Emerging Trends in The Social and Behavioral Sciences

Social Relationships and Health in Older Adulthood

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Social Relationships and Health in Older Adulthood

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Social Relationships and Health
in Older Adulthood
THEODORE F. ROBLES and JOSEPHINE A. MENKIN

Abstract
Older adults make up a larger proportion of the population and are living longer
than in any time in previous history, which has important implications for their social
relationships. This essay reviews key theory and research on changes in social networks over the lifespan, the benefits (and costs) of social relationships for physical
health, and the health impact of loss of social relationships during older age. Methodological innovations are shedding new light on the specific biological mechanisms
that explain how high and low quality social relationships can impact health, and
we review these innovations in different contexts: marriage and loneliness. While
social networks generally decrease in size across the lifespan, there is considerable
potential for expanding social networks and forming new relationships in later life.
However, the research literature on forming new friendships and intimate relationships in older adults is quite limited. Thus, this essay concludes by describing key
issues and methodological challenges involved in studying new relationship formation in older adults.

INTRODUCTION
Improvements in public health have led to a significant “graying” of populations around the world, which, along with economic challenges, poses
social challenges as well. In this essay, we address emerging trends in social
relationships in older adulthood, with a focus on implications for health
and well-being. We review seminal theory and research on changes in social
networks across the lifespan, the benefits and costs accrued from social
networks, and the health impact of specific social losses that occur in later
life. We then describe cutting-edge research in two areas: marriage and loneliness, and their impact on physical health. Finally, as the field has generally
focused on shrinkage and loss, an increasing older adult population also
brings much potential for expanding social relationships. Thus, we review
research on new relationship formation in later life, including friendships

Emerging Trends in the Social and Behavioral Sciences. Edited by Robert Scott and Stephen Kosslyn.
© 2015 John Wiley & Sons, Inc. ISBN 978-1-118-90077-2.

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and intimate relationships, describing open questions and challenges in
studying new relationship formation.
FOUNDATIONAL RESEARCH
SOCIAL NETWORK CHANGES WITH AGE
While there is likely significant interindividual variability, on average overall
social network size peaks in late adolescence/early adulthood, followed by
steady shrinking over the lifecourse (Wrzus, Hänel, Wagner, & Neyer, 2013).
The downward rate of change continues but slows in older age, primarily
due to a reduction in number of friends, but not family ties.
Widely accepted theories attribute changes in social networks to individual
changes in social motivation (socioemotional selectivity theory) or to life
events and environmental changes (social convoy theory). Socioemotional
selectivity theory posits that for social behavior, when people perceive their
future as more constrained (such as aging adults), emotion regulation
goals become increasingly valued over acquiring information, leading to
increased preference for spending time with close others (e.g., family or
friends). In contrast, when people view their future time as unlimited,
they prefer to spend time with others who provide new information or
experiences. Indeed, older adults appear to prune their social networks to
reduce numbers of acquaintances but preserve close, meaningful relationships (for a review, see Charles & Carstensen, 2010). Social convoy theory
also matches the observed data, but attributes the lower stability of more
peripheral acquaintances to external life events such as loss of a spouse or
relocation.
In addition to specific life events, older adults may experience a different
social environment more broadly. Older adults often have less time constraints than middle-aged counterparts (e.g., less conflict with work and
childcare), but they can have new constraints, such as reduced physical
and financial resources (Blieszner & Roberto, 2004). Furthermore, on a
day-to-day basis, older adults tend to report fewer situations where they
avoided or engaged in an argument than younger adults (Birditt, Fingerman,
& Almeida, 2005). Lifespan development perspectives suggest that older
adults differ from younger adults in how they think about and evaluate
interpersonal tensions (cognitive appraisals) and control the experience
and expression of emotions (emotion regulation). However, this reduction
in negative social experiences in later life may also be influenced by the
interaction partner’s behavior toward older adults. The social input model
proposes that when older adults are motivated to minimize conflict in
social relationships, their social partners (of any age) correspondingly treat

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them favorably to maintain a positive relationship (Fingerman & Charles,
2010). Thus, both internal factors (social motivation goals, ways of thinking)
and external factors (life events, how other people view older adults)
contribute to the changes in social networks in older adulthood and how
those networks are perceived and maintained over time. Such factors likely
contribute to the benefits and costs of social relationships for health.
SOCIAL SUPPORT AND NEGATIVITY AND HEALTH
Strong social relationships are associated with a lower risk of mortality
across the lifespan (Holt-Lunstad, Smith, & Layton, 2010) and in older adults
(e.g., Steptoe, Shankar, Demakakos, & Wardle, 2013). The benefits and costs
of social relationships for well-being operate through psychological, behavioral, and physiological mechanisms (for a review see Uchino, 2004). While
such processes are expected to influence health throughout the lifespan,
they may take on particular importance in later life when individuals have
greater physical vulnerability. Here, we focus on the benefits and costs of
social relationships more broadly.
Humans “need to belong” in social networks, which is on par with our
basic needs for safety, shelter, and sustenance (Baumeister & Leary, 1995).
Social relationships are a critical source of instrumental, informational,
emotional support that we receive from others during stressful events and
circumstances (Uchino, 2004). In addition, sharing good personal news with
others, known as capitalization, can prolong the positive emotions that
accompany good news (Gable, Gonzaga, & Strachman, 2006). At the same
time, social relationships inevitably incur some cost (reviewed in Brooks &
Dunkel Schetter, 2011). Social networks are a source of disagreement and
conflict. In addition, friends and family can be sources of insensitivity (i.e.,
showing disregard for one’s needs and wishes) and even impede our pursuit
of important goals.
As described, older adults normatively pursue more positive social
interactions in the process of pruning social networks. In addition, older
adults are more adept at avoiding social negativity, and show less affective
reactivity to negative social interactions when they occur. However, social
tension is unavoidable, and people with social networks characterized by
members who are sources of social support and negativity, often termed
“ambivalent” network ties (having high positive and negative self-reported
attitudes toward such individuals) may be at particular risk for poor health
and well-being because of the unpredictable nature of those relationships.
For example, in a nationally representative sample of older adults, greater
self-reported negativity of ambivalent family ties was related to greater

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limitations in physical functioning (Rook, Luong, Sorkin, Newsom, &
Krause, 2012).
LOSS OF SOCIAL RELATIONSHIPS
The loss of core social relationships is a major contributor to social network
shrinkage in old age. Over the past 20 years, the divorce rate among adults
over age 50 has doubled, accounting for one out of every four dissolved marriages; the rate of increase was largest for older adults (Brown & Lin, 2012).
Following divorce, parent–child relationship contact and quality may suffer (reviewed in Brown & Lin, 2012) and social networks show decreased
size and density (Milardo, 1987). For the divorced individual, divorce has
negative consequences for mental and physical health, including decreased
subjective well-being, increased risk for depression, and mortality (Sbarra,
Hasselmo, & Nojopranoto, 2012).
Widowhood, considered one of the most stressful events one could experience, increases risk for depression and complicated (prolonged) grief. Widowhood is also associated with worse self-rated physical health, and elevated
disability and illness (Stroebe, Schut, & Stroebe, 2007). In prospective studies widowers have 22% greater risk of early mortality compared to married
persons (Shor et al., 2012). While mortality risk due to widowhood is lower
in older relative to younger adults, widowhood itself is much more common
in older adults.
MECHANISMS
Positive and negative aspects of social relationships on health likely
exert their effects through several mechanisms (DiMatteo, 2004; Uchino,
2004). Friends and family influence health-compromising behaviors (e.g.,
smoking, drinking) and health-promoting behaviors (e.g., healthy diet,
exercise) through direct influence, such as pressuring a loved one to give
up smoking, and indirect influence, such as modeling ideal (or less than
ideal) behaviors. In addition, our social networks help protect us against
the effects of stressful events on health behaviors (i.e., self-medicating
through smoking, drinking, or eating). Another mechanism is promoting
psychological well-being, such as reduced depression or anxiety. Finally,
social relationships may exert direct impacts on biological systems with key
roles in the onset and progression of disease, such as the cardiovascular,
endocrine, and immune systems. Here, we describe cutting-edge research
that uses sophisticated methodological approaches to understanding the
impact of social relationships on biological processes in older adults.

