While the importance of family support in times of stress has been widely documented in the gerontological literature, in-depth studies of the importance of friendship support are lacking. The objective of this study was to follow a sample of recently, visually impaired, community-dwelling men and women over time to examine how they utilize friendship support, in addition to family support, in adapting to age-related, chronic vision impairment. Adaptation was measured with three scales: the domainspecific adaptation to vision loss scale, and two global measures of well-being, life satisfaction and depressive symptoms.


A 5-year longitudinal study with three times of measurement was conducted. Initial contact with participants occurred at application for rehabilitation service. Respondents were interviewed 6 months later, after the receipt of service, for a short-term follow-up, and again, 12 months later (18 months after baseline), for a long-term follow-up.


The sample (N=570) was drawn from a population of English-speaking, community-dwelling persons aged 65 and above. Study participants (average age = 80; 51% female) were mostly White (85%), without a spouse (about 60%), and with an education of high school or beyond (69%). The Time-2 and Time-3 samples consisted of 470 and 356 older adults, respectively. Analyses comparing drop-outs with participants showed that drop-outs were significantly older with poorer self-rated health and greater functional disability compared to participants. This is not uncommon in longitudinal research on older adults. There were no significant differences in vision loss severity.

Selected findings are briefly summarized below. First, analyses from the final report (listwise sample; N=313) which examined adaptation over time are presented. Findings showed that higher initial disability and increased disability over time had a negative impact on visually impaired elders' adaptation to vision loss. Initial use of coping strategies (greater acceptance and less wishfulness) had a short- and long-term impact on adaptation, but was not associated with change in adaptation over time. While family support had an important impact on adaptation initially, friendship support was associated with increased adaptation over time. Thus, the utilization of friendship, in addition to family support, is an important issue to be addressed in vision rehabilitation.

Three papers examined support variables over time. Reinhardt and Boerner (2003) examined the degree of individual change in friendship and family networks and support received (affective, instrumental) over time as a function of demographic characteristics, disability, and rehabilitation use. All network and support variables decreased over time. In terms of predicting individual variation, age (younger) and education (higher) were associated with greater friendship support at baseline, rehabilitation was related to less decrease in friend network size, and disability was positively associated with instrumental family support at each time point. Results support the importance of examining individual change and factors associated with variability in multiple support components by relationship type.

Boerner and Reinhardt (2003) also studied the predictors of support provision over time among older adults with vision loss. Both affective and instrumental support provided to family and friends decreased over time. Age (younger), gender (women), and education (higher education) were associated with higher support provision at baseline, but neither functional disability nor health emerged as significant predictors. Rehabilitation use predicted less decrease in the provision of instrumental friendship support. Support receipt was positively related to provision at each point, within and across support types, showing older adults were actively engaged in reciprocal relationships. Findings indicate that there may be feasible ways of providing support, even for older adults in need of support themselves.

Boerner, Reinhardt, Raykov, and Horowitz (2004) examined stability and change in social negativity and the link between social negativity and instrumental support over time in 570 older adults with vision loss using latent growth curve methodology. Findings demonstrated a decrease over time in social negativity received, while the level of social negativity initiated remained more stable. Links with instrumental support were positive, but stronger for received than initiated social negativity. These differential patterns for received and initiated social negativity suggest different origins for these support constructs.

Reinhardt, Boerner, and Horowitz (2006) focused on the differential effects of perceived and received support on well-being. Findings demonstrated that while higher perceived support (perception you have others to count on for help if needed) was associated with greater well-being, the actual receipt of instrumental support (e.g., help with cooking, shopping) was associated with poorer well-being. Findings underscore the importance of distinguishing the impact of multiple support components in order to fully understand how social support may buffer the effects of stressful events in later life.


Boerner, K., & Reinhardt, J. P. (2003). Giving while in need: Support provided by disabled older adults. Journal of Gerontology: Social Sciences, 58B (5), S297-S304.

Boerner, K., Reinhardt, J. P., Raykov, T., & Horowitz, A. (2004). Stability and change in social negativity in later life: Reducing received while maintaining initiated negativity. Journal of Gerontology: Social Sciences, 59B (4), S230-S237.

Reinhardt, J. P. (2000). Effects of positive and negative support received and provided on adaptation to chronic impairment. Applied Developmental Science, 5, 76-85.

Reinhardt, J. P., & Benn, D. (2000). The role of personal and social resources in elders' adaptation to chronic vision loss. In C. Stuen, A. Arditi, A. Horowitz, M.A. Lang, B. Rosenthal, & K. Seidman (Eds.). Vision rehabilitation: Assessment, intervention, and outcomes (p.650-654). Amsterdam: Swets & Zeitlinger.

Reinhardt, J. P., Boerner, K., & Benn, D. (2003). Predicting individual change in support over time among chronically impaired adults. Psychology and Aging. 4, 770-779.

Reinhardt, J.P. (2005). Social support in old age. In C.B. Fisher & R.M. Lerner (Eds.), Encyclopedia of applied developmental science, Vol. II (pp, 1024-1027). Thousand Oaks: Sage.

Reinhardt, J. P., Boerner, K., & Horowitz, A. (2006). Good to have but bad to use: Differential impact of perceived and received support on well-being. Journal of Social and Personal Relationships 23(1), 117-129.

Selected Presentations

Benn, D., & Reinhardt, J. P. (2000, November). The effect of coping patterns on change in adaptation to vision loss. Poster session presented at the annual scientific meeting of The Gerontological Society of America, Washington, DC.

Reinhardt, J. P. (2000, November). The variable role of informal support in promoting vision rehabilitation service use. In M. Cantor and M. Brennan (Chairs), Is need enough? Additional pathways to service utilization. Paper presented at the annual scientific meeting of The Gerontological Society of America, Washington, DC.

Reinhardt, J. P., Benn, D., Boerner, K., & Su, Y. (2001, November). Impact of friendship and family support on change in adaptation to chronic impairment over time. Poster session presented at the annual scientific meeting of The Gerontological Society of America, Chicago, Illinois.

Reinhardt, J. P. (2004, November). Applying social support research findings to the development and evaluation of support interventions. Informal Discussion Roundtable presented at the annual scientific meeting of the Gerontological Society of America, Washington D.C.

Investigators: Joann P. Reinhardt, PhD, Principal Investigator
Dolores Benn, PhD, Research Coordinator
Charla McKinzie, MA, Graduate Research Intern
Kathrin Boerner, PhD, Research Associate

Funded by: National Institute of Mental Health

Project Period: 1996-2001



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