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Innovation in Aging
cite as: Innovation in Aging, 2019, Vol. 3, No. 1, 1–18
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Invited Article
Friendship in Later Life: AResearchAgenda
Rosemary Blieszner, PhD,1,*, AaronM. Ogletree, PhD,2 and RebeccaG. Adams, PhD3
1Center for Gerontology, 230 Grove Lane (0555), Virginia Tech, Blacksburg. 2American Institutes for Research, Rockville,
Maryland. 3Gerontology Program, University of North Carolina at Greensboro.
*Address correspondence to: Rosemary Blieszner, PhD, Center for Gerontology, Virginia Tech, Blacksburg, VA 24061. E-mail: rmb@vt.edu
Received: October 10, 2018; Editorial Decision Date: February 11, 2019
Decision Editor: J.Jill Suitor, PhD
Abstract
Friendship is a relationship that can endure across the entire lifespan, serving a vital role for sustaining social connectedness in
late life when other relationships may become unavailable. This article begins with a description of the importance of studying
friendship in late life and the benets of friendship for older adults, pointing to the value of additional research for enhancing
knowledge about this crucial bond. Next is discussion of theoretical approaches for conceptualizing friendship research, fol-
lowed by identication of emerging areas of late-life friendship research and novel questions that investigators could explore
fruitfully. We include a presentation of innovative research methods and existing national and international data sets that
can advance late-life friendship research using large samples and cross-national comparisons. The nal section advocates for
development and assessment of interventions aimed at improving friendship and reducing social isolation among older adults.
Keywords: Friendship data sets, Friendship in old age, Friendship interventions, Friendship processes, Friendship research methods,
Friendship structure, Friendship theory
Why Is It Important to Study Friendship
in LateLife?
What Are the Benefits of Friendship to Old
People?
Friendship is a relationship that can endure across the
entire life span, serving a vital role for sustaining social
connectedness in late life when other relationships, such as
with coworkers and organization members, may be relin-
quished. Although gaining new kin is common at earlier
ages, in the later years the possibility of making new friends
is greater than the likelihood of enlarging the kin network,
at least in one’s own generation.
Friend ties have been revered as vital relationships since
ancient times, when Confucius and Aristotle extolled the
benets of associating with those who encourage moral vir-
tue, complement one’s own limitations, and provide cher-
ished companionship. Aristotle, in particular, highlighted
emotional and reciprocal aspects of friendship that are
deemed important now (Mullis, 2010), as contemporary
Translational Signicance: Social isolation places older adults in jeopardy for both poor health and low
psychological well-being. Detailed research ndings on crucial elements of friendship in late life can inform
the design of social interventions aimed at enhancing personal skills and strategies for making and keeping
friends, planning of community programs to foster friend interactions and advocacy for policies that pro-
mote rather than interfere with late-life friendship.
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adults focus on affection, trust, commitment, respect, reci-
procity, and the like when dening friendship (Blieszner &
Adams, 1992; Dunbar, 2018; Felmlee & Muraco, 2009).
At the same time, diversity in perceptions of important
elements of friendship occurs across life cycle stage, gen-
der, marital and parental status, geographic location and
cultural context, and historical eras (Adams, Blieszner, &
de Vries, 2000; Blieszner & Adams, 1992; Gillespie, Lever,
Frederick, & Royce, 2015). Early empirical studies of social
relationships, including those in late adulthood, generally
did not focus on friendship per se, so this nuanced aware-
ness of friendship is a recent phenomenon.
Although it is clear that friendship has long been an
important part of social life and important to well-being,
this close relationship has not received nearly as much atten-
tion historically as family ties. In fact, in 1950s and 1960s
when sociologists and family scientists examined close rela-
tionships, they tended to investigate marital and kin bonds,
but typically did not include friends in their studies. Not
until 1970s and 1980s did scholars begin to probe friend-
ship as a social role in its own right, separate from ties
with colleagues, neighbors, acquaintances, and other non-
kin, and to study friendship as a relationship rather than
friendliness as an individual attribute. They uncovered a
range of friendship forms and functions and identied both
unique aspects of friendship as distinct from other ties as
well as similarities between friendship and other informal
and close relationships (Blieszner & Adams, 1992).
Studies consistently show that friend relationships
are as important as family ties in predicting psychologi-
cal well-being in adulthood and old age (Chen & Feeley,
2014; Dunbar, 2018; Santini, Koyanagi, Tyrovolas, Mason,
& Haro, 2015). Of course, the closeness of both relatives
and friends varies, so studies examining specic relation-
ships as opposed to global categories are especially helpful
for understanding the relative impact of family members
versus friends on well-being in the later years. For exam-
ple, analyses by Lee and Szinovacz (2016) of 6,418 par-
ticipants in the 2008 Health and Retirement study showed
that although relationships with spouses tended to have the
strongest association with mental health, ties with friends
showed stronger associations with mental health than
those with other relatives. Results such as these suggest the
merits of investigations specically addressing friendship
and specically focusing on oldage.
Along with investigation of structural aspects of friend-
ship, such as friend roles and interaction frequency, came
awareness of the need to examine friendship in the con-
text of social networks; to view friendship as evolving
over the life course and proceeding through phases over
time; and to assess cognitive, affective, and behavioral pro-
cesses as dynamic aspects of friend interactions. This more
nuanced approach to friendship research emerged from
moving beyond laboratory experiments and broad sur-
veys to using in-depth interviews, which fostered a focus
on quality of friend interactions, not just quantity (Adams
& Blieszner, 1994; Blieszner & Adams, 1992) and recog-
nition that friends and interactions with friends involve
individual characteristics that evoke differential responses
according to individual preferences (Adams & Blieszner,
1995). As a result, research on friendship has ourished in
recent decades, including studies of friendship in middle-
age and beyond, yielding a wide-ranging literature on both
traditional (e.g., emerging from face-to-face interactions)
and innovative (e.g., formed via social media networking)
aspects of friend ties in later life (Blieszner & Ogletree,
2018).
Among the friendship and aging topics investigated, a
prominent focus has been on the contributions of friends
to psychological well-being (Blieszner, 1995; Blieszner &
Ogletree, 2018). Late-life adults report liking and caring
about their friends, laughing together and having fun,
feeling satised with their relationships, being able to con-
de in each other, and reminding each other to stay healthy
(Blieszner & Adams, 1992). Friend ties alleviate loneliness
(Chen & Feeley, 2014; Nicolaisen & Thorsen, 2017), offer
emotional and instrumental support (Felmlee & Muraco,
2009), and provide companionship through mutual inter-
ests and shared activities (Huxhold, Miche, & Schüz,
2014). The feelings of connectedness that these aspects
of friendship convey give meaning to older adults’ lives,
which is important for well-being (ten Bruggencate, Luijkx,
& Sturm, 2018). Indeed, exchanging many forms of social
support is one of the most important benets of friendship
in the second half oflife.
The advantages of late adulthood friendship reach be-
yond psychological well-being. Research shows that rela-
tional closeness and social support are also important for
maintaining cognitive functioning and physical health in
old age (Béland, Zunzunegui, Alvarado, Otero, & del Ser,
2005; Holt-Lunstad, Smith, & Layton, 2010). Moreover,
old age poses unique challenges, including health changes
that might require assistance or caregiving. Thus, it is
particularly important to study old age friendships, espe-
cially for those without family members, without proximal
family members, or without family members willing to care
for them. Indeed, some friends do assume direct caregiving
responsibilities (de Vries, 2018), particularly among les-
bian, gay, and bisexual older adults who might experience
strain in their family relationships (Muraco & Fredriksen-
Goldsen, 2011).
Although we can point to extensive evidence on the
importance and benets of friendship, unexplored research
questions about friendship across the adult years abound.