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CUTTING-EDGE RESEARCH IN SOCIAL RELATIONSHIPS
AND HEALTH IN OLD AGE
The normative changes in social networks during the lifespan make certain
relationships particularly important for well-being, such as close intimate
relationships like marriage, and make the perception of limited social interactions particularly deleterious for well-being.
MARITAL FUNCTIONING
A recent review found that greater subjective and objective ratings of the
quality of married relationships were associated with better health (Robles,
Slatcher, Trombello, & McGinn, 2014). These associations may be particularly
important in older adults (Umberson, Williams, Powers, Liu, & Needham,
2006) who in the twenty-first century will represent the highest proportion
of married individuals (Cherlin, 2010). Here, we focus on recent findings on
marital functioning and cardiovascular function and disease, because such
findings suggest plausible biological pathways.
Compared to younger adults, older adults generally show larger cardiovascular responses (greater heart rate and blood pressure changes) to brief
stressors in laboratory settings, such as performing challenging mental
arithmetic (Uchino, Holt-Lunstad, Bloor, & Campo, 2005). Greater “cardiovascular reactivity” is associated with greater risk for cardiovascular disease
(Chida & Steptoe, 2010). In married relationships, lower marital quality
is associated with greater cardiovascular responses to marital stressors,
such as when spouses discuss problems in their relationship. Thus, if older
adults show greater cardiovascular reactivity to stress, older married adults
may accordingly show larger cardiovascular responses during marital
conflict.
On the other hand, socioemotional selectivity theory predicts greater
warmth and less hostility among older married couples during conflict
discussions. Consistent with that prediction, blood pressure responses
were similar between older adult and middle-aged couples, and heart rate
responses were smaller in older adult couples (Smith et al., 2009). At the
same time, older men showed larger cardiovascular responses compared
to middle-aged men when they had to work with their spouse in planning
a schedule of errands and a route through a fictitious town to efficiently
complete those errands. Thus, while spousal discussions about problems
in the relationship become more positive over time, spousal discussions
about other topics such as collaborating to solve a problem may contribute
to cardiovascular risk in older adults.

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Although cardiovascular reactivity to conflict did not differ between
middle-aged and older couples, behaviors during conflict discussions were
associated with cardiovascular risk in those couples (Smith et al., 2011).
Specifically, women who displayed low warmth (affirming one’s spouse,
demonstrating affection) during conflict had greater levels of calcification
in their coronary arteries, which is a surrogate marker of cardiovascular
disease. Men who displayed high dominance during conflict (ignoring,
controlling) had greater coronary artery calcification. In sum, these studies
are examples of how innovative methods add to our understanding of
how marital functioning contributes to cardiovascular disease risk in older
adults.
LONELINESS
The normative decrease in social network density with age may contribute to
perceived social isolation and its deleterious effects on health and well-being.
Loneliness is the distress associated with perceiving one’s social needs are not
being met (Hawkley & Cacioppo, 2010). Importantly, loneliness is weakly
correlated with measures of social network quantity and quality (Pinquart
& Sorensen, 2001), and predicts depressive symptoms independently of perceived social support measures. Moreover, in initially dementia-free older
adults, loneliness at baseline was associated with a faster decline in cognitive
functioning over 4 years (Wilson et al., 2007).
For physical health, chronic loneliness predicted greater risk of all-cause
mortality and cardiovascular mortality (reviewed in Hawkley & Cacioppo,
2010). Similar to the mechanisms described, loneliness is associated with
worse health behaviors, including lower physical activity and worse sleep.
In terms of biological processes, greater loneliness in middle-aged and older
adults was related to higher blood pressure and larger increases in resting
blood pressure over a 4-year follow-up. Finally, loneliness may have also
have effects at the level of cells and genes, as chronically lonely older adults
showed greater expression of genes in immune cells that are involved in
immune system activation and inflammation compared to more socially
connected older adults (Cole et al., 2007). Inflammation is the body’s rapid
response to infection and injury, and two decades of research suggest that the
pathophysiology of many chronic illnesses associated with aging (e.g., heart
disease, certain cancers, Alzheimer’s disease) is fueled in part by excessive
inflammation (Robles, Glaser, & Kiecolt-Glaser, 2005). Thus, perceived social
isolation appears to pervade numerous physiological systems, all the way to
the level of gene expression, increasing risk for poor health and well-being
in old age.

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KEY ISSUES FOR FUTURE RESEARCH
NEW FRIENDSHIP FORMATION
Research on changes in social networks in later life has focused primarily
on overall decreases in network size with age. However, life events that
weaken social ties (e.g., retirement, relocation, and widowhood) can also be
opportunities to strengthen or establish new social ties, increasing time to
socialize and/or motivation to seek new social relationships. Furthermore,
a study on retirement found that respondents’ average number of social
contacts did not change significantly after retirement, but the network
composition—who these social contacts were—changed substantially (Van
Tilburg, 1992); older adults appeared to bolster their social networks to
compensate for life changes. Yet, there is a dearth of research on how people
establish new relationships in older adulthood, and the preliminary work
described later was conducted over 20 years ago. We review existing data
and key issues for future research.
Despite many studies of friendship in later life, there is relatively little
empirical work on transitions between stages of friendship, at any age. Most
work focuses on early processes such as attraction and relationship initiation,
with little examination of how people shift along a continuum of intimacy
from being an acquaintance to a close friend, or how people move through
stages of a relationship (e.g., from initiation to maintenance; Blieszner &
Roberto, 2004). The modest literature focused on later life is primarily
composed of qualitative studies, and ranges from studying compensation
and adaptation to specific life events (such as retirement, widowhood, and
relocation) to interviewing older adults about their friendship history.
The typical pattern of maintaining a small network of close friends
appears across interview-based studies in senior residences and community
settings, but a subtype of respondents are more open to making new friends
and continue to acquire more social ties (Adams, 1987; Matthews, 1986).
Other respondents had relatively restricted networks, due to feelings of
self-sufficiency or to not yet having the opportunity to compensate for a
recent life change such as relocation. These data suggest that more work is
needed to determine the prevalence and origins of individual differences
in openness to making new friends and factors such as self-sufficiency. For
example, dispositional differences in whether one seeks gains or tries to
avoid losses may influence likelihood of developing new friendships.
Older adults’ old and new relationships may provide different qualities.
Old friends knew the person from before aging became a salient change and
can provide continuity; conversely, new friends can validate shifts in one’s
sense of self (Jerrome, 1981). New friendships tended to be especially reciprocal in exchange of resources and affection, while older relationships did

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not require as much active upkeep. In addition, new friends were often less
emotionally close than longer held friendships with more shared history;
conversations focused on a more surface level, impersonal topics rather than
intimate disclosures more common with old friends (Shea, Thompson, &
Blieszner, 1988). However, some “new” friendships in later life are reactivations of dormant relationships, formed by becoming closer to more peripheral ties (e.g., Matthews, 1986).
ROMANTIC REPARTNERSHIP
Despite disincentives to remarry (e.g., inheritance issues) roughly 14% of
older adults repartner in committed dating relationships in the United
States (Brown & Shinohara, 2013) and around 4% of unmarried older adults
were in cohabiting relationships (Brown, Lee, & Bulanda, 2006). Remarriage
may partially attenuate the negative mental and physical health impact
of divorce and widowhood. For example, remarried older adults reported
lower depressive symptoms compared to those who lost a partner but
remained single (Brown, Bulanda, & Lee, 2005). Yet, little is known about
how the process of how people repartner and establish new romantic
relationships in later life, and potential impacts on health and well-being.
The existing research on dating in later life is primarily qualitative, and
primarily focused on older women and their motivation to date. Older
women tended to report less interest in dating than older men, given their
desire to maintain independence and avoid caregiving for a new partner;
yet, many were still interested in the companionship provided by a romantic
partner (e.g., Dickson, Hughes, & Walker, 2005). Limited quantitative
research has compared characteristics of older adults across relationship
statuses in nationally representative survey data. As of 2005–2006, dating
was more common for men than women, for divorced and separated than
widowed respondents, and less common among the oldest respondents.
Dating adults had higher education, wealth, health, social connectedness,
and even mobility compared to nondating adults (Brown & Shinohara,
2013). In earlier data, older cohabitors were disadvantaged compared to
remarried respondents, and slightly less socially connected than unpartnered counterparts (Brown et al., 2006). However, in these correlational
studies the direction of causality is unclear; being advantaged likely makes
someone a more appealing partner, but having a romantic partner may also
improve economic resources.
Finally, there is a dearth of research on the process of moving from a desire
for a relationship to establishing a recognized committed relationship, paralleling the lack of research on friendship phase transitions. Future research
should examine individual differences in motivation and establishment of

