A criterion-based literature survey of the relationship between family support and incidence and course of chronic disease in the elderly

Medical literature from 1986 through 1992 was reviewed in order to investigate the associations between family support and incidence and course of specific chronic diseases in the elderly. The results of 83 research reports, of which 56 were judged to be of satisfactory methodological quality, are discussed. Structural family characteristics, such as the presence of a spouse or children, appear not to be directly associated with incidence or course of chronic diseases in the elderly. Regardless of the specific disease involved, a positive perception of family support is consistently associated with a more favorable course. The relative importance of family support in ameliorating disease course probably also depends on the patient's gender and age, other sources of social support, psychological and behavioral characteristics, and on the specific disease involved. Unfortunately, these aspects are often not taken into account explicitly. Depending on the specific research questions, future research should include psychological and physical parameters of disease course, structural and functional characteristics of support networks, and positive and negative perceptions of social relationships. A longitudinal study design is mandatory, and changes of both independent and dependent variables should be taken into account.