Key purposes of this article are to provide a comprehen-
sive yet exible conceptual framework to guide research
on late-life friendship, synthesize into one framework the
multiple aspects of friendship and its predictors suggested
by various theoretical approaches, point to unanswered
questions and useful research methods, and suggest friend-
ship-related interventions that could successfully enhance
experiences of friend partners in their special bonds. Our
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goal is to encourage scholars to study this rich and fascinat-
ing dimension of aging and engage in relevant translational
science to sustain and enhance the quality of life for all
elders. We begin with an examination of theories for inves-
tigating friendship.
What Theories Can Guide Friendship
Research Toward Answering Unresolved
Questions?
Foundational Theories
Although many theories of interpersonal attraction and
relationship development could inform late-life friendship
research, relatively few have guided these investigations.
Social network theory, which focuses on predictors of the
structure of relationships rather than on their dynamics,
is relevant to understanding friendship opportunities and
constraints at any stage of life. Relatively little is known
about structural features of friendship dyads and networks,
though, because empirical studies guided by social network
theory usually have not distinguished between friends and
other close ties. Nevertheless, some research on structural
features of late-life friendship exists. For example, Adams
(1987) studied changes in the friend networks of old
women over 3years and found interesting patterns of both
expansion and contraction (not only contraction) of the
network membership and also intensication and weak-
ening (not only weakening) of emotional bonds among
friends in the network. These changes in network size and
closeness varied by the women’s demographic characteris-
tics, namely social and marital statuses. Looking at addi-
tional structural features of late-life close friend networks,
such as similarity of gender, race, religion, age, and extent
of inuence on the friend, Adams and Torr (1998) found
variation in friend networks of both older women and men
based on characteristics of the social and cultural environ-
ments in which the networks were embedded. This nding
shows that friend bonds are affected not only by personal
choice, but also by external inuences. Thus, investigations
of structural features of friend networks reveal the range
of similarities and differences across groups of older adults
based on cultural contexts, personal characteristics, and sit-
uational features of interactions with current or potential
friends.
Social exchange theory, the convoy model of relation-
ships, and socioemotional selectivity theory have been
the most common guides for research on the processes of
friendship development and sustainment. Early studies of
friendship dynamics in old age were grounded in social ex-
change theory (e.g., Roberto, 1989; Roberto & Scott, 1986),
which posits that social interactions involve costs and ben-
ets that participants assess as they establish and sustain
relationships. The types of resources exchanged (Blieszner,
1993; Shea, Thompson, & Blieszner, 1988) and the pre-
ferred and actual extent of equity and reciprocity in social
exchanges (Dunbar, 2018) are also considered in friendship
research conducted from this perspective. Li, Fok, and Fung
(2011) examined age group differences in the association
between emotional and instrumental support balance in re-
lation to support received from friends versus family, and
the implications for life satisfaction. Friendships were eval-
uated by older and younger adults as more reciprocal than
family ties, in keeping with the more voluntary nature of
friendship. However, older adults reported higher life satis-
faction when they felt emotionally (but not instrumentally)
over-beneted in friendships, whereas younger adults’ life
satisfaction was associated with reciprocity in emotional
support exchanges with friends. The general assumption
that equity in exchanges is preferable did not apply to the
older adults in this study, reecting the premises of socio-
emotional selectivity theory, discussedlater.
The convoy model of relationships (Antonucci &
Akiyama, 1987) provides another approach to analyzing
old age friendship and support interactions, connecting
both interactive and structural aspects of relationships. It
focuses on differences in perceived level of closeness, allow-
ing for comparisons across types and functions of friend-
ships as well as across stages of the life span (Antonucci
& Akiyama, 1995). Using the convoy model, Piercy and
Cheek (2004) investigated friendships among middle-aged
and older women who belonged to quilting bees and guilds.
They found evidence of strong and supportive friend con-
voys with interaction patterns suggesting these friends
would have enduring positive effects on the women’s
well-being into oldest age. Levitt, Weber, and Guacci (1993)
examined social support (e.g., conding, reassurance and
respect, assistance, advice) from friends versus relatives
across the social network structures of family triad mem-
bers from three generations. The mothers and grandmoth-
ers tended to report fewer friends than relatives in their
networks and to receive less support from friends as com-
pared with the youngest women. This pattern held across
cultures, as both English-speaking and Spanish-speaking
women reported similar network structures and sources of
support. Arecent meta-analysis by Wrzus, Hänel, Wagner,
and Neyer (2013) conrmed these cross-generational dif-
ferences in network structure (i.e., size) via a meta-analysis
of data in 277 studies from 28 countries.
More recently, socioemotional selectivity theory
(Carstensen, Isaacowitz, & Charles (1999) has under-
pinned research on friendship in the later years. This theory
proposes changes in social interactions as older adults per-
ceive their remaining lifetime becoming shorter. Specically,
old people adapt to their changing circumstances by reserv-
ing their emotional energy for their most important rela-
tionships, shedding those with less meaning and value.
Sander, Schupp, and Richter (2017) found support for this
theory in a study of German adults aged 17–85. Across age
groups, the frequency of face-to-face contacts with relatives
was similar, but such interactions with friends and others
decreased in frequency. The study by Li and colleagues
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(2011) described previously also conrmed socioemotional
selectivity theory, with ndings suggesting that older per-
sons in the study had higher life satisfaction in the context
of nonreciprocal emotional support, probably because they
prioritize emotionally meaningful exchanges over other
interactions. These ndings imply that very close friends
can continue as central gures in older adults’ social net-
works even if the networks are shrinking, regardless, per-
haps, of frequency of face-to-face contact.
An Integrative Conceptual Framework
Social network theory highlights the value of examining
structural features of friendship, how they inuence for-
mation and retention of friendships, and whether those
features change over time. Social exchange, convoy, and
socioemotional selectivity theories share similar foci on
availability and reciprocity of support in friendship and
other close relationships. They point to numerous indi-
vidual, interpersonal, and interactional characteristics that
can have an impact on friend relationships and outcomes.
Our conceptual framework for friendship research (Adams
& Blieszner, 1994; Adams, Hahmann, & Blieszner, 2017;
Ueno & Adams, 2006) integrates the psychological and
sociological perspectives highlighted in social exchange,
convoy, socioemotional selectivity, social network, and
other theories to provide a exible and comprehensive
guide for investigating many intersecting dimensions of
friendship in old age. Propositions and hypotheses from the
focal theory can be formulated around the concepts and
variables identied in the friendship framework.
As shown in Figure 1, the integrative friendship frame-
work posits a series of reciprocal inuences on friend part-
ners that affect their typical modes of interacting and hence,
their emergent and ongoing interaction patterns. The gray
box and arrows signify that friendship patterns are dynamic
and contextualized in time and space and across cultures;
the dashed lines signify that individuals, friend dyads, and
friend networks embedded in these contexts affect them
and are affected by them. The left panel shows that friends
bring their individual characteristics to the relationship, in-
cluding both social structural positions and psychological
dispositions, which are mutually inuential through the
social psychological interpretation and internalization pro-
cesses described by Cooley and Mead (Adams & Blieszner,
1994; Cooley, 1964; Mead, 1962). That is, propensities
emerging from socialization experiences and personality af-
fect how a person internalizes expectations associated with
specic social locations, and social locations affect how
a person interprets friendship-related opportunities and
constraints. These personal characteristics lead to choices
about where to spend time and how and when to interact
with friends, as well as ways of thinking and feeling about
friends and friendship, signied as interactive motifs and
Structural, Cultural, Temporal, and Spaal Context
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Social
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Psychological
Disposion
Dyads
Individual
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Interacve Mofs
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Modify
Sustain
Facilitates
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Paerns
Inter
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Figure 1. Integrative conceptual framework for friendship research. From Ueno and Adams (2006), reprinted with permission from Routledge
Publishing, Inc.