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dating relationships as well as the process of moving from initial to later
stages of relationship formation. Having an established romantic partner
may benefit health and well-being in the long run, but the uncertainty
involved in a fledgling relationship could act as a stressor in the short run.
RESEARCH CHALLENGES AND FUTURE DIRECTIONS
BROADENING THE SCOPE
The lack of research on new relationship formation in older adulthood
reflects the difficulty of studying relationship formation more generally,
which requires prospective, longitudinal research. While challenging,
identifying populations to recruit is possible; for example, studying new
friendship formation by recruiting people moving into a new senior residence (e.g., Shea et al., 1988). Volunteer programs and social interventions
are fertile ground for friendship research, and older adults are increasingly
using online dating services. Regardless of recruitment avenue, long-term
follow-up is needed to help differentiate between short- and long-term
outcomes associated with establishing new social relationships in older
adulthood.
Sample size and generalizability is another challenge. The previously
described friendship formation research interviewed small samples (often
under 50 respondents). Thus, partnering with stakeholders in the community may be necessary to recruit larger samples in the future. Prior samples
were also relatively homogeneous in gender; larger studies with older
men and women are necessary to examine gender differences in friendship
formation. Notably, despite movement toward a lifespan perspective, few
studies address friendship in middle age. Indeed, given the need for longitudinal, prospective studies, the ideal place to begin initial data collection is
during midlife. Asking questions about new social relationship formation
in nationally representative samples would also facilitate describing general
patterns and qualities of new friendships. Finally, much of the early research
on friendship was conducted within the United States, raising concern that
observed patterns may not hold across cultures. Thus, future work must
incorporate cultural influences on social behavior in later life.
ADDRESSING METHODOLOGICAL CHALLENGES
A further challenge is that in large national surveys, questions must be succinct. Unfortunately, short self-report items such as “how many new friends
have you made in the last year” may yield less accurate and reliable data
than longer, more intensive methods such as generating comprehensive lists

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of social contacts and determining how long the person has known each contact (e.g., Rook & Sorkin, 2003). Friendship is a broad term (acquaintance or
best friend?); therefore, researchers should clarify definitions for participants
to facilitate more reliable responses in survey research. Previous qualitative
research on the meanings of friendship can inform social survey construction.
Future approaches to measurement should differentiate the consequences
of wanting to establish new relationships from the effects of actually creating
new social ties. Motivation to pursue and establish new relationships is easier
to query through self-report measures, but may not translate to the likelihood
of making new friends. Conversely, making a new friend or repartnering
may influence someone differently depending on personal motivations and
goals. Repartnering may lead to different shifts in well-being depending on
whether the individual values independence from others or pines for a new
relationship.
New relationship formation could also be studied using experimental designs such as randomized controlled trials (RCTs; that is, random
assignment to either the treatment or a no treatment or a placebo control
condition) which allow greater control and causal inference. RCTs have
tested interventions to reduce social isolation and loneliness (see Masi,
Chen, Hawkley, & Cacioppo, 2011 for a review); however, most target
perceived loneliness rather than social network size. Future RCTs should
examine what interventions promote social engagement, and how those
improvements influence health and well-being. Most interventions target
people who are highly lonely and isolated, but efforts to improve social
integration may benefit the broader aging population as well (e.g., through
volunteering; Rook & Sorkin, 2003).
Establishing new relationships is takes effort and resources, so researchers
should also examine how the costs (e.g., energy input) stack up against the
benefits of new relationships. Identifying for whom new friendships are most
beneficial (or costly), and whether the costs and benefits differ in the short
and long run, are key directions for future research. Given that old and new
friendships differ in quality, future work should also examine whether there
are correspondingly differential effects on health and well-being.
Finally, because social relationships are inherently interpersonal,
researchers must strive to measure phenomena at dyadic and network
levels. Statistical techniques such as the actor–partner interdependence
model allow researchers to examine how focal individuals and their partners influence their own and their partner’s outcomes over time, taking
into account dependence within each dyad. Researchers also suggest
examining how one’s macro-level network influences friendship patterns
(e.g., Bleiszner & Roberto, 2004). For example, having more family social ties
may influence the likelihood of seeking and developing new relationships,

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or changes in global network size could lead to corresponding changes in
intimacy with the remaining social ties.
CONCLUSION
We highlighted the social challenges and opportunities that emerge in later
life. Observed changes in older adults’ motivations and social environment
mean their relationships are often highly rewarding for well-being and
health. However, social relationships are not universally positive; low
warmth and greater dominance contribute to cardiovascular risk, and
perceiving insufficient support is associated with poor health outcomes.
Thus, research on the association between social functioning and well-being
clearly suggests that losing and gaining relationships may have important
implications for older adults. The psychological and physical health benefits
of repartnering or even making new friends in later life remain unclear
and demand empirical attention, and our essay provides some suggestions
for moving forward. To conclude, while social networks shrink with age,
this normative pattern may mask important dynamic processes involved
in establishing new friendship and intimate relationships, suggesting that
there is still much to learn about social relationships and health in older
adulthood.
ACKNOWLEDGMENTS
Work on this essay was supported by National Institutes of Health Grants
R21AG032494 to Theodore F. Robles, and National institute on Aging training grant T32AG033533 to Josephine A. Menkin. The content is solely the
responsibility of the authors and does not necessarily represent the official
views of the National Institute on Aging or the National Institutes of Health.
We thank Melissa Fales, Angie Shu-Sha Guan, and Ben Shulman for reviewing an early draft of this essay.
REFERENCES
Adams, R. G. (1987). Patterns of network change: A longitudinal study of friendships
of elderly women. The Gerontologist, 27, 222–227. doi:10.1093/geront/27.2.222
Baumeister, R. F., & Leary, M. R. (1995). The need to belong: desire for interpersonal
attachments as a fundamental human motivation. Psychological Bulletin, 117, 497.
doi:10.1037/0033-2909.117.3.497
Birditt, K. S., Fingerman, K. L., & Almeida, D. M. (2005). Age differences in exposure
and reactions to interpersonal tensions: A daily diary study. Psychology and Aging,
20, 330. doi:10.1037/0882-7974.20.2.330

12

EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES

Brooks, K. P., & Dunkel Schetter, C. (2011). Social negativity and health: Conceptual and measurement issues. Social and Personality Psychology Compass, 5, 904–918.
doi:10.1111/j.1751-9004.2011.00395.x
Brown, S. L., Bulanda, J. R., & Lee, G. R. (2005). The significance of nonmarital cohabitation: Marital status and mental health benefits among middle-aged and older
adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences,
60(1), S21–S29. doi:10.1093/geronb/60.1.S21
Chida, Y., & Steptoe, A. (2010). Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status a metaanalysis of prospective evidence. Hypertension, 55(4), 1026–1032. doi:10.1161/
HYPERTENSIONAHA.109.146621
Cole, S. W., Hawkley, L. C., Arevalo, J. M., Sung, C. Y., Rose, R. M., & Cacioppo, J. T.
(2007). Social regulation of gene expression in human leukocytes. Genome Biology,
8(9), R189. doi:10.1186/gb-2007-8-9-r189
Dickson, F. C., Hughes, P. C., & Walker, K. L. (2005). An exploratory investigation
into dating among later-life women. Western Journal of Communication, 69, 67–82.
doi:10.1080/10570310500034196
DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment:
A meta-analysis. Health Psychology, 23, 207. doi:10.1037/0278-6133.23.2.207
Fingerman, K. L., & Charles, S. T. (2010). It takes two to tango: Why older people have
the best relationships. Current Directions in Psychological Science, 19(3), 172–176.
doi:10.1177/0963721410370297
Gable, S. L., Gonzaga, G. C., & Strachman, A. (2006). Will you be there for me when
things go right? Supportive responses to positive event disclosures. Journal of Personality and Social Psychology, 91, 904. doi:10.1037/0022-3514.91.5.904
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. (C. Brayne, Ed.). PLoS Medicine, 7, e1000316.
doi:10.1371/journal.pmed.1000316
Jerrome, D. (1981). The significance of friendship for women in later life. Ageing and
Society, 1, 175–197. doi:10.1017/S0144686X00008746
Masi, C. M., Chen, H. Y., Hawkley, L. C., & Cacioppo, J. T. (2011). A meta-analysis of
interventions to reduce loneliness. Personality and Social Psychology Review, 15(3),
219–266. doi:10.1177/1088868310377394
Matthews, S. H. (1986). Friendships through the life course: Oral biographies in old age.
Beverly Hills, CA: Sage.
Milardo, R. M. (1987). Changes in social networks of women and men following divorce: A review. Journal of Family Issues, 8, 78–96. doi:10.1177/
019251387008001004
Pinquart, M., & Sorensen, S. (2001). Influences on loneliness in older adults: A
meta-analysis. Basic and Applied Social Psychology, 23(4), 245–266. doi:10.1207/
S15324834BASP2304_2
Robles, T. F., Glaser, R., & Kiecolt-Glaser, J. K. (2005). Out of balance: A new look
at chronic stress, depression, and immunity. Current Directions in Psychological Science, 14, 111–115. doi:10.1111/j.0963-7214.2005.00345.x

