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Purpose: This report analyzes relationships between chronic inflammation and quality of life (QoL). It assesses the potential role of intimate relationships in associations between inflammation, medical sequelae such as pain and disability, and QoL.

Design/Methodology/Approach: Limited longitudinal data from the National Social Life, Health, and Aging Project (NSHAP) were analyzed. Inflammation was assessed via the biomarker C-reactive protein (CRP). The authors examined pathwise associations between CRP levels and general happiness. The authors used ordinal logistic regression with companion OLS models, and conducted a variety of sensitivity analyses.

Findings: Intimate partnerships – especially marriage – appear to impact associations between inflammation and QoL. When QoL is measured using general happiness, intimate relationships appear to shape directional associations between inflammation and QoL along with medical consequences of inflammation.

Research Limitations/Implications: Inflammation and its clinical consequences may substantially alter intimate relationship involvement and quality that in turn impact QoL. These relationships should not be viewed as unilateral explanations of the tremendous variability observed in QoL among people with inflammatory conditions, but rather as possible elements of complex causal frameworks. Further investigation using advanced methods for longitudinal modeling from limited waves of data can help to shed additional light on the nuances of happiness and QoL among people living with chronic inflammation.

Originality/Value: This chapter provides an overview of possible causal relationships between chronic inflammation, associated clinical and social experiences, and QoL. Researchers interested in advanced causal modeling of relationships between chronic inflammation and QoL can build on this work using novel methods and data sources.

To conduct an exploratory mixed-methods study of attitudes toward extramarital relationships in the context of spousal Alzheimer’s disease.

We present descriptive analyses of quantitative data from the National Social, Health, and Aging Project and of qualitative comments posted online by readers of newspaper articles that focus on extramarital relationships in the context of caring for a spouse with Alzheimer’s disease.

Analyses of the quantitative data indicate the Alzheimer’s caregivers report more negative attitudes toward extramarital sex in the context of spousal Alzheimer’s disease. However, this difference is driven by non-spousal caregivers’ attitudes; spousal caregivers have substantially less negative attitudes. Analyses of public comments suggest that those who are most negative are focused on traditional religious and family values. Those who express less negative attitudes espouse a compassionate pragmatism that makes allowances for caregiver needs in the context of managing the difficulties of the spouse-caregiver role.

Quantitative data are limited by the small number of Alzheimer’s caregivers; qualitative analyses are based on a convenience sample of online comments.

Findings can inform future research, educational initiatives for professionals, the media, and people living with Alzheimer’s disease and their family members.

The number of individuals living with Alzheimer’s disease and spousal caregivers will increase as the Baby Boomer generation ages. Norms regarding extramarital relationships in the context of caring for a spouse with Alzheimer’s disease are evolving.

Little social scientific research examines attitudes toward extramarital relationships in the context of spousal Alzheimer’s disease.

Purpose: This study examines the relationship between marital satisfaction and sexual satisfaction, as well as other contributing factors, in the lives of older American adults.

Design/methodology/approach: Data from a restricted sample (N = 1,278) from the second wave of the National Social Life, Health, and Aging Project (NSHAP) was analyzed. Regression models were used to examine associations with marital satisfaction.

Findings: Within ordinary least squares regression gender, education level, mental health, self-rated happiness, the absence of sexual quality, physical satisfaction, and emotional satisfaction were each statistically significant. Females reported higher marital satisfaction than males. Higher educated individuals expressed less satisfaction within their marriages than those with less formal education. Those that rated their mental health, happiness, and physical and emotional satisfaction high also reported higher marital satisfaction. Participants that reported an absence of sexual quality generally rated their marital satisfaction lower.

Originality/value: Most studies focus on the experiences of younger and middle-aged adults, often excluding older adults. Further, while there have been efforts to focus more research on the relationships of adults in midlife to late life, sexuality is still largely ignored.

This study assessed the marital quality of older men and women in first marriages and remarriages, examining gender differences within first marriages and remarriages, and marriage order differences for men and women separately.

The study employed nationally representative survey data for 1,243 married adults, aged 62–91, from Wave II of the National Social Life, Health, and Aging Project (NSHAP), conducted in 2010–2011. Marital quality was assessed with six positive relationship dimensions and two negative ones.

