Pal Power

Lotte Prager owes her life, and much of the happiness she has enjoyed during her 81 years, to friends. It was friends who helped her escape Nazi Germany in 1937 by paying her first year's tuition at a British teaching college. Then friends at the college helped her get her relatives, including her parents, out of Germany. Following her move to the U.S., Prager met her husband-to-be at a party given by other friends, and after her husband died and her children had grown up, yet another friend helped her find an apartment in New York City. Retired from her career as a social worker, Prager now relies on friends for companionship and the comfort of knowing, as she says simply, that "they will do for me and I will do for them."

Prager's saga may be dramatic, but there is a growing body of evidence that a rich social network may play a life-enhancing, even lifesaving role, particularly as we age. In study after study, researchers have found that people who have strong social relationships live longer--and happier--lives. In a recent study of 2,800 people 65 and older in New Haven, Conn., for example, Carlos Mendes de Leon, at the Rush-Presbyterian-St. Luke's Medical Center in Chicago, found that those who had more friends were less likely to become disabled and more likely to recover if they did suffer a period of disability. In an earlier study of 11,000 people 65 and older, Teresa Seeman, now at the UCLA School of Medicine, found that, over a five-year period, those with no ties to others were two to three times as likely to die as those with bonds to spouses, friends, relatives, churches and other organizations. Other studies have found that people with narrower social networks are more likely to have a heart attack--and to die afterward--while people with more social contacts are less likely to suffer cognitive decline.

Why are good relationships so good for our health? Seeman suggests two mechanisms. The first is behavioral: family and friends encourage loved ones to eat better, consume less alcohol, curb tobacco use, exercise and seek medical care. Second, good relationships appear to enhance actual physical well-being. In experiments, the presence of a friend decreased physiological stress responses in subjects performing difficult mental tasks, whereas unsupportive social situations increased them.

Though friends and family are frequently lumped together in research measuring the link between health and social support, they are distinct and separate in real life. The chief difference? "You choose your friends, but you're stuck with your family" is how an adolescent might put it. That's good news and bad news for friendship. "Friends don't make the demands that family members do. Friends generally won't be asked to give money or nursing care," says sociologist Jan Yager, author of Friendshifts. "They are probably going to mainly have fun together." On the other hand, she notes, "because it's optional, friendship can be withdrawn more easily than family relationships."

Paradoxically, the optional nature of friendship, which makes it more fragile than family ties, may increase its value. "Friendship contributes more to people's happiness in old age than their family relationships do," says Rebecca Adams, sociology professor at the University of North Carolina at Greensboro. "If we don't like our friends, we terminate the relationships or let them fade, so the ones we're left with are often fairly positive compared with family relationships, which we can't terminate." Furthermore, we tend to feel more gratitude for a friend's kindness than for a relative's. "If a family member comes over to help us when we're sick, we feel they did what they were supposed to do," says Adams. "But if a friend does the same thing, we consider it above and beyond the call of duty."

While families are finite, friends are a renewable resource, which is fortunate given the odds against sustaining a friendship. The career-building years can entail repeated moves that result in separations from friends. In midlife, the competing claims of work and child rearing can force friendship onto the back burner. Then there's divorce, which divides spouses not only from each other but often from the friends they once held in common. When we retire, the migration to the Sunbelt takes a toll both on those who leave and those who remain behind. Finally, as we age, our social networks can be further eroded by disabilities--our own and those of our friends-- and, saddest of all, by death.

Though the number of friends may dwindle as we age, it seems our pleasure in them grows. Reason: "People become more selective and get better at knowing the kind of people they like and don't like," says Stanford psychology professor Laura Carstensen. "And they steer away from those they don't care for."

Women tend to have more close friends than men do. "In order to be close to someone, you have to admit your weaknesses," explains Adams. "That's more difficult for men to do, because they tend to be very competitive." Women may need more friends, since they are more likely than men to be single in old age. That's partly because they have a longer life expectancy and tend to marry men older than themselves. Indeed, among people 85 and older, women outnumber men 5 to 2. For Anne Anderson, 72, a single, childless New Yorker, friends fill in for the family she lacks. "Friends help you through the bad times and make good times better," she says.