Does volunteering moderate the relation between functional limitations and mortality?

Volunteer group participation and subsequent health and well-being among older adults in Japan: An outcome-wide longitudinal approach

BACKGROUND

Prior studies have underscored the importance of studying volunteering in the East Asian context. However, no study has conducted a holistic assessment of the relationship between volunteering and the multidimensional health and well-being outcomes of East Asian populations using a strong study design for causal inference. To address this gap, this study examined the associations between volunteer group participation and the subsequent health and well-being of Japanese older adults.

METHODS

Three waves of data (2013, 2016, and 2019), obtained from the Japan Gerontological Evaluation Study-a nationwide cohort study of physically and cognitively independent older adults, aged ≥ 65 years, in Japan-were utilized. Exposure was evaluated as the frequency of volunteer group participation: ≥ 1/week, 1 - 3 times a month, a few times a year, and none (2016). As outcomes, 40 indicators of health and well-being were assessed across seven domains (2019): physical/cognitive health, health behaviors, mental health, subjective well-being, social well-being, pro-social/altruistic behaviors, and cognitive social capital. We included 47,318 respondents for four outcomes (death, dementia, and functional disability [any level and level 2 or greater]) and 34,187 respondents for the 36 other outcomes.

RESULTS

More frequent volunteering (≥ 1/week) was associated with higher social well-being outcomes, more frequent pro-social/altruistic behaviors and outings, and fewer depressive symptoms, even after considering multiple testing.

CONCLUSION

Throughout the three-year follow-ups, volunteer group participation was beneficial for depressive symptoms, social well-being, and other proximal outcomes.

Exploring the barriers and facilitators to volunteering as an intervention for those with long-term neurological conditions: How make therapeutic volunteering possible?

BACKGROUND

Volunteering may have therapeutic benefits, but little is known about its requirements and potential for people with neurological conditions (pwNC).

DESIGN

Two separate focus groups were conducted in Darmstadt, Germany: one group consisting of six pwNC and another group consisting of four health care professionals and three volunteering service providers. The focus groups were audio-recorded, transcribed and data were managed using NVivo12. The thematic analysis was applied.

RESULTS

Four main themes were identified: (1) Impact of volunteering, (2) Individualisation, (3) Developmental space and (4) Funded supported volunteering.

CONCLUSION

According to the findings, volunteering can be used as a strategy to enhance physical, mental and social well-being in disease management for people with long-term neurological conditions.

PATIENTS OR PUBLIC CONTRIBUTION

Facilitators for accessibility of therapeutic volunteering; involvement of pwNC.

Does the integration of urban and rural health insurance influence the functional limitations of the middle-aged and elderly in rural China?

In January 2016, the Chinese government integrated the two systems of urban resident basic medical insurance and new rural cooperative medical system to establish a unified Urban and Rural Resident Medical Insurance. The integration of medical insurance is purported to enhance access for the rural population; however, a dearth of literature exists regarding its effect on functional impairment among middle-aged and elderly residing in rural areas. This study aims to evaluate the impact of urban-rural health insurance integration on functional limitation among middle-aged and elderly individuals in rural China. A longitudinal survey was conducted among 7855 middle-aged and elderly individuals in rural China. Using a nonequivalent control group pretest-posttest design, we exploit these policy changes to evaluate their impact on middle-aged and elderly individuals' functional limitation. The results showed that the integration of urban and rural health insurance systems was significantly associated with reduced functional limitation (Odds ratio .742; 95%CI 0.603, 0.914) among middle-aged and elderly individuals in rural China. Our findings also indicate that prevalent behaviors such as tobacco use, and alcohol consumption may exacerbate functional limitation among middle-aged and elderly individuals. These findings suggest that the integration of urban and rural health insurance systems can have a positive impact on the functional limitation of middle-aged and elderly individuals in rural China and could be an important factor in improving the health and well-being of middle-aged and elderly individuals in rural areas.

Effects of functional limitations and activities of daily living on the mortality of the older people: A cohort study in China

Introduction

Prevalence of functional limitations (FLs) and disabled activities of daily living (ADL) cause heavy burdens to the health of the older people. Stratified by gender, this study aimed to explore the effects of FL and ADL on the mortality of the older people in China, and the mechanism was then discussed.

Methods

We used survey data of a prospective 10-year cohort (2008-2018), from the China Longitudinal Healthy Longevity Survey (CLHLS). The primary outcome was all-cause mortality, and Independent variables included FL, basic ADL (BADL), and instrumental ADL (IADL). Covariates involved socio-demographic characteristics, health-related behaviors, and health status of the participants in the CLHLS project.

