Living arrangements and survival among middle-aged and older adults in the NHANES I epidemiologic follow-up study

Abstract

Background: There is concern about but little information on how living alone affects the health and survival of older adults.

Methods: We examined the association between living arrangements (living alone, with a spouse, or with someone other than a spouse) and survival among 7651 adults, aged 45 to 74 years in the National Health and Nutrition Examination Survey (NHANES I) (1971-1975) and traced at the NHANES I Follow-up Study (1982-1984), to see whether certain sociodemographic factors (race, education, income, and employment), health behaviors (alcohol, smoking, physical activity, and obesity), or chronic medical conditions were influential in the association.

Results: We found a stronger association of living arrangements with survival for men than for women, and for middle-aged men than for older men. For men, those living alone and those living with someone other than a spouse were equally disadvantaged in terms of survival. Income, race, employment, and physical activity influenced the association of living arrangements and survival, but their impact varied by age, gender, and living arrangement.

Conclusion: Living arrangements had a weak impact on survival among men, but had no effect among women.