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The Journals of Gerontology Series B: Psychological Sciences and Social Sciences Advance Access published online on June 18, 2009
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, doi:10.1093/geronb/gbp050
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Diabetes-Related Support, Regimen Adherence, and Health Decline Among Older Adults

Emily J. Nicklett1,2 and Jersey Liang1,3

1 Department of Health Management and Policy, School of Public Health
2 Department of Sociology
3 Institute of Gerontology, University of Michigan, Ann Arbor

Address correspondence to Emily J. Nicklett, Department of Health Management and Policy, School of Public Health, University of Michigan, 109 South Observatory Street, SPH 2, Ann Arbor, MI 49109-2029. Email: enicklet{at}umich.edu


  Abstract

Objectives: Social support is generally conceptualized as health promoting; however, there is little consensus regarding the mechanisms through which support is protective. Illness support has been proposed to promote regimen adherence and subsequent prevention of health decline. We hypothesize that (a) support for regimen adherence is negatively associated with self-reported health decline among older diabetic adults and that (b) regimen adherence is negatively associated with health decline among older diabetic adults.

Methods: We used the Health and Retirement Study data on individuals over the age of 60 years with type 2 diabetes mellitus (n = 1,788), examining change in self-reported health status over a 2-year period using binomial and cumulative ordinal logistic regression models.

Results: Diabetic support is not significantly associated with health decline, but it is strongly associated with adherence to health-promoting activities consisting of a diabetic regimen. Therefore, the extent to which one receives illness support for a given regimen component is highly positively associated with adhering to that component, although this adherence does not necessarily translate into protection against perceived decline in health.

Conclusions: Illness-related support appears to be a mechanism through which social support matters in the diabetic population. Although this relationship did not extend to prevention of health status decline among diabetics, the relationship between support and illness management is promising.

Key Words: Chronic illness • Health determinants • Medical regimens • Patient adherence • Self-care • Self-rated health • Social support • Type 2 diabetes

Received March 3, 2009; Accepted May 21, 2009

Decision Editor: Kenneth A. Ferraro, PhD


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