Social Relationships and Health in Older Adulthood

13

Rook, K. S., Luong, G., Sorkin, D. H., Newsom, J. T., & Krause, N. (2012). Ambivalent versus problematic social ties: Implications for psychological health, functional health, and interpersonal coping. Psychology and Aging, 27, 912. doi:10.1037/
a0029246
Rook, K. S., & Sorkin, D. S. (2003). Fostering social ties through a volunteer role:
Implications for older-adults’ psychological health. International Journal of Aging
and Human Development, 57, 313–337. doi:10.2190/NBBN-EU3H-4Q1N-UXHR
Sbarra, D. A., Hasselmo, K., & Nojopranoto, W. (2012). Divorce and death: A case
study for health psychology. Social and Personality Psychology Compass, 6, 905–919.
doi:10.1111/spc3.12002
Shea, L., Thompson, L., & Blieszner, R. (1988). Resources in older adults’ old and
new friendships. Journal of Social and Personal Relationships, 5, 83–96. doi:10.1177/
0265407588051005
Shor, E., Roelfs, D. J., Curreli, M., Clemow, L., Burg, M. M., & Schwartz, J. E. (2012).
Widowhood and mortality: A meta-analysis and meta-regression. Demography, 49,
575–606. doi:10.1007/s13524-012-0096-x
Smith, T. W., Uchino, B. N., Berg, C. A., Florsheim, P., Pearce, G., Hawkins, M., …
Olsen-Cerny, C. (2009). Conflict and collaboration in middle-aged and older couples: II. Cardiovascular reactivity during marital interaction. Psychology and Aging,
24, 274. doi:10.1037/a0016067
Smith, T. W., Uchino, B. N., Florsheim, P., Berg, C. A., Butner, J., Hawkins, M., …
Yoon, H. C. (2011). Affiliation and control during marital disagreement, history of
divorce, and asymptomatic coronary artery calcification in older couples. Psychosomatic Medicine, 73, 350–357. doi:10.1097/PSY.0b013e31821188ca
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National
Academy of Sciences, 110, 5797–5801. doi:10.1073/pnas.1219686110
Stroebe, M., Schut, H., & Stroebe, W. (2007). Health outcomes of bereavement. The
Lancet, 370, 1960–1973. doi:10.1016/S0140-6736(07)61816-9
Uchino, B. N., Holt-Lunstad, J., Bloor, L. E., & Campo, R. A. (2005). Aging and cardiovascular reactivity to stress: Longitudinal evidence for changes in stress reactivity.
Psychology and Aging, 20, 134. doi:10.1037/0882-7974.20.1.134
Umberson, D., Williams, K., Powers, D. A., Liu, H., & Needham, B. (2006). You make
me sick: Marital quality and health over the life course. Journal of Health and Social
Behavior, 47, 1–16. doi:10.1177/002214650604700101
Van Tilburg, T. (1992). Support networks before and after retirement. Journal of Social
and Personal Relationships, 9, 433–445. doi:10.1177/0265407592093006
Wilson, R. S., Krueger, K. R., Arnold, S. E., Schneider, J. A., Kelly, J. F., Barnes, L.
L. … Bennett, D. A. (2007). Loneliness and risk of Alzheimer disease. Archives of
General Psychiatry, 64, 234. 10.1001/archpsyc.64.2.234

FURTHER READING
Blieszner, R., & Roberto, K. A. (2004). Friendship across the life span: Reciprocity
in individual and relationship development. In F. R. Lang & K. L. Fingerman

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(Eds.), Growing together: Personal relationships across the lifespan. Cambridge, England: Cambridge University Press.
Brown, S. L., Lee, G. R., & Bulanda, J. R. (2006). Cohabitation among older adults:
A national portrait. The Journals of Gerontology Series B: Psychological Sciences and
Social Sciences, 61(2), S71–S79. doi:10.1093/geronb/61.2.S71
Brown, S. L., & Lin, I. (2012). The gray divorce revolution: Rising divorce among
middle-aged and older adults, 1990–2010. Journals of Gerontology: Series B, 67,
731–741. doi:10.1093/geronb/gbs089
Brown, S. L., & Shinohara, S. K. (2013). Dating relationships in older adulthood:
A national portrait. Journal of Marriage and Family, 75, 1194–1202. doi:10.1111/
jomf.12065
Cherlin, A. J. (2010). Demographic trends in the United States: A review of
research in the 2000s. Journal of Marriage and Family, 72, 1–17. doi:10.1111/j.17413737.2010.00710.x
Charles, S. T., & Carstensen, L. L. (2010). Social and emotional aging. Annual Review
of Psychology, 61, 383–409. doi:10.1146/annurev.psych.093008. 100448
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40,
218–227. doi:10.1007/s12160-010-9210-8
Robles, T. F., Slatcher, R. B., Trombello, J. M., & McGinn, M. M. (2014). Marital
quality and health: A meta-analytic review. Psychological Bulletin, 140, 140–187.
doi:10.1037/a0031859
Uchino, B. N. (2004). Social support and physical health: Understanding the health consequences of relationships. New Haven, CN: Yale University Press.
Wrzus, C., Hänel, M., Wagner, J., & Neyer, F. J. (2013). Social network changes and
life events across the lifespan: A meta-analysis. Psychological Bulletin, 139, 53–80.
doi:10.1037/a0028601

THEODORE F. ROBLES SHORT BIOGRAPHY
Theodore F. Robles is an associate professor in Health Psychology at the
University of California at Los Angeles. He received a BS in Psychology at
University of Wisconsin-Madison, and a PhD in Clinical Psychology from
The Ohio State University. His research examines the biological mechanisms
that explain how social relationships impact health, with a particular focus
on marital and family relationships. His work has been published in such
journals as Psychological Bulletin, Physiology and Behavior, Psychosomatic
Medicine, Psychoneuroendocrinology, Health Psychology, International Journal of
Psychophysiology, and Journal of Social and Personal Relationships. He currently
studies how family dynamics influence susceptibility to upper respiratory
infections in children, the impact of close relationship functioning on sleep,
and how retirement impacts the marital functioning and health. For more
about his research, visit http://rhl.psych.ucla.edu.

Social Relationships and Health in Older Adulthood

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JOSEPHINE A. MENKIN SHORT BIOGRAPHY
Josephine A. Menkin is a graduate student in Health Psychology at the
University of California at Los Angeles. She received her BA in Psychology
at Northwestern University, where she studied how people perceive older
black adults. She also worked as the laboratory manager for the Carstensen
Life-span Development Laboratory at Stanford University for 2 years before
beginning her graduate study. She now combines her interests in age stigma
and adult development. Her graduate research focuses on predictors and
consequences of new social relationship formation in later life, with additional focus on how attitudes and beliefs about aging may influence social
engagement and health.
RELATED ESSAYS
Telomeres (Psychology), Nancy Adler and Aoife O’Donovan
Terror Management Theory (Psychology), Alisabeth Ayars et al.
Gender Segregation in Higher Education (Sociology), Alexandra Hendley
and Maria Charles
Controlling the Influence of Stereotypes on One’s Thoughts (Psychology),
Patrick S. Forscher and Patricia G. Devine
Normal Negative Emotions and Mental Disorders (Sociology), Allan V.
Horwitz
The Development of Social Trust (Psychology), Vikram K. Jaswal and Marissa
B. Drell
The Neurobiology and Physiology of Emotions: A Developmental Perspective (Psychology), Sarah S. Kahle and Paul D. Hastings
How Brief Social-Psychological Interventions Can Cause Enduring Effects
(Methods), Dushiyanthini (Toni) Kenthirarajah and Gregory M. Walton
Making Sense of Control: Change and Consequences (Psychology), Margie E.
Lachman et al.
Social, Psychological, and Physiological Reactions to Stress (Psychology),
Bruce S. McEwen and Craig A. McEwen
Health and Social Inequality (Sociology), Bernice A. Pescosolido
The Role of Cultural, Social, and Psychological Factors in Disease and Illness
(Sociology), Robert A. Scott
Regulation of Emotions Under Stress (Psychology), Amanda J. Shallcross
et al.
Did That Brownie Do Its Job? Stress, Eating, and the Biobehavioral Effects of
Comfort Food (Psychology), A. Janet Tomiyama et al.
Incarceration and Health (Sociology), Christopher Wildeman
Emotion Regulation (Psychology), Paree Zarolia et al.



