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Cited by 437Aging, Health, and DisabilityAging and Gerontology ResearchHealth disparities and outcomes

Relationship of activity and social support to the functional health of older adults

Everard, K. M., Lach, H. W., Fisher, E. B., Baum, M. C.·2000·The Journals of Gerontology Series B: Psychological Sciences and Social Sciences
DOI 10.1093/geronb/55.4.s208
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Abstract

OBJECTIVES: According to J. W. Rowe and R. L. Kahn (1997), successful aging is the combination of low probability of disease, high functioning, and active engagement with life. The purpose of this study was to assess the relationship between active engagement with life and functioning in a convenience sample of community-dwelling adults aged 65 and older. METHODS: In this cross-sectional study, 244 members of an organization for older adults were mailed a survey containing the Activity Checklist and the Social Support Inventory as measures of engagement with life and the SF-12 Health Survey as a measure of functioning. RESULTS: Hierarchical linear regression showed that maintenance of instrumental, social, and high-demand leisure activities was associated with higher physical health scores and maintenance of low-demand leisure activities was associated with lower physical health scores. Maintenance of low-demand leisure activities was associated with higher mental health scores. DISCUSSION: If changes in potentially modifiable risk factors such as activity are associated with the beginning of functional decline, early intervention may be possible before disability ensues, thus reducing the risk of disability and ultimately health care costs.

AI snapshot

Written from the paper’s full text.

TL;DR

In a cross-sectional survey of 244 community-dwelling older adults, maintenance of instrumental, social, and high-demand leisure activities was associated with better physical health, while low-demand leisure activities were associated with worse physical health but better mental health. Social support was not independently associated with functioning when activity variables were included.

Key findings

  • The physical health model accounted for 30.2% of variance (*p* = .0001); activity and social support added 25.5% beyond controls. Male gender (β = .16, *p* = .013), instrumental activities (β = .19, *p* = .006), social activities (β = .30, *p* = .0001), and high-demand leisure activities (β = .30, *p* = .0001) were positively associated with physical health; low-demand leisure activities were negatively associated (β = −.19, *p* = .015).
  • The mental health model accounted for 18.1% of variance (*p* = .0001); activity and social support added 14.7% beyond controls. Only maintenance of low-demand leisure activities was independently associated with higher mental health (β = .31, *p* = .0001).
  • Social support was not associated with functioning in this study.
  • Participants were primarily White (97.5%) and female (75%), with mean age 73 (*SD* = 5.3, range 65–89); 56.6% were married, 45% were college graduates, and 10.2% had incomes below $15,000.

Methods

  • Cross-sectional mailed survey of 244 members of OASIS, an organization for older adults. Of 1,007 questionnaires mailed, 23 were undeliverable, leaving 984 as the denominator; 697 were returned (71% response rate). A social support measure was added midway through data collection, and analyses used the 244 participants who completed it and other measures.
  • Measures included a 55-item Activity Checklist with instrumental, social, high-demand leisure, and low-demand leisure subscales; a 17-item Social Support Inventory assessing directive/nondirective and emotional/instrumental support; and the SF-12 Health Survey for physical and mental health functioning.
  • Two hierarchical linear regression models used SF-12 physical and mental health subscales as dependent variables. Age, gender, income, and marital status were entered first as controls; activity and social support variables were entered second.

Limitations

  • Stated: the sample was a random selection of members of an older adult organization but not representative of community-dwelling older adults; it was primarily White, well-educated, in good health, and high income, with few lower-income participants. Age was not associated with functioning, possibly due to the restricted, healthy sample.
  • Stated: cross-sectional data confine the study to describing associations; the authors cannot determine whether activity engagement leads to better functioning or whether functioning influences activity levels.
  • Evident: functioning was measured by mailed self-report SF-12 rather than a performance measure, and the social support measure was added midway through data collection, reducing the analytic sample to 244.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1093/geronb/55.4.s208

Cites

36 of 36 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 20 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Maintenance of high-demand leisure activities was associated with higher physical health scores in the sample of community-dwelling older adults.

    “Maintenance of instrumental ( ␤ ϭ .19,p ϭ .006),social ( ␤ ϭ .30,p ϭ .0001),and high-demand leisure ( ␤ ϭ .30,p ϭ .0001)activities was positively associated with physical health.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.
  • Findingown data

    Being male was associated with higher physical health scores in the sample of community-dwelling older adults.

    “Being male was associated with higher physical health scores ( ␤ ϭ .16,p ϭ .013).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.
  • Findingown data

    Maintenance of social activities was associated with higher physical health scores in the sample of community-dwelling older adults.

