed recall.
Average memory scores declined from 11 in 1998 to 10 in 2004, the researchers reported. People who were more socially engaged at the start of the study had a slower decline in memory, compared with people who were more socially isolated, the researchers found.
According to Ertel, the findings indicate that "social activity may help preserve cognitive functioning in the elderly. In addition, people who are socially active may also have other healthful behaviors, which may be related to cognition and better physical health."
In another study in the same issue of the journal, Finnish researchers reported that elderly people are more likely to be institutionalized following the death of a spouse.
"We found that the risk of entering long-term institutional care was higher among older adults who had lost their spouse than among those living with their spouse," said lead researcher Elina Nihtila, from the department of sociology at the University of Helsinki.
Moreover, the excess risk of institutionalization was highest during the first month after the spouse's death, Nihtila said. "The risk was more than three times among both men and women, and decreased with time from bereavement, stabilizing at approximately 20 percent to 50 percent higher over one to five years," she said.
Fortunately, a large proportion of surviving spouses are likely to recover from partner loss, and feelings of despair and anxiety typically do diminish over time, Nihtila said. This "emotional recovery could explain why the very large excess risk of entering institutional care among those recently bereaved dropped with time from the spouse's death," she said.
The study involved data on almost 141,000 people 65 and older living with a spouse. During five years of follow-up, the risk of being institutionalized rose immediately after the death of a spouse, the researchers found.
There could be various explanations for these findings, Nihtila said, including a "loss of social and instrumental support, in the form of care and help with daily activities such as help in cooking, cleaning, and shopping formerly shared with the deceased spouse."
In addition, grief and spousal loss may cause various symptoms, such as depression and anxiety, loss of appetite, sleep disturbances, fatigue and loss of concentration, Nihtila noted. "Furthermore, grief may cause increased susceptibility to physical diseases that could also increase the need for institutional care," she said.
Home help services targeted to the bereaved immediately after a spouse's death might help ease the strain, Nihtila said.
One expert said the studies highlight the problem of growing social isolation among the elderly.
"There is nothing like being face-to-face with someone," said Colin Milner, CEO of the Vancouver-based International Council on Active Aging. "But I think we are manufacturing that [contact] out of our lifestyle and that will have a long term detrimental effect on the mental health of the population," he said.
More outreach to older people, especially when a spouse dies, will be key, Milner said. "There should be programs when a spouse dies to help them get back into the swing of life," he said.
For more on healthy aging, visit the U.S. Centers for Disease Control and Prevention.
SOURCES: Elina Nihtila, Department of Sociology, University of Helsinki, Finland; Karen Ertel, Ph.D., postdoctoral fellow, Department of Society, Human Development and Health, Harvard School of Public Health, Boston; Colin Milner, CEO, International Council on Active Aging, Vancouver, British Columbia, Canada; May 29, 2008, online edition, American Journal of Public Health
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