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In reply—Association of Social Support Source and Size of Social Support Network With All-Cause Mortality in a National Prospective Cohort

      We greatly appreciate the letter to the editor submitted by Loprinzi and El-Sayed in response to our recent article.
      • Becofsky K.M.
      • Shook R.P.
      • Sui X.
      • Wilcox S.
      • Lavie C.J.
      • Blair S.N.
      Influence of the source of social support and size of social network on all-cause mortality.
      In their letter, they present the results of an epidemiological investigation into the influence of social relations on all-cause mortality in a nationally representative sample of older adults from the National Health and Nutrition Examination Survey. They report that perceiving spousal support and having one or more close friends were protective against mortality. These findings complement our findings from the Aerobics Center Longitudinal Study, as well as those from another recent report from the Netherlands of lower mortality risk among older adults reporting large, diverse social networks.
      • Ellwardt L.
      • van Tilburg T.
      • Aartsen M.
      • Wittek R.
      • Steverink N.
      Personal networks and mortality risk in older adults: a twenty-year longitudinal study.
      Taken together, these findings serve as a reminder that humans are innately social beings and that social functioning is as important as traditional biological and behavioral risk factors in determining health and well-being.
      As epidemiological evidence continues to mount, efforts must shift to clinical assessment and intervention. As documented in both our article
      • Becofsky K.M.
      • Shook R.P.
      • Sui X.
      • Wilcox S.
      • Lavie C.J.
      • Blair S.N.
      Influence of the source of social support and size of social network on all-cause mortality.
      and the letter by Loprinzi and El-Sayed, social relations can be assessed with a few simple questions (eg, “Can you count on anyone to provide you with emotional support such as talking over problems or helping you make a difficult decision?” and “How many close friends do you have?”). In order for individuals reporting low levels of support and/or few friends to receive evidence-based “treatment” options, individual-level interventions must be developed and tested. One novel approach that might simultaneously improve both perceptions of support and social integration could be the facilitation of pet adoption because pets can both provide companionship and serve as a catalyst for social interaction.
      • McNicholas J.
      • Gilbey A.
      • Rennie A.
      • Ahmedzai S.
      • Dono J.A.
      • Ormerod E.
      Pet ownership and human health: a brief review of evidence and issues.
      • Wood L.
      • Martin K.
      • Christian H.
      • et al.
      The pet factor—companion animals as a conduit for getting to know people, friendship formation and social support.
      This may be one instance in which we can create (rather than improve) an intimate, supportive relationship for individuals with few existing family members or friends while also motivating additional social engagement in the community.
      The findings reported by Loprinzi and El-Sayed in their letter to the editor complement our previous findings and contribute to the impressive evidence base on the importance of social relations to survival. We hope this discussion will motivate the establishment of clinical assessment procedures and the development of novel interventions to promote health and longevity.

      References

        • Becofsky K.M.
        • Shook R.P.
        • Sui X.
        • Wilcox S.
        • Lavie C.J.
        • Blair S.N.
        Influence of the source of social support and size of social network on all-cause mortality.
        Mayo Clin Proc. 2015; 90: 895-902
        • Ellwardt L.
        • van Tilburg T.
        • Aartsen M.
        • Wittek R.
        • Steverink N.
        Personal networks and mortality risk in older adults: a twenty-year longitudinal study.
        PLoS One. 2015; 10: e0116731
        • McNicholas J.
        • Gilbey A.
        • Rennie A.
        • Ahmedzai S.
        • Dono J.A.
        • Ormerod E.
        Pet ownership and human health: a brief review of evidence and issues.
        BMJ. 2005; 331: 1252-1254
        • Wood L.
        • Martin K.
        • Christian H.
        • et al.
        The pet factor—companion animals as a conduit for getting to know people, friendship formation and social support.
        PLoS One. 2015; 10: e0122085

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