    “Maintenance of instrumental ( ␤ ϭ .19,p ϭ .006),social ( ␤ ϭ .30,p ϭ .0001),and high-demand leisure ( ␤ ϭ .30,p ϭ .0001)activities was positively associated with physical health.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.
  • Findingown data

    The mental health regression model accounted for 18.1% of the variance in mental health.

    “In the regression model with mental health as the dependent variable, 18.1% of the variance was accounted for by the independent variables ( p ϭ .0001).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.
  • Findingown data

    The physical health regression model accounted for 30.2% of the variance in physical health.

    “In the model with physical health as the dependent variable, 30.2% of the variance in physical health was accounted for by the independent variables ( p ϭ .0001).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.
  • Classified as probably not a substantial claim. 18
  • May combine two claims. 10

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The sample was primarily White (97.5%).

    “Participants were primarily White (97.5%) and female (75%).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.

  • May combine two claims.

    Findingown data

    Both regression models testing the relationship of activity and social support to physical and mental health were significant.

    “Both regression models testing the relationship of activity and social support to physical and mental health were significant.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The sample was primarily female (75%).

    “Participants were primarily White (97.5%) and female (75%).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The sample was well educated, with 45% being college graduates.

    “Participants were well educated, with 45% being college graduates.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Mean age was 73 (SD 5.3, range 65-89).

    “Mean age was 73 ( SD ϭ 5.3, range ϭ 65-89)”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Participants reported high income.

    “Participants also reported high income”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.

  • May combine two claims.

    Findingnone given

    The sample was primarily a White, well-educated sample in good health.

    “Ours was primarily a White, well-educated sample in good health.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 244 participants who completed the social support measure are representative of the larger sample of respondents.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The SF-12 physical subscale had relative validity coefficients ranging from .43 to .78 and the mental subscale from .93 to .98 in previous tests.

    “Relative validity coefficients, measured with a known groups procedure, for the physical subscale ranged from .43 to .78 and for the mental subscale ranged from .93 to .98 in previous tests (Ware, Kosinski, & Keller, 1996).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ware, Kosinski, & Keller, 1996

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Participants were randomly selected to include older adults in health promotion courses, in non-health-related courses, and in no courses.

    “participants were randomly selected to include older adults in health promotion courses, in non-health-related courses, and in no courses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The survey response rate was 71% (697 returned of 984 delivered).

    “697 were returned for a response rate of 71%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The SF-12 physical subscale had test-retest reliability of .89 and the mental subscale .76 over a 2-week interval.

    “Test-retest reliability with a 2-week time interval was .89for the physical subscale and .76 for the mental subscale (McHorney, Kosinski, & Ware, 1994).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites McHorney, Kosinski, & Ware, 1994

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The Social Support Inventory subscales had Cronbach's alphas of .83, .69, .88, and .93 for directive instrumental, nondirective instrumental, directive emotional, and nondirective emotional support, respectively.

    “Cronbach's alphas were .83,.69,.88,and .93 for directive instrumental, nondirective instrumental, directive emotional, and nondirective emotional support, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The bivariate correlation between the dependent variables (-.025) and the path between them from the simultaneous model (-.10) were not significant, so two regression models were chosen.

    “Neither the bivariate correlation between the dependent variables ( Ϫ .025)nor the path between the dependent variables from the simultaneous model ( Ϫ .10)was significant.Thus, we chose to use two regression models.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The sample may have greater access to programs that offer opportunities to engage in activities that could affect health.

    “Our sample may have greater access to programs that offer the opportunity to engage in activities that could affect health.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Age, gender, income, and marital status were included in the models as controls.

    “age, gender, income, and marital status were included in the models as controls”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Maintenance of social, leisure, and instrumental activities was associated with better functioning in terms of both physical and mental health, although low-demand leisure activities may differentially affect health.

    “Maintenance of social, leisure, and instrumental activities was associated with better functioning in terms of both physical and mental health, although low-demand leisure activities may differentially affect health.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Rowe and Kahn proposed a model of successful aging comprising three components: avoidance of disability, maintenance of physical functioning, and active engagement with life.

    “Rowe and Kahn (1997) proposed a model of successful aging comprising three components: avoidance of disability, maintenance of physical functioning, and active engagement with life.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rowe and Kahn (1997)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Social support is related to positive effects on the cardiovascular, endocrine, and immune systems.

    “In their review of 81 studies, Uchino, Cacioppo and Kiecolt-Glaser (1996) found that social support was related to positive effects on the cardiovascular, endocrine, and immune systems.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Uchino, Cacioppo and Kiecolt-Glaser (1996) source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    High income has been associated with better health.