Social Relationships and Health
in Older Adulthood
THEODORE F. ROBLES and JOSEPHINE A. MENKIN

Abstract
Older adults make up a larger proportion of the population and are living longer
than in any time in previous history, which has important implications for their social
relationships. This essay reviews key theory and research on changes in social networks over the lifespan, the benefits (and costs) of social relationships for physical
health, and the health impact of loss of social relationships during older age. Methodological innovations are shedding new light on the specific biological mechanisms
that explain how high and low quality social relationships can impact health, and
we review these innovations in different contexts: marriage and loneliness. While
social networks generally decrease in size across the lifespan, there is considerable
potential for expanding social networks and forming new relationships in later life.
However, the research literature on forming new friendships and intimate relationships in older adults is quite limited. Thus, this essay concludes by describing key
issues and methodological challenges involved in studying new relationship formation in older adults.

INTRODUCTION
Improvements in public health have led to a significant “graying” of populations around the world, which, along with economic challenges, poses
social challenges as well. In this essay, we address emerging trends in social
relationships in older adulthood, with a focus on implications for health
and well-being. We review seminal theory and research on changes in social
networks across the lifespan, the benefits and costs accrued from social
networks, and the health impact of specific social losses that occur in later
life. We then describe cutting-edge research in two areas: marriage and loneliness, and their impact on physical health. Finally, as the field has generally
focused on shrinkage and loss, an increasing older adult population also
brings much potential for expanding social relationships. Thus, we review
research on new relationship formation in later life, including friendships

Emerging Trends in the Social and Behavioral Sciences. Edited by Robert Scott and Stephen Kosslyn.
© 2015 John Wiley & Sons, Inc. ISBN 978-1-118-90077-2.

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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES

and intimate relationships, describing open questions and challenges in
studying new relationship formation.
FOUNDATIONAL RESEARCH
SOCIAL NETWORK CHANGES WITH AGE
While there is likely significant interindividual variability, on average overall
social network size peaks in late adolescence/early adulthood, followed by
steady shrinking over the lifecourse (Wrzus, Hänel, Wagner, & Neyer, 2013).
The downward rate of change continues but slows in older age, primarily
due to a reduction in number of friends, but not family ties.
Widely accepted theories attribute changes in social networks to individual
changes in social motivation (socioemotional selectivity theory) or to life
events and environmental changes (social convoy theory). Socioemotional
selectivity theory posits that for social behavior, when people perceive their
future as more constrained (such as aging adults), emotion regulation
goals become increasingly valued over acquiring information, leading to
increased preference for spending time with close others (e.g., family or
friends). In contrast, when people view their future time as unlimited,
they prefer to spend time with others who provide new information or
experiences. Indeed, older adults appear to prune their social networks to
reduce numbers of acquaintances but preserve close, meaningful relationships (for a review, see Charles & Carstensen, 2010). Social convoy theory
also matches the observed data, but attributes the lower stability of more
peripheral acquaintances to external life events such as loss of a spouse or
relocation.
In addition to specific life events, older adults may experience a different
social environment more broadly. Older adults often have less time constraints than middle-aged counterparts (e.g., less conflict with work and
childcare), but they can have new constraints, such as reduced physical
and financial resources (Blieszner & Roberto, 2004). Furthermore, on a
day-to-day basis, older adults tend to report fewer situations where they
avoided or engaged in an argument than younger adults (Birditt, Fingerman,
& Almeida, 2005). Lifespan development perspectives suggest that older
adults differ from younger adults in how they think about and evaluate
interpersonal tensions (cognitive appraisals) and control the experience
and expression of emotions (emotion regulation). However, this reduction
in negative social experiences in later life may also be influenced by the
interaction partner’s behavior toward older adults. The social input model
proposes that when older adults are motivated to minimize conflict in
social relationships, their social partners (of any age) correspondingly treat

Social Relationships and Health in Older Adulthood

3

them favorably to maintain a positive relationship (Fingerman & Charles,
2010). Thus, both internal factors (social motivation goals, ways of thinking)
and external factors (life events, how other people view older adults)
contribute to the changes in social networks in older adulthood and how
those networks are perceived and maintained over time. Such factors likely
contribute to the benefits and costs of social relationships for health.
SOCIAL SUPPORT AND NEGATIVITY AND HEALTH
Strong social relationships are associated with a lower risk of mortality
across the lifespan (Holt-Lunstad, Smith, & Layton, 2010) and in older adults
(e.g., Steptoe, Shankar, Demakakos, & Wardle, 2013). The benefits and costs
of social relationships for well-being operate through psychological, behavioral, and physiological mechanisms (for a review see Uchino, 2004). While
such processes are expected to influence health throughout the lifespan,
they may take on particular importance in later life when individuals have
greater physical vulnerability. Here, we focus on the benefits and costs of
social relationships more broadly.
Humans “need to belong” in social networks, which is on par with our
basic needs for safety, shelter, and sustenance (Baumeister & Leary, 1995).
Social relationships are a critical source of instrumental, informational,
emotional support that we receive from others during stressful events and
circumstances (Uchino, 2004). In addition, sharing good personal news with
others, known as capitalization, can prolong the positive emotions that
accompany good news (Gable, Gonzaga, & Strachman, 2006). At the same
time, social relationships inevitably incur some cost (reviewed in Brooks &
Dunkel Schetter, 2011). Social networks are a source of disagreement and
conflict. In addition, friends and family can be sources of insensitivity (i.e.,
showing disregard for one’s needs and wishes) and even impede our pursuit
of important goals.
As described, older adults normatively pursue more positive social
interactions in the process of pruning social networks. In addition, older
adults are more adept at avoiding social negativity, and show less affective
reactivity to negative social interactions when they occur. However, social
tension is unavoidable, and people with social networks characterized by
members who are sources of social support and negativity, often termed
“ambivalent” network ties (having high positive and negative self-reported
attitudes toward such individuals) may be at particular risk for poor health
and well-being because of the unpredictable nature of those relationships.
For example, in a nationally representative sample of older adults, greater
self-reported negativity of ambivalent family ties was related to greater

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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES

limitations in physical functioning (Rook, Luong, Sorkin, Newsom, &
Krause, 2012).
LOSS OF SOCIAL RELATIONSHIPS
The loss of core social relationships is a major contributor to social network
shrinkage in old age. Over the past 20 years, the divorce rate among adults
over age 50 has doubled, accounting for one out of every four dissolved marriages; the rate of increase was largest for older adults (Brown & Lin, 2012).
Following divorce, parent–child relationship contact and quality may suffer (reviewed in Brown & Lin, 2012) and social networks show decreased
size and density (Milardo, 1987). For the divorced individual, divorce has
negative consequences for mental and physical health, including decreased
subjective well-being, increased risk for depression, and mortality (Sbarra,
Hasselmo, & Nojopranoto, 2012).
Widowhood, considered one of the most stressful events one could experience, increases risk for depression and complicated (prolonged) grief. Widowhood is also associated with worse self-rated physical health, and elevated
disability and illness (Stroebe, Schut, & Stroebe, 2007). In prospective studies widowers have 22% greater risk of early mortality compared to married
persons (Shor et al., 2012). While mortality risk due to widowhood is lower
in older relative to younger adults, widowhood itself is much more common
in older adults.
MECHANISMS
Positive and negative aspects of social relationships on health likely
exert their effects through several mechanisms (DiMatteo, 2004; Uchino,
2004). Friends and family influence health-compromising behaviors (e.g.,
smoking, drinking) and health-promoting behaviors (e.g., healthy diet,
exercise) through direct influence, such as pressuring a loved one to give
up smoking, and indirect influence, such as modeling ideal (or less than
ideal) behaviors. In addition, our social networks help protect us against
the effects of stressful events on health behaviors (i.e., self-medicating
through smoking, drinking, or eating). Another mechanism is promoting
psychological well-being, such as reduced depression or anxiety. Finally,
social relationships may exert direct impacts on biological systems with key
roles in the onset and progression of disease, such as the cardiovascular,
endocrine, and immune systems. Here, we describe cutting-edge research
that uses sophisticated methodological approaches to understanding the
impact of social relationships on biological processes in older adults.