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depicted in the middle of the gure. Cognitive, affective,
and behavioral interactive motifs thus affect the friendship
patterns (right panel) that occur between friend pairs and
in larger friend networks in which the pairs are embedded.
For either friend dyads or friend networks, internal struc-
tural features (homogeneity and hierarchy in dyads; size,
density, homogeneity, and hierarchy in networks) facilitate
and constrain interactive processes (cognitive, affective,
behavioral), which in turn modify or sustain the internal
structural features.
Friendships are not static, so Figure 2 demonstrates that
the patterns exhibited in Figure 1 occur across the phases
of friendship formation, sustainment, and dissolution.
Friendships have a starting point, they can become closer
or less close, and sometimes they end (Adams & Blieszner,
1994, 1998; Blieszner & Adams, 1992, 1998). Use of the
term phases avoids the notion of unidirectional stages of
relationships, which does not apply well to friendship.
Rather, movement across phases of friendship is uid and
potentially bidirectional. For example, an incipient friend-
ship might wax and wane in the formation phase before
becoming solidied as an ongoing friendship, or a dis-
solved friendship might be resumed later. Within any of the
phases, closeness and other process aspects could increase,
decrease, or remain stable. Finally, transitions across phases
are inuenced by internal structural features and interac-
tive processes.
Studies Illustrating Elements of the Friendship
Framework
The most common structural dimensions examined to
date are friendship network size and frequency of con-
tact (which is merely a proxy for interactive processes,
revealing existence of connections, but nothing about the
type or quality of the interactions). The typical interactive
dimensions appearing in late-life friendship research are
behavioral processes, such as provision of instrumental,
emotional, and social support. Few investigators have
examined the phases of friendship in late life intentionally
and systematically.
Examples of research investigating structural aspects of
friendship appear in the meta-analysis of social network
size by Wrzus and colleagues (2013) described previously.
They found reliable cross-cultural evidence that friendship
networks decrease in size across the years of adulthood.
Social structural position includes age group, and Wrzus
and colleagues noted that both normative and nonnorma-
tive life events occurring at different ages have an impact
on the friend network as needs, other relationships, and
life circumstances modulate social interactions. Indeed,
Litwin and Shiovitz-Ezra (2006) found that being embed-
ded in friend-focused networks was a protective factor
against mortality risk for older adults and de Vries, Utz,
Caserta, and Lund (2014) found that friends were partic-
ularly helpful in providing social support and assistance in
early widowhood.
Focusing on psychological disposition, Lecce and col-
leagues (2017) showed that individual differences in theory
of mind skills (extent of awareness that thoughts, beliefs,
and emotions affect social interactions) were associated
with differences in friend but not family ties among older
adults in Italy. Moreover, this theory of mind effect was
moderated by social motivation (in this study, the impor-
tance of being liked by others), such that it occurred only
for those who had a high or medium level of social mo-
tivation. Thus, understanding others and being motivated
to use social skills to foster positive relationships inuence
friendship outcomes. Looking instead at the impact of one’s
perceptions of aging on friendship outcomes and employ-
ing a longitudinal design, Menkin, Robles, Gruenewald,
Tanner, and Seeman (2017) found that holding more pos-
itive expectations about aging to begin with was associ-
ated with greater perceived availability of social support
from friends a year later and with having made more new
friends, with more of them close, 2years later. Thus, these
ndings showed that a personal attribute inuenced cogni-
tive, behavioral, and affective friendship processes, respec-
tively overtime.
Research on friendship phases as depicted in Figure 2—
how older adults form, sustain, and dissolve friendships—is
scarce. Piercy and Cheek (2004) noted that quilting pro-
vided a context for older women to make new friends and
Menkin and colleagues (2017) noted existence of new
friends, but these researchers did not delve into aspects of
interaction that contributed to older adults moving from
being acquaintances to being friends. Insight into this phase
transition comes from Blieszner (1989) and Shea and col-
leagues (1988) who reported on friendship initiation over
5months among strangers who relocated simultaneously
to a newly constructed retirement community. Key con-
tributors to initiation phase transitions involved changes in
feelings and activities. Spending time together in mutually
Internal
Structure
Interacve
Processes
Sustainment
Formaon
Dissoluon
Figure 2. Friendship phases: changes over time in internal structure
and interactive processes.
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appealing activities increased feelings of liking, loving, and
commitment to the friendship. These affective processes
built trust and promoted ongoing exchanges of social and
instrumental support.
Blieszner (1989) and Shea and colleagues (1988) also
found examples of older adults’ efforts to sustain both the
new and previously existing friendships through express-
ing affection, disclosing personal information and feelings,
helping one another, and engaging in activities together.
Another example of activities and feelings that sustain
friendship comes from a study of old male veterans by
Elder and Clipp (1988). They discovered that the process
of veterans sharing memories of their intense combat expe-
riences and losses with veteran friends served to perpetuate
these very long-term friendships.
Finally, in a randomly selected sample of adults aged 55
and older (n=53) and data from face-to-face interviews,
Blieszner and Adams (1998) inquired about dissolution-
related phases of friendship. Some friendships were fading
away (mentioned by 68% of participants), either because of
circumstances unrelated to the dyad, such as relocation of
one partner, or because one friend was intentionally letting
the friendship drift apart due to a problem in the relation-
ship. In addition, a small proportion of participants (25%)
had ended a friendship intentionally, usually because of
betrayal. As these research examples show, structural, cog-
nitive, affective, and behavioral aspects of friendship inter-
actions all came into play in the formation, sustainment,
and dissolution phases of friendship.
The literature also contains studies relevant to the in-
tegrative friendship framework that address multiple
dimensions simultaneously. Although we did not intend the
friendship framework to be predictive, an early operation-
alization of one component shown in Figure 1 was con-
ducted by Dugan and Kivett (1998). Using a sample of 282
rural and urban adults aged 65–97years, they sought to
determine whether personal characteristics and behavioral
motifs predicted interactive processes. Results of regression
analyses showed that two personal characteristics (gender
and education) predicted affective and behavioral pro-
cesses; behavioral motif as indexed by social involvement
in clubs, hobbies, and volunteerism, predicted behavioral
processes but not affective or cognitive ones; and proximity
predicted all three interactive processes. The effect of cul-
tural context, assessed by rural or urban residence, was not
signicant in this sample. Although this research employed
one part of the framework to predict other parts, the work
of other investigators illustrates the application of frame-
work components in studies of a diverse array of outcome
variables.
Using data from the Wisconsin Longitudinal Study,
Kahn, McGill, and Bianchi (2011) addressed the intersec-
tions of individual characteristics (age and gender) with
the friend and other nonkin behavioral interactions (pro-
viding assistance) over time. Women were more likely to
provide emotional support and men were more likely to
provide instrumental support. Both women and men with
more resources (e.g., more education) were more likely to
provide help, and after retirement or widowhood, men
increased their help giving.
Dunbar (2018) provided an overview of research illus-
trating the intersection of friendship structure at the dyadic
and network levels with cognitive, affective, and behavioral
processes. Emotional closeness affects the likelihood of en-
gaging in companionship and sharing the social and psy-
chological support that typically dene friendship. Because
developing emotional closeness and trust requires a signif-
icant time investment, the number of people in one’s circle
of closest friends is limited. Moreover, cognitive processes—
assessing implicit social contracts related to assumptions of
ongoing support, inhibiting some of one’s own preferences
and behaviors to enable friends to satisfy theirs, and the
perspective-taking that fosters understanding of friends’
needs and motives – are crucial for establishing and sus-
taining emotionally close and satisfying friendships.
As these examples of late-life friendship research show,
the integrative conceptual framework supports examina-
tion of myriad intersecting dimensions of friendship and its
outcomes in a systematic way. Combining this framework
with relationship theory permits development of hypoth-
eses to evaluate, and also can illuminate the more subtle
inuences on friendship that warrant investigation.