    “which has been associated with better health (Guralnik & Simonsick, 1993).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Guralnik & Simonsick, 1993

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Less strenuous leisure activities have been associated with better functioning and survival among older adults.

    “However, less strenuous leisure activities, such as attending classes or volunteering, also have been associated with better functioning (Berkman et al., 1995;Herzog, Franks, Markus, & Holmberg, 1998) and survival (Glass, Mendes de Leon, Marottoli, & Berkman, 1999) among older adults.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Berkman et al., 1995 source

      Not checked in the free run.

    • cites Herzog, Franks, Markus, & Holmberg, 1998 source

      Not checked in the free run.

    • cites Glass, Mendes de Leon, Marottoli, & Berkman, 1999 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Premisecitation

    Successful aging occurs at the intersection of the three components and is more than the absence of disease and maintenance of high functioning.

    “Successful aging occurs at their intersection and is more than the absence of disease and maintenance of high functioning.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rowe and Kahn (1997)

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Among older adults, emotional support has been associated with better physical functioning and reduced mortality risks.

    “Among older adults, emotional support has been associated with better physical functioning (Seeman et al., 1995) and reduced mortality risks (Penninx et al., 1997)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Seeman et al., 1995 source

      Not checked in the free run.

    • cites Penninx et al., 1997 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Engagement in social activities was associated with increased physical function and predicted a slower decline in functional status over a 6-year period.

    “Unger, Johnson, and Marks (1997) found that engagement in social activities was associated with increased physical function and predicted a slower decline in functional status over a 6-year period.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Unger, Johnson, and Marks (1997)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    The authors believe that if activity engagement is related to functioning in this sample, it would be related in the population of community-dwelling older adults.

    “Even with the shortcomings of this study, if activity engagement is related to functioning in this group, we believe they would be related in the population.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    According to Rowe and Kahn, engagement with life includes activity and social support.

    “According to Rowe and Kahn (1997), engagement with life includes activity and social support.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rowe and Kahn (1997)

      Not checked in the free run.

25 of 25

  • The authors state this as an assumption.

    Activity is a potentially modifiable factor that can be changed by intervention.

    “What we have found in this study are potentially modifiable factors associated with functioning that could enhance successful aging.”

  • The paper relies on this without support.

    The 244 participants who completed the social support measure are representative of the larger sample of respondents.

    “A measure of perceived social support was added to the survey midway through data collection.Our analyses were conducted with the 244 participants who completed this and other measures.”

  • The authors state this as an assumption.

    Few studies have included both activity and social support, and none have included social, instrumental, and leisure activities together.

    “Few researchers have included both activity and social support when examining the relationship between engagement with life and functioning in older adults, and to our knowledge no studies have included social, instrumental, and leisure activities together.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conclusion overstates which activities were associated with mental health

    Major

    The conclusion says social, leisure, and instrumental activities were associated with better physical and mental health. The results say that only low-demand leisure activity was independently associated with increased mental health.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Berkman, 1992, Annals of Internal Medicine, 117, 1003, 10.1059/0003-4819-117-12-1003 · DOI
  2. 1996, Medical care, 32, 220

Cited by

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Related

Authors
Everard, K. M., Lach, H. W., Fisher, E. B., & Baum, M. C.
Affiliations
Washington University in St. Louis (US)
Corresponding author
Everard, K. M.
ORCID
Venue
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Publisher
Oxford University Press (OUP)
Published
2000-07-01
Volume
55
Issue
4
Pages
S208-S212
ISSN
  • 1079-5014 (ISSN-L)
  • 1758-5368
DOI
10.1093/geronb/55.4.s208
OpenAlex
W2149121845
Semantic Scholar
9400b138016de31b8b13c65bed3b08cf3de63854
Cited by
437
References
35
Citations by year
2026: 7 · 2025: 8 · 2024: 7 · 2023: 7 · 2022: 19 · 2021: 17 · 2020: 16 · 2019: 18 · 2018: 28 · 2017: 20 · 2016: 33 · 2015: 24 · 2014: 28 · 2013: 18 · 2012: 36
FWCI
5.48
Type
journal article
Language
en
Open access
closed
Locations
  • The Journals of Gerontology Series B (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (2T32HL07456, T32HL007456)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
  • Social Sciences › Health › Health disparities and outcomes
Keywords
successful aging, older adults, leisure, social support, functional health, physical health, mental health, instrumental activities, community-dwelling older adults, disability risk, health care costs
MeSH terms
Activities of Daily Living, Aged, Aged, 80 and over, Aging, Female, Humans, Leisure Activities, Life Style, Male, Mental Health, Social Support, Health Behavior

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