Social Relationships and Health in Older Adulthood

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CUTTING-EDGE RESEARCH IN SOCIAL RELATIONSHIPS
AND HEALTH IN OLD AGE
The normative changes in social networks during the lifespan make certain
relationships particularly important for well-being, such as close intimate
relationships like marriage, and make the perception of limited social interactions particularly deleterious for well-being.
MARITAL FUNCTIONING
A recent review found that greater subjective and objective ratings of the
quality of married relationships were associated with better health (Robles,
Slatcher, Trombello, & McGinn, 2014). These associations may be particularly
important in older adults (Umberson, Williams, Powers, Liu, & Needham,
2006) who in the twenty-first century will represent the highest proportion
of married individuals (Cherlin, 2010). Here, we focus on recent findings on
marital functioning and cardiovascular function and disease, because such
findings suggest plausible biological pathways.
Compared to younger adults, older adults generally show larger cardiovascular responses (greater heart rate and blood pressure changes) to brief
stressors in laboratory settings, such as performing challenging mental
arithmetic (Uchino, Holt-Lunstad, Bloor, & Campo, 2005). Greater “cardiovascular reactivity” is associated with greater risk for cardiovascular disease
(Chida & Steptoe, 2010). In married relationships, lower marital quality
is associated with greater cardiovascular responses to marital stressors,
such as when spouses discuss problems in their relationship. Thus, if older
adults show greater cardiovascular reactivity to stress, older married adults
may accordingly show larger cardiovascular responses during marital
conflict.
On the other hand, socioemotional selectivity theory predicts greater
warmth and less hostility among older married couples during conflict
discussions. Consistent with that prediction, blood pressure responses
were similar between older adult and middle-aged couples, and heart rate
responses were smaller in older adult couples (Smith et al., 2009). At the
same time, older men showed larger cardiovascular responses compared
to middle-aged men when they had to work with their spouse in planning
a schedule of errands and a route through a fictitious town to efficiently
complete those errands. Thus, while spousal discussions about problems
in the relationship become more positive over time, spousal discussions
about other topics such as collaborating to solve a problem may contribute
to cardiovascular risk in older adults.

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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES

Although cardiovascular reactivity to conflict did not differ between
middle-aged and older couples, behaviors during conflict discussions were
associated with cardiovascular risk in those couples (Smith et al., 2011).
Specifically, women who displayed low warmth (affirming one’s spouse,
demonstrating affection) during conflict had greater levels of calcification
in their coronary arteries, which is a surrogate marker of cardiovascular
disease. Men who displayed high dominance during conflict (ignoring,
controlling) had greater coronary artery calcification. In sum, these studies
are examples of how innovative methods add to our understanding of
how marital functioning contributes to cardiovascular disease risk in older
adults.
LONELINESS
The normative decrease in social network density with age may contribute to
perceived social isolation and its deleterious effects on health and well-being.
Loneliness is the distress associated with perceiving one’s social needs are not
being met (Hawkley & Cacioppo, 2010). Importantly, loneliness is weakly
correlated with measures of social network quantity and quality (Pinquart
& Sorensen, 2001), and predicts depressive symptoms independently of perceived social support measures. Moreover, in initially dementia-free older
adults, loneliness at baseline was associated with a faster decline in cognitive
functioning over 4 years (Wilson et al., 2007).
For physical health, chronic loneliness predicted greater risk of all-cause
mortality and cardiovascular mortality (reviewed in Hawkley & Cacioppo,
2010). Similar to the mechanisms described, loneliness is associated with
worse health behaviors, including lower physical activity and worse sleep.
In terms of biological processes, greater loneliness in middle-aged and older
adults was related to higher blood pressure and larger increases in resting
blood pressure over a 4-year follow-up. Finally, loneliness may have also
have effects at the level of cells and genes, as chronically lonely older adults
showed greater expression of genes in immune cells that are involved in
immune system activation and inflammation compared to more socially
connected older adults (Cole et al., 2007). Inflammation is the body’s rapid
response to infection and injury, and two decades of research suggest that the
pathophysiology of many chronic illnesses associated with aging (e.g., heart
disease, certain cancers, Alzheimer’s disease) is fueled in part by excessive
inflammation (Robles, Glaser, & Kiecolt-Glaser, 2005). Thus, perceived social
isolation appears to pervade numerous physiological systems, all the way to
the level of gene expression, increasing risk for poor health and well-being
in old age.

Social Relationships and Health in Older Adulthood

7

KEY ISSUES FOR FUTURE RESEARCH
NEW FRIENDSHIP FORMATION
Research on changes in social networks in later life has focused primarily
on overall decreases in network size with age. However, life events that
weaken social ties (e.g., retirement, relocation, and widowhood) can also be
opportunities to strengthen or establish new social ties, increasing time to
socialize and/or motivation to seek new social relationships. Furthermore,
a study on retirement found that respondents’ average number of social
contacts did not change significantly after retirement, but the network
composition—who these social contacts were—changed substantially (Van
Tilburg, 1992); older adults appeared to bolster their social networks to
compensate for life changes. Yet, there is a dearth of research on how people
establish new relationships in older adulthood, and the preliminary work
described later was conducted over 20 years ago. We review existing data
and key issues for future research.
Despite many studies of friendship in later life, there is relatively little
empirical work on transitions between stages of friendship, at any age. Most
work focuses on early processes such as attraction and relationship initiation,
with little examination of how people shift along a continuum of intimacy
from being an acquaintance to a close friend, or how people move through
stages of a relationship (e.g., from initiation to maintenance; Blieszner &
Roberto, 2004). The modest literature focused on later life is primarily
composed of qualitative studies, and ranges from studying compensation
and adaptation to specific life events (such as retirement, widowhood, and
relocation) to interviewing older adults about their friendship history.
The typical pattern of maintaining a small network of close friends
appears across interview-based studies in senior residences and community
settings, but a subtype of respondents are more open to making new friends
and continue to acquire more social ties (Adams, 1987; Matthews, 1986).
Other respondents had relatively restricted networks, due to feelings of
self-sufficiency or to not yet having the opportunity to compensate for a
recent life change such as relocation. These data suggest that more work is
needed to determine the prevalence and origins of individual differences
in openness to making new friends and factors such as self-sufficiency. For
example, dispositional differences in whether one seeks gains or tries to
avoid losses may influence likelihood of developing new friendships.
Older adults’ old and new relationships may provide different qualities.
Old friends knew the person from before aging became a salient change and
can provide continuity; conversely, new friends can validate shifts in one’s
sense of self (Jerrome, 1981). New friendships tended to be especially reciprocal in exchange of resources and affection, while older relationships did

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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES

not require as much active upkeep. In addition, new friends were often less
emotionally close than longer held friendships with more shared history;
conversations focused on a more surface level, impersonal topics rather than
intimate disclosures more common with old friends (Shea, Thompson, &
Blieszner, 1988). However, some “new” friendships in later life are reactivations of dormant relationships, formed by becoming closer to more peripheral ties (e.g., Matthews, 1986).
ROMANTIC REPARTNERSHIP
Despite disincentives to remarry (e.g., inheritance issues) roughly 14% of
older adults repartner in committed dating relationships in the United
States (Brown & Shinohara, 2013) and around 4% of unmarried older adults
were in cohabiting relationships (Brown, Lee, & Bulanda, 2006). Remarriage
may partially attenuate the negative mental and physical health impact
of divorce and widowhood. For example, remarried older adults reported
lower depressive symptoms compared to those who lost a partner but
remained single (Brown, Bulanda, & Lee, 2005). Yet, little is known about
how the process of how people repartner and establish new romantic
relationships in later life, and potential impacts on health and well-being.
The existing research on dating in later life is primarily qualitative, and
primarily focused on older women and their motivation to date. Older
women tended to report less interest in dating than older men, given their
desire to maintain independence and avoid caregiving for a new partner;
yet, many were still interested in the companionship provided by a romantic
partner (e.g., Dickson, Hughes, & Walker, 2005). Limited quantitative
research has compared characteristics of older adults across relationship
statuses in nationally representative survey data. As of 2005–2006, dating
was more common for men than women, for divorced and separated than
widowed respondents, and less common among the oldest respondents.
Dating adults had higher education, wealth, health, social connectedness,
and even mobility compared to nondating adults (Brown & Shinohara,
2013). In earlier data, older cohabitors were disadvantaged compared to
remarried respondents, and slightly less socially connected than unpartnered counterparts (Brown et al., 2006). However, in these correlational
studies the direction of causality is unclear; being advantaged likely makes
someone a more appealing partner, but having a romantic partner may also
improve economic resources.
Finally, there is a dearth of research on the process of moving from a desire
for a relationship to establishing a recognized committed relationship, paralleling the lack of research on friendship phase transitions. Future research
should examine individual differences in motivation and establishment of