Results

There were 967 (19.20%) male and 2,235 (32.36%) female older people performed functional limitations, and their survival time was 60.98 (SE = 0.66) and 55.19 (SE = 0.55) months, respectively. Old adults with FL had significantly poorer survival than the ones without (Log-rank test, P < 0.001). Weibull regression suggested that FL (P < 0.001), abnormal BADL (P < 0.001) and IADL (P < 0.001) were negatively associated with the survival of the older people. Further analysis showed that BADL and IADL performed significantly mediating roles in the relation of FL and survival time in old adults; additionally, for female older people, BADL also exhibited a significant moderating role in the effect of FL on survival.

Conclusions

Prevalence of FL was serious among the older people in China, especially for the women. Disabilities of BADL and IADL and FL were negatively associated with the survival time of the older people in China. Regarding the effect of FL on survival, BADL and IADL performed significantly mediating roles, and the moderating role of BADL existed only for the female. These suggested evidence to implement strategies to maintain health in the older people.

Social Engagement and All-Cause Mortality: A Focus on Participants of the Minority Aging Research Study

INTRODUCTION

Social engagement is known to improve health; less is known about whether social activities at the core of African American life decrease mortality risk in this minoritized population. This study investigated whether and which aspects of social engagement predict mortality risk in older African Americans.

METHODS

Data from 768 African Americans (aged ∼73 years; nondemented at baseline) participating in the Minority Aging Research Study, a longitudinal community-based, cohort study of aging, was collected between 2004 and 2020 and analyzed in 2020. Participants self-reported late-life social activity, social network size, life space, and purpose in life at baseline and completed approximately 6.5 years of annual follow-up (range=15.70). Cox models included time from baseline to death or censoring and an indicator for death versus censored with age, sex, education, cardiovascular disease risk factor burden, depressive symptomatology, and motor gait performance as covariates.

RESULTS

As of March 2020, 25% of participants died (n=192; age at death ∼83 years). In fully adjusted Cox models, mortality risk decreased by 34% (hazard ratio=0.66; 95% CI=0.48, 0.91; p=0.012) for those with higher compared with that for those with lower social activity generally, with community/volunteer-, group-, and socially-related activities specifically driving these results.

CONCLUSIONS

Engaging in late-life social activity, especially group- and socially-based activities, was most consistently and robustly associated with reduced mortality risk in African Americans regardless of health. These results lay the foundation for considering community-based approaches to increase and/or maintain social participation in older African Americans as a potential means by which to increase longevity in this population.

Functional Limitations, Volunteering, and Diurnal Cortisol Patterns in Older Adults

OBJECTIVES

Older adults often experience functional limitations that affect their everyday lives, but many of them continue to make positive contributions to society and benefit from these contributions themselves. We examine (a) whether older adults' functional limitations are associated with diurnal cortisol patterns and (b) whether these associations vary on volunteering days versus nonvolunteering days.

METHODS

Participants were adults aged older than 60 years (N = 435) from the National Study of Daily Experiences, part of the Midlife in the United States Study. They completed an initial interview on functional limitations and background characteristics, indicated volunteering activities in daily interviews, and also provided salivary samples across 4 days.

RESULTS

Multilevel models showed that older adults with greater functional limitations exhibited dysregulated cortisol awakening responses and diurnal cortisol slopes throughout the rest of the day, compared to older adults with lower limitations. Yet, we also observed a significant moderating effect of volunteering on these associations.

DISCUSSION

This study advances our understanding of functional limitations and cortisol stress responses, revealing the benefits of volunteering to older adults who experience these limitations. Rather than treating these older adults solely as care recipients, interventions should offer them opportunities to help others.

Voluntary work for the physical and mental health of older volunteers: A systematic review

Background

The increasing imbalance between the number of older adults not working and the number of adults in the age range of labour force participation (age range 20-64) has long been a fundamental public policy challenge in the Organization for Economic Co-operation and Development member countries. At a societal level, this growing imbalance raises serious concerns about the viability and funding of social security, pensions and health programmes. At an individual level, the concern is probably more that of aging well with the prospect of many years in retirement. Some research suggests that retiring for some carries the risk of a fast decline in health. Volunteering can play a significant role in people's lives as they transition from work to retirement, as it offers a "structured" means of making a meaningful contribution in society once the opportunity to do so through work has been cut off. Some older people consider voluntary work as a way to replicate aspects of paid work lost upon retirement, such as organisational structure and time discipline. In many countries, volunteering of the older adults is increasing and programmes designed specifically for this subpopulation are emerging. Volunteering may contribute to both individuals aging well and society aging well, as volunteering by the older adults at the same time relieves the societal burden if it helps maintain health and functionality for those who volunteer. It thus remains to be established to what extent volunteering impacts on the physical and mental health of those who volunteer.

