Gender differences in the effect of social support on health-related quality of life: results of a population-based prospective cohort study in old age in Germany.
André Hajek, Christian Brettschneider, Carolin Lange, Tina Posselt, Birgitt Wiese, Susanne Steinmann, Siegfried Weyerer, Jochen Werle, Michael Pentzek, Angela Fuchs, Janine Stein, Tobias Luck, Horst Bickel, Edelgard Mösch, Steffen Wolfsgruber, Kathrin Heser, Wolfgang Maier, Martin Scherer, Steffi G Riedel-Heller, Hans-Helmut König
Author Information
André Hajek: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. a.hajek@uke.de.
Christian Brettschneider: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Carolin Lange: Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Tina Posselt: Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Birgitt Wiese: WG Medical Statistics and IT-Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
Susanne Steinmann: WG Medical Statistics and IT-Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
Siegfried Weyerer: Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Jochen Werle: Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Michael Pentzek: Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Angela Fuchs: Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Janine Stein: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Tobias Luck: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Horst Bickel: Department of Psychiatry, Technical University of Munich, Munich, Germany.
Edelgard Mösch: Department of Psychiatry, Technical University of Munich, Munich, Germany.
Steffen Wolfsgruber: Department of Psychiatry, University of Bonn, Bonn, Germany.
Kathrin Heser: Department of Psychiatry, University of Bonn, Bonn, Germany.
Wolfgang Maier: Department of Psychiatry, University of Bonn, Bonn, Germany.
Martin Scherer: Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Steffi G Riedel-Heller: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Hans-Helmut König: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PURPOSE: The causality between social predictors and HRQoL in old age remains almost unclear as only a few studies have examined the influence of social support on HRQoL in a longitudinal setting. Moreover, available studies investigating gender differences in the effect of social support on HRQoL in old age have been solely cross-sectional. Consequently, the aim of this study was to examine whether social support affects health-related quality of life (HRQoL) in old age and whether this effect is moderated by gender. METHODS: In a population-based cohort (N = 2443) of people aged 75 years and older in Germany, the development of HRQoL was prospectively observed over a 3-year period. Quality of life was quantified by using the visual analogue scale of the EQ-5D instrument. Social support was assessed by using the 14-item form of the questionnaire for social support (F-SozU K-14). In order to control for unobserved heterogeneity, fixed-effects regression analysis was used. RESULTS: In the total sample (β = 0.55, p < 0.05) and in men (β = 1.39, p < 0.001), a strong positive impact of social support on HRQoL was found. There was no significant effect of social support on HRQoL in women. The effect of social support on HRQoL was significantly moderated by gender (p < 0.05). CONCLUSIONS: Findings accentuate the fundamental role of social support in HRQoL in old age. Particularly in men, it is therefore crucial to strengthen the social ties in old age.
