A Life Course Perspective on Social Connectedness and Adult Health.pdf

Functional impairment is increasingly prevalent among middle-aged and older adults, with 2 in 5 adults over the age of 65 having some form of disability, the majority being limitations on mobility. Many older adults are able to maintain functional capacity well into later life, but the factors that contribute to high levels of function and the mechanisms by which they operate are unclear, although prior work has demonstrated the importance of social relationships for health. Guided by principles from the life course perspective and perspectives on social connectedness, this dissertation examined the role of social connectedness across the life course as a predictor of functional capacity in adulthood. I used existing longitudinal data from the national Midlife in the United States (MIDUS) study to pursue three central aims.

First, Paper 1 compared theoretical and data-driven approaches to classifying life course relationships, including multiple dimensions of social connectedness at different time points across the life course. Results showed that the data-driven approach (i.e., latent profile analysis) was a stronger predictor of functional limitations than the theoretical approach and revealed relationship trajectories consistent with life course cumulative processes. Second, using the profiles obtained from Paper 1, Paper 2 probed the association between life-course social connectedness and functional limitations by examining the potential mediating role of candidate biological and behavioral mechanisms, and moderation by socioeconomic status (SES). Paper 2 findings suggested that observed differences in later-life functional limitations based on life-course social connectedness can be at least partially explained by physical activity, but do not vary by SES. Contrary to hypotheses, inflammation was not a significant mediator. Third, Paper 3 used monozygotic twin data and within-family analyses to sharpen the focus on potential causal associations between life-course social connectedness and adult functional status. Results suggested that the association is likely driven by genetic and/or shared environmental influences. 

Taken together, these results add to our understanding of social connectedness and health and address important gaps in the literature. These findings are used to generate theory- and intervention-relevant insights into the successful maintenance of health, independence, and function across the lifespan.