What Novel Aspects of Friendship Demand
Scholarly Exploration?
Despite a breadth of research on social networks across
the life course, friendship in the second half of life remains
underexplored when compared with information about kin
relationships. Moreover, the entrance of new cohorts into
old age along with social and cultural change over time
suggests the need to examine new dimensions of late-life
friendship. This section provides a brief overview of re-
search questions that remain unanswered and are now ripe
for further exploration.
Friendship, Health, and Well-Being
Much contemporary research has focused on contributions
of friends to health and psychological well-being among
older adults. At the structural level of analysis, for ex-
ample, Sander and colleagues (2017) documented a con-
nection between social contact frequency and health across
adulthood. Visits with nonfamily members declined over
the study waves relative to family visits, with an indication
that poorer health in old age explains the less frequent vis-
iting with friends, neighbors, and acquaintances exhibited
at that stage oflife.
Provision of social support is the most common behav-
ioral process examined in old age friendship research.
Auseful resource for data on the connection of social sup-
port from friends and others and health with well-being
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outcomes is the review article by ten Bruggencate and col-
leagues (2018). These authors analyzed how having social
needs satised is a protective inuence on the health and
well-being of old people. Unmet social needs can lead to
loneliness and social isolation, which in turn can cause
health to decline. In contrast, older adults with strong ties
to family and friends are more likely to retain indepen-
dence, a sense of meaning and purpose in life, and effec-
tive physical and psychological functioning longer. Thus,
understanding the connection between friend support and
psychological problems such as depression is important for
promoting health and well-being among older adults.
A review of 51 studies (published between 2004 and
2014) of associations among social support, social net-
works, and depression from around the world by Santini
and colleagues (2015) conrmed that perceived emotional
support within large and diverse social networks is pro-
tective against depression, as is perceived instrumental
support. More research is needed, however, particularly
prospective studies, to tease out causality in the associa-
tions among social support, social networks, and depres-
sion. Are those with fewer depressive symptoms better
able to secure large friend networks and receive support
than persons exhibiting depression? Is greater availability
of social support from a robust social network protective
against the development of depressive symptoms?
Being engaged in a friend network can also buffer the
effects of life events that may occur in old age. Marital status
has traditionally been used as a benchmark for well-being,
so comparing the associations of marital status, friendship,
and well-being is one approach to understanding the role
of friends in buffering the effects of negative life events.
Studies in this domain contrast friendship effects among
married old people, those who are formerly married, and
those who never married, at least in the traditional sense.
They also illuminate variation in friendship structure and
processes across different subgroups of the older adult
population.
Han, Kim, and Burr (2017) used longitudinal data from
the Health and Retirement Study to examine the connec-
tion between friendship and depression among married
couples. Partners who had more frequent social interac-
tions with their friends reported fewer depressive symp-
toms than those with fewer friend interactions, particularly
in the context of poorer marital quality. Moreover, dyadic
growth curve models showed that one partner’s responses
to friendship had implications for the well-being of the
other one, demonstrating that the effects of friendship ex-
tend beyond the focal person.
Concerning older adults who are no longer mar-
ried, both de Vries and colleagues (2014) and Bookwala,
Marshall, and Manning (2014) studied friendship in the
context of marital loss through widowhood. The ndings
from de Vries and colleagues showed that higher friendship
satisfaction was associated with more positive self-evalua-
tion and more positive affective responses in the rst half
year of widowhood, whereas Bookwalla and colleagues
found that having a friend condante helped mitigate de-
pressive symptoms and promote better health as reported
up to 12years after spousalloss.
Examination of friendship among committed partners
comes from the work of Kim, Fredriksen-Goldsen, Bryan,
and Muraco (2017) who demonstrated the importance of
large and diverse social networks, including the availability
of friends, for mental health among lesbian, gay, bisexual,
and transgender older adults. Although these elders may
not have as many family ties as others, having supportive
social ties within friend networks are as essential for them
as for anyone in preventing social isolation and reducing
the likelihood of depressive symptoms.
However, marriage is not the only context in which
friendship affects psychological well-being. Other struc-
tural factors besides marital status, such as cultural back-
ground, gender, racial ethnic status, and socioeconomic
status, no doubt inuence friendship opportunities and
constraints that affect social integration or isolation and
psychological well-being or depression. Research on the
friendship patterns of such subgroups in the older adult
population remains to be conducted. The integrative con-
ceptual framework for friendship research offers guidance
for investigating the effects of social locations and person-
ality characteristics on friendship patterns.
Another perspective on the connection between friend-
ship and well-being in old age is related to the notion that
relational partners are interdependent; the actions of one
affect the thoughts, feelings, and behaviors of the other
(Kelley & Thibaut, 1978). Thus, life events can have an im-
pact not only on oneself, but also on one’s friends, leading
to research questions such as whether someone’s misfortune
rallies friendships or drives friends away. Indeed, Breckman
etal. (2018) reported that family and friends who know
about an older adult’s mistreatment also suffer distress,
illustrating how friendship can have negative as well as
positive impacts. However, this cross-sectional study did
not follow the abuse victims and their social network mem-
bers, so how the friends who knew about the abuse fared
as time went on could not be assessed. What other personal
events and circumstances that have not yet been examined
for impact on others might interfere with friendship or be
buffered by friendship support?
Friendship and Caregiving
Another crucial focus for contemporary friendship research is
the contributions of friends to providing care for older adults.
Given that offspring and other relatives may live a great dis-
tance away from loved ones who require assistance and care-
giving, the potential for local friends to ll in when frailty
emerges needs systematic examination. Questions about
interest in helping one’s friends in this way and willingness
to provide more than casual support, and questions about
the efcacy of friend caregiving, remain largely unanswered.
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Lilly, Richards, and Buckwalter (2003) found that some
caregivers of loved ones with dementia mentioned the value
of their friends in providing the caregivers with emotional
support and social integration. No doubt, those helpful
friends buoyed the family caregivers as they dealt with mem-
ory loss. Of course, friends are not always helpful, as Abel
(1989) noted. In her interviews with adult daughters caring
for frail elderly parents, some of the participants pointed
out that friends (and relatives) often exacerbated caregiv-
ing stress instead of alleviating it, such as by trivializing
the difculties of caregiving. This type of research, however,
does not focus directly on care provision by friends. In fact,
most caregiving studies do not differentiate across family
and friends when examining helpers for older adults. Our
literature search on studies related to “friends and caregiv-
ing” uncovered 33 articles published since 2012, but all
the analyses combined responses for relatives and friends.
Therefore, whether it is practical for health care workers to
involve friends in care planning, particularly when relatives
do not live nearby, merits additional scholarly attention.
Friendship in the DigitalAge
A clear avenue for innovative friend research is the inclusion
of communication technology and social media as mecha-
nisms for understanding how older adults establish and
sustain friendships throughout adulthood. Current ndings
on Internet use and social media use through websites such
as Facebook indicate that older people are less likely than
their younger counterparts to be frequent users (Barbosa
Neves, Fonseca, Amaro, & Pasqualotti, 2018; Cotten,
McCullouch, & Adams, 2011; Yu, Ellison, & Lampe,
2018). However, older people are adopting technology to
sustain social relationships (Tsai, Shilliar, & Cotten, 2017)
and keep in contact with friends and relatives who may be
geographically distant (Tsai, Shilliar, Cotten, Winstead, &
Yost, 2015). Internet use, for example, is associated lower
rates of depression and loneliness (Cotten, Ford, Ford, &
Hale, 2012) and greater levels of social capital (e.g., quality
and quantity of social ties) when compared with adults
who did not use the Internet at all or who used it less fre-
quently (Barbosa Neves etal., 2018).