Descriptive data revealed mean ratings above scale midpoints on all positive dimensions of marital quality, and mean ratings generally below the midpoints on the negative dimensions for men and women in both first marriages and remarriages. Multivariate analyses indicated an overall stronger influence of gender than marriage order on marital quality for this sample of older adults. In both first marriages and remarriages, men reported more favorable perceptions of marriage across several positive dimensions (e.g., emotional satisfaction, physical pleasure), though they also reported more spousal criticism than did women. Within gender groups, marriage order was not associated with any of the dimensions of marital quality that were assessed.

This study demonstrates that marriage order does not have a significant influence on the marital quality of older adults today, but that long-standing gender differences in marital quality hold across marriage order. These findings are critical given the increasingly diverse marital histories of individuals entering old age in the early 21st century, and the importance of a positive, supportive marriage for older adults’ well-being.

Purpose: The present study examines how relationship status and gender are associated with social network experiences among older adults. Two relationship status groupings were examined: comparisons of (1) marrieds, divorced, and widowed individuals and (2) never marrieds, cohabiters, and daters.

Methodology: Data from the second wave of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative dataset, was used. Of the final sample of respondents, 10.3% identified as Black, 6.8% identified as Hispanic, 52.9% identified as female, and the mean age of respondents was 72.54 (SD = 7.52). Linear mixed models were conducted.

Results: Overall, men reported talking less and received less family and friend support than women. For only those who were divorced, widowed, or married, men were less close with their social networks and had less friend support than women. Widows were closer to their social networks than married and divorced individuals. Among women, divorced women were less close to their social network than married or widowed women. Those who were married talked less to their social networks than those who were divorced or widowed and cohabiters talked less than daters. Widows reported receiving greater family support than those who were married. Cohabiters had lower neighborhood social ties than those who were dating. Several significant interaction effects between gender and relationship status also occurred.

Value: The present study found that both gender and relationship status plays a role in how social network experiences and lends some support to marriage and cohabitation serving as “greedy” institutions.

Marriage is a social institution that integrates individuals to form families. Yet, the social embeddedness of married couples is surprisingly rarely examined, particularly for remarriage. Drawing from multiple datasets, this chapter shows that before marriage, remarried dyads are socially less embedded than their continuously married counterparts; after marriage, their social relations rely more on the spouse. First, with the attrition of close associates over the life course and the disruption in social network due to divorce, individuals tend to look outside their networks and at less conventional venues, and to adopt dating strategies involving fewer contacts from existing network, resulting in greater socio-demographic heterophily in remarriage. Second, such dating strategies and the greater socio-demographic heterogamy imply socially invisible wedding ceremonies for remarried couples. Third, remarried individuals’ social networks, in the absence of spousal ties, remain as fragmented as those of the divorced in terms of network characteristics such as density, volume of contacts, and emotional closeness. A remarried individual’s network is akin to that of the divorced plus a spouse. Compared to first marriage, the spouse is much more prominent in the social relations of remarried individuals.

Health care services are typically viewed as institutions or agencies offering professional care or care supervised by professionals. The concept of availability of health care services involves the degree to which persons can readily find professional care. Few scholars have considered the relevance of these notions to life-circumstances of older homebound women who experience emergent situations (ES) at home such as falls, unintentional injuries, or health problems. During a larger descriptive phenomenological study of the experience of reaching help quickly, 33 of 40 homebound women, aged 85–98 years, who were living alone, reported 57 situations of interest during open-ended interviews over 18 months. The purposes of this facet of the study were (a) to describe the life-world of women who had fortuitous help with ES at home, (b) to categorize helpers involved, and (c) to elaborate the reported influence of such situations on recognizing the risk of being unable to reach help quickly in the future. Life-world was featured by having help right now from someone on the scene. We categorized involved helpers into six types, including four previously identified types of home care helpers as well as (a) “on-the-spot” helpers, acquaintances not among the woman's home care helpers and (b) “at-this-scene-only” helpers, who were not likely to encounter the woman afterwards. In these ES, the home – not the health care institution – was the setting. On-the-scene helpers served as critical health care resources. In contrast to the typical focus on availability of health care services in a public space, availability of on-the-scene helpers in the home, a private space, was critical to the well-being of these old homebound women. This work raises new notions about availability of health care services for older homebound women and offers new perspectives on the key support network concepts of proximity and frequency of contact.