Social Relationships and Health in Older Adulthood

9

dating relationships as well as the process of moving from initial to later
stages of relationship formation. Having an established romantic partner
may benefit health and well-being in the long run, but the uncertainty
involved in a fledgling relationship could act as a stressor in the short run.
RESEARCH CHALLENGES AND FUTURE DIRECTIONS
BROADENING THE SCOPE
The lack of research on new relationship formation in older adulthood
reflects the difficulty of studying relationship formation more generally,
which requires prospective, longitudinal research. While challenging,
identifying populations to recruit is possible; for example, studying new
friendship formation by recruiting people moving into a new senior residence (e.g., Shea et al., 1988). Volunteer programs and social interventions
are fertile ground for friendship research, and older adults are increasingly
using online dating services. Regardless of recruitment avenue, long-term
follow-up is needed to help differentiate between short- and long-term
outcomes associated with establishing new social relationships in older
adulthood.
Sample size and generalizability is another challenge. The previously
described friendship formation research interviewed small samples (often
under 50 respondents). Thus, partnering with stakeholders in the community may be necessary to recruit larger samples in the future. Prior samples
were also relatively homogeneous in gender; larger studies with older
men and women are necessary to examine gender differences in friendship
formation. Notably, despite movement toward a lifespan perspective, few
studies address friendship in middle age. Indeed, given the need for longitudinal, prospective studies, the ideal place to begin initial data collection is
during midlife. Asking questions about new social relationship formation
in nationally representative samples would also facilitate describing general
patterns and qualities of new friendships. Finally, much of the early research
on friendship was conducted within the United States, raising concern that
observed patterns may not hold across cultures. Thus, future work must
incorporate cultural influences on social behavior in later life.
ADDRESSING METHODOLOGICAL CHALLENGES
A further challenge is that in large national surveys, questions must be succinct. Unfortunately, short self-report items such as “how many new friends
have you made in the last year” may yield less accurate and reliable data
than longer, more intensive methods such as generating comprehensive lists

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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES

of social contacts and determining how long the person has known each contact (e.g., Rook & Sorkin, 2003). Friendship is a broad term (acquaintance or
best friend?); therefore, researchers should clarify definitions for participants
to facilitate more reliable responses in survey research. Previous qualitative
research on the meanings of friendship can inform social survey construction.
Future approaches to measurement should differentiate the consequences
of wanting to establish new relationships from the effects of actually creating
new social ties. Motivation to pursue and establish new relationships is easier
to query through self-report measures, but may not translate to the likelihood
of making new friends. Conversely, making a new friend or repartnering
may influence someone differently depending on personal motivations and
goals. Repartnering may lead to different shifts in well-being depending on
whether the individual values independence from others or pines for a new
relationship.
New relationship formation could also be studied using experimental designs such as randomized controlled trials (RCTs; that is, random
assignment to either the treatment or a no treatment or a placebo control
condition) which allow greater control and causal inference. RCTs have
tested interventions to reduce social isolation and loneliness (see Masi,
Chen, Hawkley, & Cacioppo, 2011 for a review); however, most target
perceived loneliness rather than social network size. Future RCTs should
examine what interventions promote social engagement, and how those
improvements influence health and well-being. Most interventions target
people who are highly lonely and isolated, but efforts to improve social
integration may benefit the broader aging population as well (e.g., through
volunteering; Rook & Sorkin, 2003).
Establishing new relationships is takes effort and resources, so researchers
should also examine how the costs (e.g., energy input) stack up against the
benefits of new relationships. Identifying for whom new friendships are most
beneficial (or costly), and whether the costs and benefits differ in the short
and long run, are key directions for future research. Given that old and new
friendships differ in quality, future work should also examine whether there
are correspondingly differential effects on health and well-being.
Finally, because social relationships are inherently interpersonal,
researchers must strive to measure phenomena at dyadic and network
levels. Statistical techniques such as the actor–partner interdependence
model allow researchers to examine how focal individuals and their partners influence their own and their partner’s outcomes over time, taking
into account dependence within each dyad. Researchers also suggest
examining how one’s macro-level network influences friendship patterns
(e.g., Bleiszner & Roberto, 2004). For example, having more family social ties
may influence the likelihood of seeking and developing new relationships,

Social Relationships and Health in Older Adulthood

11

or changes in global network size could lead to corresponding changes in
intimacy with the remaining social ties.
CONCLUSION
We highlighted the social challenges and opportunities that emerge in later
life. Observed changes in older adults’ motivations and social environment
mean their relationships are often highly rewarding for well-being and
health. However, social relationships are not universally positive; low
warmth and greater dominance contribute to cardiovascular risk, and
perceiving insufficient support is associated with poor health outcomes.
Thus, research on the association between social functioning and well-being
clearly suggests that losing and gaining relationships may have important
implications for older adults. The psychological and physical health benefits
of repartnering or even making new friends in later life remain unclear
and demand empirical attention, and our essay provides some suggestions
for moving forward. To conclude, while social networks shrink with age,
this normative pattern may mask important dynamic processes involved
in establishing new friendship and intimate relationships, suggesting that
there is still much to learn about social relationships and health in older
adulthood.
ACKNOWLEDGMENTS
Work on this essay was supported by National Institutes of Health Grants
R21AG032494 to Theodore F. Robles, and National institute on Aging training grant T32AG033533 to Josephine A. Menkin. The content is solely the
responsibility of the authors and does not necessarily represent the official
views of the National Institute on Aging or the National Institutes of Health.
We thank Melissa Fales, Angie Shu-Sha Guan, and Ben Shulman for reviewing an early draft of this essay.
REFERENCES
Adams, R. G. (1987). Patterns of network change: A longitudinal study of friendships
of elderly women. The Gerontologist, 27, 222–227. doi:10.1093/geront/27.2.222
Baumeister, R. F., & Leary, M. R. (1995). The need to belong: desire for interpersonal
attachments as a fundamental human motivation. Psychological Bulletin, 117, 497.
doi:10.1037/0033-2909.117.3.497
Birditt, K. S., Fingerman, K. L., & Almeida, D. M. (2005). Age differences in exposure
and reactions to interpersonal tensions: A daily diary study. Psychology and Aging,
20, 330. doi:10.1037/0882-7974.20.2.330