Additional research shows that older Facebook users
have smaller numbers of online “friends” but a greater
proportion of actual friends than younger Facebook users
(Chang, Choi, Bazarova, & Lockenhoff, 2015; Yu et al.,
2018), a nding consistent with socioemotional selectiv-
ity theory (Carstensen etal., 1999). Given the prevalence
of social media, it is important that future work examines
the extent to which virtual social networks complement
actual friend networks and the types of support exchanged
with both types of friends. Will friend networks become
increasingly more diverse, including friends both in-person
and online, proximal and distal? Will friendships last lon-
ger, reducing relationship dissolution, due to the ease of
connection among long-distance older persons? Will social
media inuence the ways in which old people engage in
friendship? Will completely virtual friendships interactions
differ from past patterns in which friendships typically
began with face-to-face interactions even if they were sus-
tained over long distances via mail and telephone? Research
on social media use among older adults is still in its infancy
and will be a burgeoning area of research as digital natives
age into midlife and beyond.
Friendship in the Age of theBrain
An additional area of innovation for friend research is
the association between friendship and cognitive func-
tioning. Our review of the literature yielded few studies
that explicitly explored this topic, which contrasts with
the preponderance of research on general social re-
sources and cognitive functioning in old age (Kuiper
etal., 2016). The longitudinal study by Béland and col-
leagues (2005) showed that having friends was associ-
ated with slower cognitive decline in women but not
men over the course of 7years. Béland and colleagues
argued that this finding might be due to women’s gen-
der-based social roles that necessitated greater social in-
tegration over the years. Amore recent study by La Fleur
and Salthouse (2017) found that contact with friends,
but not family, was positively associated with general
intelligence. However, this finding approached nonsig-
nificance after examining the effects of education, sug-
gesting that individuals who are better educated spend
more leisure time with friends.
These studies illuminate a path forward for friend
research and lead to the following questions: How might
cognition and, specically, problem-solving skills and
inhibitory control relate to the quality of interactions
between older adult friends? For example, research dem-
onstrates that inhibitory control is negatively associated
with impulsivity (Logan, Schachar, & Tannock, 1997),
while additional research documents that impulsivity is
related to negative interpersonal encounters in young
adults (aan het Rot, Moskowitz, & Young, 2015). Are
older adults with poorer inhibitory control more likely
to report negative interactions with friends? Conversely,
are those with better inhibitory control more likely to
report positive interactions with friends? Similarly,
problem-solving skills are associated with memory, rea-
soning, processing, and global mental status; each of
these domains is related to everyday functioning among
older adults and translates to performance on common
instrumental activities of daily living (Gross, Rebok,
Unverzagt, Willis, & Brandt, 2011). If a key domain
of adult friendship is the exchange of instrumental and
emotional support, then more research is needed to doc-
ument the implications of cognition in late-life behav-
ioral friendship processes.
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Table 1. Friendship Variables in Regional, National, and International Data Sets
Ages (N) at
Wave 1
Examples of friendship variables/questions
Data source Years Friendship structure Cognitive processes Affective processes Behavioral processes
Andrus Study
of Older Adult
Friendship
(Adams & Blieszner,
1993a)
1993 55–84 (N=53) “How many friends do you
have?”; “How close are you with
[close friend]? [very close, close,
or casual]”; “How far do you live
from [close friend]?”; “How long
have you been friends?”; “How
similar are you and [close friend]?”
“How willing would
[friend/s] be to provide
help if needed?”; “How
important are [attitudes,
values, and characteristics]
of friends?”
“How do you feel about
[different types of friends
in friend network]?”;
“How do you feel
when....?”; “What are
your feelings regarding
relationships that are
changing or fading?”
“Has [friend name] done a favor/
provided advice or support?”;
“What do you think are some
barriers to seeing or talking with
[friend]?”; “How frequently
do you [communicate] with
[friend]?”; “How do you resolve
conict and disagreements with
[friend]?”
Americans’ Changing
Lives (ACL)a
1986, 1989, 1994,
2002
25+ (N=3,617)
in 1986
“About how many friends or other
relatives do you have whom you
could call on for advice or help if
you needed it?”
“In your lifetime, have
friends gotten more
important, less important,
or stayed the same [in
importance]?”
— “How often do you talk with
friends, neighbors, and relatives in
a week?”
The Irish Longitudi-
nal Study on Ageing
(TILDA)b
2009–2011 50+ (N=8,504)
in 2009
“In general, how many close friends
do you have?”; “Have any of your
close friends died in the past ve
years?”
“How much do they
[friends] really understand
the way you feel about
things?”
“How much do they
[friends] get on your
nerves?”
“In the last two years, did your
neighbors or friends give you any
kind of help...”
Longitudinal Aging
Study Amsterdam
(LASA)c
1992, 2002, 2012,
2015 (on-going)
55–84
(N=3,107) in
1992
“How many years have you known
[friend]?”; “How long does it
take you to travel to [friend]?”;
“How often are you in touch with
[friend]?”
— — “How often did it occur in the
last year that [friend] helped you
with daily chores in and around
the house...?”; “How often did
it occur in the last year that you
quarreled with [friend]?”
Longitudinal Study
of Generations
(LSG)d
1971, 1985, 1988,
1991, 1994, 1997,
2000, 2005
60s
(Grandparents)
40s (Parents)
15–26 (Grand-
children)
(N=300
families) in 1971
“How many close friends do you
see or hear from?”
“Please compare your
political views with your
close friends’”; “How
important is your role
as friend?”; “Rank your
quality of performance in
your role as a friend.”
“How satised are you
with the amount of
contact with your close
friends?”
—
Swedish Adoption/
Twin Study on Aging
(SATSA)e
1984, 1987, 1990,
1993, 2003, 2007,
2010
26–93
(N=2,018) in
1984
“How many friends do you have
that can visit you, or who you
can visit, anytime and feel right at
home?”; “How often do friends
visit?”
— “Are you satised with
support from friends?”
—
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Ages (N) at
Wave 1
Examples of friendship variables/questions
Data source Years Friendship structure Cognitive processes Affective processes Behavioral processes
Wisconsin Longitudi-
nal Study (WGS)f
1957, 1964, 1975,
1992, 2004, 2011
(on-going)
17+ (N=10,317)
in 1957
“Could you give me the names
of some of the [same-sex friends]
who were your best friends in
your senior class in high school?”;
“Think back to 1957...what was
the name of your closest...friend?”;
“During the past 12months, how
often did you have contact with
[friend]?”
“Overall, how do you
think you compare with
[friend]?” [In reference
to work, education, and
nances]
“How much do [friends
and relatives] make you
feel loved and cared for?
“Is there a friend outside your
family with whom you can share
very private concerns?”; “How
much are they [friends and
relatives] critical of what you do?”
National Social Life,
Health, and Aging
Project (NSHAP)g
2005–2006,
2010–2011,
2015–2016
(on-going)
57–85
(N=3,005) in
2005–2006
[Social network approach] “How
frequently do [name from network]
and [name from network] talk to
each other?”; “About how many
friends would you say that you
have?”; “How close do you feel is
your relationship with [name from
network]?”
— — “How often do they [friends]
make too many demands of
you?”; “How often do they
[friends] criticize you?” “How
often can you rely on them
[friends] for help if you have a
problem?”
Health and
Retirement Study
(HRS)h
1992, 1994, 1996,
1998, 2000, 2002,
2004, 2006, 2008,
2010, 2012, 2014,
2016 (on-going)
51–61
(N=12,652) in
1992–1993
“How many friends would you say
you have a close relationship with?”
“How much do they
[friends] really understand
the way you feel about
things?”
“How much do they
[friends] get on your
nerves?”
“On average, how often do you do
each of the following with any of
your friends? (meet up, speak on
the phone, write or email)
Midlife in the United
States (MIDUS)i
1995, 2004, 2011,
2013
25–74
(N=7,108) in
1995–1996
“Considering only friends you feel
close to, how many friends do you
have contact with at least once a
month?” (2013 only)
“How much do they
[friends] really understand
the way you feel about
things?”(all waves); “When
Icompare myself to friends
and acquaintances, it
makes me feel good about
who Iam.” (2004 only)
“How much do they
[friends] get on your
nerves?” (all waves); “I
often feel lonely because
Ihave few close friends
with whom to share my
concerns.” (2004 only)
“On average, about how many
hours per month do you spend
giving informal emotional support
to each of the following people?”
[including friends] (2004 only)
Survey of Health,
Ageing, and
Retirement in Europe
(SHARE)j
2004–2006,
2006–2010,
2011–2012, 2013,
2015 (on-going)
50+ (N=31,115
from 12
countries) in
2004
“Who gave you help?” — — “Which types of help has this
person provided in the last twelve
months?”; “In the last twelve
months, how often altogether have
you [or your partner] received
such help from this person?”
Table 1. Continued
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Ages (N) at
Wave 1
Examples of friendship variables/questions
Data source Years Friendship structure Cognitive processes Affective processes Behavioral processes
German Ageing
Survey (DEAS)k
1996, 2002,
2008, 2011, 2014
(on-going)
40+ (N=4,838)
in 1996
“How often do you visit friends or
acquaintances or invite them over
to your home?”; “How has your
relationship with friends or ac-
quaintances changed over the past
6years?”; “If you think about your
friends and acquaintances, your
family, and other people that you
have everyday dealings with, which
of these people do you spend most
of your time with?”
“How much currently
do you think of or do
something about...” [sat-
isfying friendships, social
integration]
“Are there people [in
your social network] who
are causing you worry or
concern? If so, who?”;
“Are there people who
give you great joy or hap-
piness? If so, who?”
“Which person [in your social net-
work] can you turn to when you
need comfort or cheering up when
you are feeling sad?”
Note. Dates in italic font indicate veried availability of friend variables at that wave. Dates in roman font indicate either no veried friend variables or the questionnaire was not available in English.
ahttps://www.isr.umich.edu/acl/
bhttps://tilda.tcd.ie/
chttps://www.lasa-vu.nl/index.htm
dhttps://www.icpsr.umich.edu/icpsrweb/NACDA/studies/22100
ehttps://ki.se/en/meb/satsa-the-swedish-adoptiontwin-study-of-aging
fhttps://www.ssc.wisc.edu/wlsresearch/
ghttp://www.norc.org/Research/Projects/Pages/national-social-life-health-and-aging-project.aspx
hhttp://hrsonline.isr.umich.edu/
ihttp://midus.wisc.edu/
jhttp://www.share-project.org/
khttps://www.dza.de/en/research/deas.html
Table 1. Continued
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Friendship as a Unique Relationship
Innovative ndings on late-life friendship might also be un-
covered through the intentional inclusion of friend-related
variables as separate from family and neighbor relation-
ships. For example, research on social relationships among
lesbian, gay, bisexual, and transgender (LGBT) older adults
has focused on the importance of friendship in aging, com-
monly using language such as “chosen families” (de Vries
& Megathlin, 2009). The same attention to the value of
friendship in aging has not been applied in non-LGBT
research. This gap in the literature implies that scholars
presume the presence and supremacy of biological kin net-
works in old age, thus ignoring the value of non-biolog-
ical relationships. Investigators have used the ambiguous
grouping of friend relationships into categories, such as
“friends/neighbors,” “friends or other relatives,” and “so-
cial resources,” with the latter going so far as to subsume
all social relationships into one undifferentiated group. Yet
research clearly shows that friends, neighbors, and kin rela-
tionships provide varying levels and types of support. For
example, LaPierre and Keating (2013) found that among
324 nonkin caregivers, friends provided help with personal
care, bills, banking, and transportation whereas neighbors
were more likely to help with less personal tasks such as
home maintenance. Further, friends were more involved
in providing care for nonkin than neighbors were and as-
sisted care recipients with a greater number of tasks for
more hours per week. Such research indicates that friends
are unique voluntary relationships that are more intimate
than more emotionally distal ties that might occur with
neighbors. Moreover, friends often contribute more posi-
tively to psychological well-being than family relationships
do (Huxhold etal., 2014). Thus, it is imperative that future
research on older persons’ social network members focus
specically on friendship as a unique relationship and dis-
tinguish differential structures, functions, processes, and
phases across types of relationships in great detail.
What Innovative Designs and Technologies
Would Reveal Untapped Elements of
Friendship and ItsValue?
We identied three main ways in which friendship research
might be advanced, thus revealing untapped elements of
friend relationships and their value. First, more research is
needed that goes beyond the structure of friendship (“How
many close friends do you have?”) to explore interactive
processes that convey deeper perceptions of, feelings about,
and activities within older adult friendships—their cogni-
tive, affective, and behavioral dimensions. Second, studies
of friendship have been conducted in regional and cul-
tural silos that were not being translated across disciplines
and cultural boundaries. Third, most studies of friendship
have incorporated cross-sectional designs, inhibiting un-
derstanding of changes and stability in friendship over the
adult lifespan.
These three current limitations point to the value of
linking Adams and Blieszner’s (1994) integrative concep-
tual framework for friendship with data harmonization
techniques that permit combining regional, national, and
international data sources. For example, Hofer and Piccinin
(2010) described the potential for integrating multiple lev-
els of analysis, theories, and designs to enable synthesis
of results across multiple data sets, including longitudinal
studies of aging, to broaden the scope of research on a
given topic; Survey Research Center (2016) provided de-
tailed guidelines for such work. Existing longitudinal data
sets could be exploited for secondary analyses using Adams
and Blieszner’s framework for guidance on the variable se-
lection, thus enabling scholars to uncover prevailing trends
in friendship as well as idiosyncrasies across data sources
and across cultures andtime.
To prompt this new kind of friendship research, we offer
an analysis of the potential for nding structural, cogni-
tive, affective, and behavioral variables as enumerated in
the Adams and Blieszner (1994) conceptual framework
within regional, national, and international data sets. First,
we used the Inter-university Consortium for Political and
Social Research to conduct a search of studies that included
middle-aged and older adults. We then examined each data
source for friendship variables and, for those that included
friend variables, reviewed their list of publications for studies
with friends as a focal topic. We also searched the major ge-
rontological and relationship journals for articles related
to older adult friendship and reviewed their data sources.
This process yielded 11 large-scale longitudinal data sets
suitable for pursuing cross-national and longitudinal re-
search on adult friendship. The data sets are (1) Americans’
Changing Lives (ACL); (2) The Irish Longitudinal Study on
Ageing (TILDA); (3) Longitudinal Aging Study Amsterdam
(LASA); (4) Longitudinal Study of Generations (LSG);
(5) Swedish Adoption/Twin Study on Aging (SATSA); (6)
Wisconsin Longitudinal Study (WLS); (7) National Social
Life, Health, and Aging Project (NSHAP); (8) Health and
Retirement Study (HRS); (9) Midlife in the United States
(MIDUS); (10) Survey of Health, Ageing, and Retirement in
Europe (SHARE); and (11) German Ageing Survey (DEAS).
Next, we classied each data source’s friend-related
questions and variables according to the Adams and
Blieszner (1994) integrative conceptual framework,
as shown in Table 1. For reference, we also included
the Adams and Blieszner Andrus Study of Older Adult
Friendship (Adams & Blieszner, 1993a), which guided the
formulation of the integrative conceptual framework for
friendship and provides examples of structural, cognitive,
affective, behavioral, and phase questions. Note that the
information presented in this table is not exhaustive of
each data source’s friend-related questions; rather, it high-
lights questions corresponding to the integrated conceptual
framework for friendship. The variables derived from these
questions could be addressed by data harmonization pro-
cesses to enlarge the size of samples and scope of variables
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available for analysis of cognitive, affective, and behav-
ioral friendship processes and phases over time and across
cultures.