12

EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES

Brooks, K. P., & Dunkel Schetter, C. (2011). Social negativity and health: Conceptual and measurement issues. Social and Personality Psychology Compass, 5, 904–918.
doi:10.1111/j.1751-9004.2011.00395.x
Brown, S. L., Bulanda, J. R., & Lee, G. R. (2005). The significance of nonmarital cohabitation: Marital status and mental health benefits among middle-aged and older
adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences,
60(1), S21–S29. doi:10.1093/geronb/60.1.S21
Chida, Y., & Steptoe, A. (2010). Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status a metaanalysis of prospective evidence. Hypertension, 55(4), 1026–1032. doi:10.1161/
HYPERTENSIONAHA.109.146621
Cole, S. W., Hawkley, L. C., Arevalo, J. M., Sung, C. Y., Rose, R. M., & Cacioppo, J. T.
(2007). Social regulation of gene expression in human leukocytes. Genome Biology,
8(9), R189. doi:10.1186/gb-2007-8-9-r189
Dickson, F. C., Hughes, P. C., & Walker, K. L. (2005). An exploratory investigation
into dating among later-life women. Western Journal of Communication, 69, 67–82.
doi:10.1080/10570310500034196
DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment:
A meta-analysis. Health Psychology, 23, 207. doi:10.1037/0278-6133.23.2.207
Fingerman, K. L., & Charles, S. T. (2010). It takes two to tango: Why older people have
the best relationships. Current Directions in Psychological Science, 19(3), 172–176.
doi:10.1177/0963721410370297
Gable, S. L., Gonzaga, G. C., & Strachman, A. (2006). Will you be there for me when
things go right? Supportive responses to positive event disclosures. Journal of Personality and Social Psychology, 91, 904. doi:10.1037/0022-3514.91.5.904
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. (C. Brayne, Ed.). PLoS Medicine, 7, e1000316.
doi:10.1371/journal.pmed.1000316
Jerrome, D. (1981). The significance of friendship for women in later life. Ageing and
Society, 1, 175–197. doi:10.1017/S0144686X00008746
Masi, C. M., Chen, H. Y., Hawkley, L. C., & Cacioppo, J. T. (2011). A meta-analysis of
interventions to reduce loneliness. Personality and Social Psychology Review, 15(3),
219–266. doi:10.1177/1088868310377394
Matthews, S. H. (1986). Friendships through the life course: Oral biographies in old age.
Beverly Hills, CA: Sage.
Milardo, R. M. (1987). Changes in social networks of women and men following divorce: A review. Journal of Family Issues, 8, 78–96. doi:10.1177/
019251387008001004
Pinquart, M., & Sorensen, S. (2001). Influences on loneliness in older adults: A
meta-analysis. Basic and Applied Social Psychology, 23(4), 245–266. doi:10.1207/
S15324834BASP2304_2
Robles, T. F., Glaser, R., & Kiecolt-Glaser, J. K. (2005). Out of balance: A new look
at chronic stress, depression, and immunity. Current Directions in Psychological Science, 14, 111–115. doi:10.1111/j.0963-7214.2005.00345.x

Social Relationships and Health in Older Adulthood

13

Rook, K. S., Luong, G., Sorkin, D. H., Newsom, J. T., & Krause, N. (2012). Ambivalent versus problematic social ties: Implications for psychological health, functional health, and interpersonal coping. Psychology and Aging, 27, 912. doi:10.1037/
a0029246
Rook, K. S., & Sorkin, D. S. (2003). Fostering social ties through a volunteer role:
Implications for older-adults’ psychological health. International Journal of Aging
and Human Development, 57, 313–337. doi:10.2190/NBBN-EU3H-4Q1N-UXHR
Sbarra, D. A., Hasselmo, K., & Nojopranoto, W. (2012). Divorce and death: A case
study for health psychology. Social and Personality Psychology Compass, 6, 905–919.
doi:10.1111/spc3.12002
Shea, L., Thompson, L., & Blieszner, R. (1988). Resources in older adults’ old and
new friendships. Journal of Social and Personal Relationships, 5, 83–96. doi:10.1177/
0265407588051005
Shor, E., Roelfs, D. J., Curreli, M., Clemow, L., Burg, M. M., & Schwartz, J. E. (2012).
Widowhood and mortality: A meta-analysis and meta-regression. Demography, 49,
575–606. doi:10.1007/s13524-012-0096-x
Smith, T. W., Uchino, B. N., Berg, C. A., Florsheim, P., Pearce, G., Hawkins, M., …
Olsen-Cerny, C. (2009). Conflict and collaboration in middle-aged and older couples: II. Cardiovascular reactivity during marital interaction. Psychology and Aging,
24, 274. doi:10.1037/a0016067
Smith, T. W., Uchino, B. N., Florsheim, P., Berg, C. A., Butner, J., Hawkins, M., …
Yoon, H. C. (2011). Affiliation and control during marital disagreement, history of
divorce, and asymptomatic coronary artery calcification in older couples. Psychosomatic Medicine, 73, 350–357. doi:10.1097/PSY.0b013e31821188ca
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National
Academy of Sciences, 110, 5797–5801. doi:10.1073/pnas.1219686110
Stroebe, M., Schut, H., & Stroebe, W. (2007). Health outcomes of bereavement. The
Lancet, 370, 1960–1973. doi:10.1016/S0140-6736(07)61816-9
Uchino, B. N., Holt-Lunstad, J., Bloor, L. E., & Campo, R. A. (2005). Aging and cardiovascular reactivity to stress: Longitudinal evidence for changes in stress reactivity.
Psychology and Aging, 20, 134. doi:10.1037/0882-7974.20.1.134
Umberson, D., Williams, K., Powers, D. A., Liu, H., & Needham, B. (2006). You make
me sick: Marital quality and health over the life course. Journal of Health and Social
Behavior, 47, 1–16. doi:10.1177/002214650604700101
Van Tilburg, T. (1992). Support networks before and after retirement. Journal of Social
and Personal Relationships, 9, 433–445. doi:10.1177/0265407592093006
Wilson, R. S., Krueger, K. R., Arnold, S. E., Schneider, J. A., Kelly, J. F., Barnes, L.
L. … Bennett, D. A. (2007). Loneliness and risk of Alzheimer disease. Archives of
General Psychiatry, 64, 234. 10.1001/archpsyc.64.2.234

FURTHER READING
Blieszner, R., & Roberto, K. A. (2004). Friendship across the life span: Reciprocity
in individual and relationship development. In F. R. Lang & K. L. Fingerman

14

EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES

(Eds.), Growing together: Personal relationships across the lifespan. Cambridge, England: Cambridge University Press.
Brown, S. L., Lee, G. R., & Bulanda, J. R. (2006). Cohabitation among older adults:
A national portrait. The Journals of Gerontology Series B: Psychological Sciences and
Social Sciences, 61(2), S71–S79. doi:10.1093/geronb/61.2.S71
Brown, S. L., & Lin, I. (2012). The gray divorce revolution: Rising divorce among
middle-aged and older adults, 1990–2010. Journals of Gerontology: Series B, 67,
731–741. doi:10.1093/geronb/gbs089
Brown, S. L., & Shinohara, S. K. (2013). Dating relationships in older adulthood:
A national portrait. Journal of Marriage and Family, 75, 1194–1202. doi:10.1111/
jomf.12065
Cherlin, A. J. (2010). Demographic trends in the United States: A review of
research in the 2000s. Journal of Marriage and Family, 72, 1–17. doi:10.1111/j.17413737.2010.00710.x
Charles, S. T., & Carstensen, L. L. (2010). Social and emotional aging. Annual Review
of Psychology, 61, 383–409. doi:10.1146/annurev.psych.093008. 100448
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40,
218–227. doi:10.1007/s12160-010-9210-8
Robles, T. F., Slatcher, R. B., Trombello, J. M., & McGinn, M. M. (2014). Marital
quality and health: A meta-analytic review. Psychological Bulletin, 140, 140–187.
doi:10.1037/a0031859
Uchino, B. N. (2004). Social support and physical health: Understanding the health consequences of relationships. New Haven, CN: Yale University Press.
Wrzus, C., Hänel, M., Wagner, J., & Neyer, F. J. (2013). Social network changes and
life events across the lifespan: A meta-analysis. Psychological Bulletin, 139, 53–80.
doi:10.1037/a0028601

THEODORE F. ROBLES SHORT BIOGRAPHY
Theodore F. Robles is an associate professor in Health Psychology at the
University of California at Los Angeles. He received a BS in Psychology at
University of Wisconsin-Madison, and a PhD in Clinical Psychology from
The Ohio State University. His research examines the biological mechanisms
that explain how social relationships impact health, with a particular focus
on marital and family relationships. His work has been published in such
journals as Psychological Bulletin, Physiology and Behavior, Psychosomatic
Medicine, Psychoneuroendocrinology, Health Psychology, International Journal of
Psychophysiology, and Journal of Social and Personal Relationships. He currently
studies how family dynamics influence susceptibility to upper respiratory
infections in children, the impact of close relationship functioning on sleep,
and how retirement impacts the marital functioning and health. For more
about his research, visit http://rhl.psych.ucla.edu.

Social Relationships and Health in Older Adulthood

15

JOSEPHINE A. MENKIN SHORT BIOGRAPHY
Josephine A. Menkin is a graduate student in Health Psychology at the
University of California at Los Angeles. She received her BA in Psychology
at Northwestern University, where she studied how people perceive older
black adults. She also worked as the laboratory manager for the Carstensen
Life-span Development Laboratory at Stanford University for 2 years before
beginning her graduate study. She now combines her interests in age stigma
and adult development. Her graduate research focuses on predictors and
consequences of new social relationship formation in later life, with additional focus on how attitudes and beliefs about aging may influence social
engagement and health.
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