Review of these longitudinal data sources demonstrates
that, indeed, there is immense potential for the future of
older adult friend research using data harmonization tech-
niques. Almost all the data sources included questions about
structural components of friendship, including number of
friends or close friends. Descriptive analyses might reveal
similarities or differences in the size and composition of
friend networks across multiple countries and regions and
changes in networks across stages of adulthood. For cog-
nitive processes, most (7 out of 11)data sources included
reective or comparative questions in reference to friends.
For example, three studies (TILDA, HRS, MIDUS) asked,
“How much do [friends] really understand the way you
feel about things?” Affective processes were assessed in 7 of
the 11 studies, as well. Four studies (TILDA, HRS, MIDUS,
DEAS) tapped negative dimensions of friend relationships,
inquiring whether friends “get on [their] nerves” or were
“causing worry.” Two studies (LSG, SATSA) evaluated
satisfaction with friends, a positive feeling. Finally, most
studies (9 out of 11)included questions that assessed be-
havioral processes, such as support exchanged, frequency
of contact, and availability of support from friends. Two
studies (WLS, NSHAP) asked the question, “How much/
often do [friends] criticize you?” Conversely, four studies
(TILDA, LASA, MIDUS, SHARE) evaluated actual support
exchanged between friends.
Exploring these structural elements and cognitive, affec-
tive, and behavioral friendship processes across large cross-
national data sources could reveal novel insights regarding
friends and aging. Are there cultural differences in sup-
port exchanges or in the size, composition, and closeness
of friend networks? What groups of older adults are more
likely to experience negative interactions with friends and
might these exchanges have implications for health over
time by affecting the availability of supportive resources?
Further, how do friendship processes change over time and
across places? There are many paths forward for the fu-
ture of friend research, but we believe that more robust use
of existing data sources is a feasible next step. Moreover,
newly launched studies should incorporate friend vari-
ables that assess nuanced dimensions of friendship pro-
cesses and phases rather than focusing solely on structural
components.
What Interventions Can Be Employed
to Increase Satisfaction With Friend
Relationships and Improve Friend
Interactions?
In 1992, Blieszner and Adams described how programs
affecting the friendship patterns depicted in Figures 1 and
2, and thus individual outcomes, could be implemented at
the individual, dyadic, network, immediate environment,
community, or societal levels. Although in a subsequent
article Adams and Blieszner (1993b, p.173) stated clearly
that they did not “necessarily intend to advocate friendship
intervention,” they conservatively cautioned policymak-
ers, program planners, and human service providers not to
design and implement interventions that would inadver-
tently undermine existing social relationships. The reasons
for not fully endorsing friendship interventions at the time
were twofold. First, research on friendship was not robust
enough to suggest details of what sorts of interventions
might be most needed, efcient, and effective. Second was
recognition that friendships were culturally dened as vol-
untary and, though they are much more structurally con-
strained than many friends realize, some would nd such
interventions uncomfortable or inappropriate.
Although the friendship research literature is now more
robust, the literature assessing the effectiveness of inter-
ventions is still scarce. Increased public focus on the con-
sequences of loneliness and isolation is leading to more
recognition of the necessity of promoting friendship, but
systematic interventions into all aspects of friendship pat-
terns described in the previous sections have not been
introduced. That is, just as most research on friendship has
focused on behavioral processes such as social support to
the relative neglect of examining other behavioral processes
as well as cognitive and affective processes, so too friend-
ship intervention programs have emphasized behavioral
strategies such as skill enhancement as approaches to de-
veloping friendships, with little attention to addressing the
impact of thoughts and feelings on friendship interactions.
Now that more recent research has demonstrated the im-
portance of friendships to well-being, health, and longevity,
it seems prudent to begin designing, intentionally imple-
menting and assessing a broad range of friendship inter-
ventions among older adults. First, we present examples
of research assessing intervention programs that address
various parts of the integrative conceptual framework and
levels of intervention, then cite literature pointing to other
possibilities for enhancing friendship among older adults.
This section ends with suggestions for enacting and assess-
ing such friendship interventions.
Examples of Friendship Intervention Research
Stevens and colleagues in The Netherlands have been inves-
tigating intervention strategies for enhancing friendship
at the individual level of analysis. For example, Stevens,
Martina, & Westerhof (2006) showed that participating
in a 12-week program designed to promote self-esteem
(individual characteristic) and relational competence, so-
cial skills, and friendship formation skills (behavioral
processes) enabled older women to establish new friend-
ships and improve existing ones, thus reducing loneliness
and improving well-being. These outcomes endured for
at least a year. Building on that work, Martina, Stevens,
and Westerhof (2012) used self-management of well-being
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theory to probe mechanisms underlying friendship-related
improvements. Interview data from the intervention partic-
ipants and control group members revealed that compared
with control group members, women who completed the
friendship enrichment program showed greater increases
in behaviors related to taking the initiative and engaging
in actions aimed at developing and improving friendships
(behavioral processes). Extending the in-person friend-
ship intervention approach to an online one, Bouwman,
Aartsen, van Tilburg, and Stevens (2017) demonstrated the
effectiveness of focusing on network development (struc-
ture), adapting personal standards for friendship, and re-
ducing the salience of the discrepancy between actual and
desired relationships (cognitive processes). Both follow-up
studies showed continued promise for assisting old persons
with honing friendship skills that can improve relation-
ships and boost personal well-being. In related work, re-
search by both Lecce and colleagues (2017) and Vargheese,
Sripada, Masthoff, and Oren (2016) suggests interventions
related to cognitive processes. The Lecce team focused on
the importance of both increasing theory of mind skills, or
the understanding of others’ mental states, and increasing
social motivation to use those skills in friendship interac-
tions, which could reduce loneliness and social isolation.
The Vargheese group demonstrated that professionals can
employ theoretically derived persuasive strategies to en-
courage older adults to participate in social activities.
Development and assessment of additional interventions
addressing a broad range of affective, cognitive, and be-
havioral friendship patterns would offer more options for
assisting lonely or isolated old people with improving their
friendships. Acknowledging the dynamic nature of friend-
ship, these programs should give attention to skills for ini-
tiating versus sustaining friendships, rejuvenation of faded
friendships, and repair of problematic and conictual ones.
Directions for New Friendship Interventions
Research on associations across older adults’ personal
preferences for friendships and their social needs, health,
and well-being point to many possibilities for friendship
interventions related to the elements of the integrative con-
ceptual framework for friendship research described pre-
viously. Earlier life experiences and current age-related life
events can affect older adults’ social needs, their friend
networks, and their friend-related cognitive, affective, and
behavioral processes (Blieszner & Ogletree, 2017; Wrzus
etal., 2013). Older adults vary with respect to the number
and types of friends they prefer to have, whether they desire
only close or more peripheral relationships, the importance
they place on various friendship interaction processes and
forms of social support, and the amount of reciprocity they
expect among their friendships—and those preferences can
change over time (Blieszner, 1995; ten Bruggencate et al.,
2018). The contexts in which older adults are living, in-
cluding the family versus friend composition of their
social network, their residence (community-dwelling, as-
sisted living, nursing home), and the presence or absence
of socially isolating chronic health conditions, also affect
their needs for friends and options available for interven-
tions (Blieszner & Ogletree, 2017; Litwin & Shiovitz-Ezra,
2006; Vargheese etal., 2016).
Taken together, these research ndings indicate that dif-
ferent friendship-related intervention strategies are needed
for different people and segments of late life. Developing
interventions that are exible and take the diversity of ex-
pectations and preferences among older adults into account
is more likely to be successful than attending only to the
practitioner’s perceptions of friendship or assuming a given
intervention will be equally successful across all elders.
Enacting and Assessing Interventions
We suggest that gerontological researchers form partner-
ships with service providers interested in increasing the so-
cial connectedness of older adults to plan interventions and
appropriate assessment components. Designing research-
informed interventions aimed at addressing identied needs
could lead to more nuanced, hence more effective, inter-
ventions. As shown by research ndings described in this
article, different groups of older adults would likely benet
from programs targeting specic aspects of friendship struc-
ture versus interactive processes and dyadic versus network
outcomes. The results of such collaborations could also in-
form friendship research by increasing knowledge of the
antecedents and consequences of friendship patterns and
how these change across the life course.
This suggestion also is consonant with Cornwell,
Laumann, and Schumm’s (2008) urging increased dialogue
between social gerontological and social network research-
ers. The former researchers tend to have a more applied
orientation and to have ties with those in direct contact
with older adults, whereas the latter tend to have more ap-
preciation for the complexity of friendships. Perhaps so-
cial gerontological researchers could act as bridges between
professionals who work with older adults and social net-
work researchers.
Gerontological practitioners are more likely to be in-
terested in collaboration on friendship intervention design
and evaluation now than in the past because today the im-
portance of social connectedness for older adults is more
widely recognized and the need for interventions is a sub-
ject of public dialogue. For example, in the introduction
to an issue of the Public Policy & Aging Report, Hudson
(2017, p.121) discussed isolation, loneliness, and a lack
of social connection among older adults, noting that “[p]
olicymakers, practitioners, and researchers have come to
focus attention on this little-recognized and dangerous
condition facing so many older people.” In the same issue,
Ryerson (2017) described AARP’s Connect2Affect ini-
tiative (https://connect2affect.org/), which is facilitating
the type of collaboration between researchers and service
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providers we recommend. This collaborative effort with
the Gerontological Society of America, Give an Hour, the
National Association of Area Agencies on Aging, and the
UnitedHealth Group provides tools and resources designed
to assess risk and help isolated older adults become more
involved with their communities. The initiatives Ryerson
described use technology to improve connectedness—de-
velopment of a ride-hailing app to increase the use of public
transportation, examination of whether the use of hands-
free voice-controlled communication devices decreases
isolation, and evaluation of the effectiveness of phone
outreach in helping retirees feel more connected to oth-
ers. Although these interventions were designed to increase
connectedness in general rather than in friendships per se, it
is promising that AARP is facilitating collaboration among
service providers and researchers, evaluating the effective-
ness of selected interventions, and producing results that
could lead to the systematic implementation of programs
at the community, state, or national levels.
The clear benets of social engagement among old people
and concern about lack of social connectedness point to
the value of and need for continued collaboration among
researchers and service providers. The framework for con-
ceptualizing friendship structure, processes, and phases
discussed previously and illustrated in Figures 1 and 2 pro-
vides guidelines for identifying needs and designing tailored
interventions targeted to addressing them. Accumulating
evidence that such programs are effective in increasing con-
nections among friends, improving friendship quality, and
benetting older adults’ health and well-being is essential
prior to advocating for policies to support systematic im-
plementation of programs across groups of older adults in
need of better social integration.
Conclusion
Friendship is a relationship that can last longer over the life
course than any other. The majority of adults participate
in friendship, even as the end of life draws near. The likeli-
hood of older adults continuing to enjoy and benet from
interactions with friends combined with the potential for
social isolation in old age suggests the importance of inves-
tigating friendship in creative new ways to advance un-
derstanding of friendship structure, processes, and phases
along with their implications for health and well-being.
In turn, ndings from research on friendship can inform
strategies for enhancing friendship opportunities and inter-
actions in order to prevent or alleviate loneliness, social iso-
lation, and depression.
As this review of theories relevant to friendship research
in old age and available literature on late-life friendship
shows, many unanswered questions about the roles of
friends in supporting psychological well-being and health
of older adults exist. The integrative conceptual framework
combined with theory pertinent to social relationships
offers guidance for additionalwork.
Some structural elements of friendship, such as number
of friends and frequency of contact, may not require fur-
ther investigation—at least, in Western cultures, yet rela-
tively less information is available on the effects of other
structural features on friendship, such as gender, racial
ethnic status, subcultural group, and the contexts in which
older adults enact friendship. Likewise, many studies have
explored various forms of social support, but much less is
understood about other behavioral processes. Data on cog-
nitive processes in late-life friendship are scarce, including
how people think about and analyze their friend relation-
ships or how perceptions of friends and friend interactions
inuence friendship initiation, stability, or loss. Similarly,
few studies have examined the inuence of emotions on
friendship quality and phases. An implicit assumption
seems to be that friend relations are positive and benecial,
which is generally true. After all, being friends with a partic-
ular person is optional. Nevertheless, evidence shows that
older adults can be quite troubled by problems with friends
yet do not necessarily wish to terminate the relationship
(Adams & Blieszner, 1998; Blieszner & Adams, 1998). We
need to know more about any dark sides of friendship.
As shown in the section on interventions, most programs
aimed at improving friendship opportunities and outcomes
for older adults address behavioral processes useful in the
phases of forming new ties and enhancing those that exist,
in service of preventing or mitigating loneliness and social
isolation. Certainly more programs like those are needed
as the population of elders increases around the globe.
Nevertheless, it also important for community practitio-
ners to focus on problem-solving in friendships, not just in
family relationships, to help elders sustain rewarding friend
ties that may entail minor disagreements and annoyances,
as well as to provide strategies for dissolving friendships
that are not merely uncomfortable, but actuallytoxic.
Friendship intervention programs must also be assessed
for suitability to friendship styles in late adulthood as well
as programs’ effectiveness in achieving desired outcomes.
To build on the intervention research described previously,
we suggest that expanding research on friendship in old
age will yield useful data on potential suitability and effec-
tiveness of existing programs and might suggest different
approaches to explore. It is difcult to plan better-targeted
interventions without knowing more about friendship
structure and processes. We need studies on the social and
psychological costs of friendship, not just benets, and on
what interferes with friendship enactment and satisfac-
tion, not just what promotes it. We need investigations of
similarities and differences in friendship across cultural
subgroups both domestically and internationally so inter-
ventions can vary by context as needed.
The deeper understanding of friendship in old age will
also result from mining the data sets identied in Table 1
and exploring data harmonization techniques to conduct
cross-national comparisons. In addition to the countries
represented in Table 1, we cited friendship research from
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Spanish-speaking individuals, participants from Hong
Kong, Israel, Italy, and Norway, and residents of rural
versus urban communities. The articles by ten Bruggencate
and colleagues (2018) and Wrzus and colleagues (2013)
included data from multiple countries. Though we might
rightly assume that friendship is a universal role found in
every country, the literature on friendship in late life lacks a
comprehensive global perspective.
Initiating more longitudinal studies to track friend-
ship transitions across stages of adulthood and changes in
health would conrm or expand cross-sectional ndings.
Employing designs that tap perspectives of friend dyads
and friend networks and using statistical procedures such
as latent growth curve analysis and hierarchical linear
modeling would permit identifying reciprocal effects of
friends on one another and the reciprocal impact of friend
networks on dyads and individuals. The results of all these
recommendations would offer important and useful new
insights about this crucial relationship in the advanced
years of life.
Funding
None reported.
Acknowledgments
R. Blieszner conceived of the manuscript, drafted sec-
tions, and integrated sections written by coauthors. A.M.
Ogletree conducted an extensive literature review, drafted
sections, developed Table 1, and helped to review the man-
uscript. R.G. Adams contributed to the literature review,
drafted the interventions section, and helped to review the
manuscript. R.G. Adams and R.Blieszner developed and
revised Figures 1 and 2 over the course of their research
collaboration. We appreciate the assistance of Koji Ueno in
suggesting the concept of cognitive and affective motifs and
drafting Figure 2.
Conflict of Interest
None reported.
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