Objectives

The main objective of this review is to answer the following research question: what are the effects of volunteering on the physical and mental health of people aged 65 years or older?

Search Strategy

Relevant studies were identified through electronic searches of bibliographic databases, governmental and grey literature repositories, hand search in specific targeted journals, citation tracking, contact to international experts and internet search engines. The database searches were carried out to December 2018 and other resources were searched in September 2019 and October 2019. We searched to identify both published and unpublished literature. The searches were international in scope. Reference lists of included studies and relevant reviews were also searched.

Selection Criteria

The intervention of interest was formal volunteering which can be described as voluntary, on-going, planned, helping behaviour that intend to increase the well-being of strangers, offers no monetary compensation and typically occurs within an organisational context. We included older people aged 65 or over who are engaged in formal voluntary work. The primary focus was on measures of physical and mental health. All study designs that used a well-defined control group were eligible for inclusion. Studies that utilised qualitative approaches were not included.

Data Collection and Analysis

The total number of potential relevant studies constituted 17,046 hits. A total of 90 studies, met the inclusion criteria and were critically appraised by the review authors. The 90 studies analysed 47 different populations. Only 26 studies (analysing 19 different populations) could be used in the data synthesis. Forty-six studies could not be used in the data synthesis as they were judged to have too high risk of bias and, in accordance with the protocol, were excluded from the meta-analysis on the basis that they would be more likely to mislead than inform. Eighteen studies did not provide enough information enabling us to calculate an effects size and standard error or did not provide results in a form enabling us to use it in the data synthesis. Finally, of the 26 studies that could be used in the data synthesis, two pairs of studies used the same two data sets and reported on the same outcome(s), thus in addition two studies were not used in the data synthesis.Meta-analysis of both physical health outcomes and mental health outcomes were conducted on each metric separately. All analyses were inverse variance weighted using random effects statistical models that incorporate both the sampling variance and between study variance components into the study level weights. Random effects weighted mean effect sizes were calculated using 95% confidence intervals (CIs).Sensitivity analysis was carried out by restricting the meta-analysis to a subset of all studies included in the original meta-analysis and was used to evaluate whether the pooled effect sizes were robust across components of risk of bias.

Results

The 24 studies (analysing 19 different populations), used for meta analysis were from Australia, Ireland, Israel, Japan, Korea and United States, three were a randomised controlled trial and 21 were NRS. The baseline time period (the year the voluntary work that was analysed was measured) spanned by the included studies is 30 years, from 1984 to 2014 and on average the baseline year was 2001. On average the number of follow up years was 5, although with great variation from 0 to 25 years. The average number of volunteers analysed (not reported in four studies) was 2,369, ranging from 15 to 27,131 and the average number of controls was 13,581, ranging from 13 to 217.297. In total the average number of participants analysed was 14,566, ranging from 28 to 244.428.Ten studies analysed the effect of voluntary work on mortality, however, eight studies reported a hazard ratio and two studies reported an odds ratio. We analysed these two types of effect sizes separately. A hazard ratio <1 indicates that the treated, the volunteers is favoured. That is, the conditional mortality rate is lower for volunteers. All reported results indicated an effect favouring the volunteers, primary study effect sizes lied in the range 0.67-0.91. The random effects weighted mean hazard ratio was 0.76 (95% CI, 0.72-0.80) and statistically significant. The two studies that reported odds ratios of mortality supported this result. There was no heterogeneity between the studies in either of the meta analyses.Three studies analysed the effect of voluntary work on incident functional disability, using a hazard ratio as effect measure. All reported results indicated an effect favouring the volunteers, primary study effect sizes lied in the range 0.70-0.99. The random effects weighted mean hazard ratio was 0.83 (95% CI, 0.72-0.97) and statistically significant. There was a small amount of heterogeneity between the studies.Two studies analysed the effect of voluntary work on decline in instrumental activities of daily living, using an odds ratio as effect measure. Both reported results indicated an effect favouring the volunteers (0.63 and 0.83). The random effects weighted mean odds ratio was 0.73 (95% CI, 0.53-1.01) and not statistically significant. There is no heterogeneity between the two studies.Three studies analysed the effect of voluntary work on maintenance of functional competence, using an odds ratio as effect measure. All reported results indicated an effect favouring the volunteers, primary study effect sizes lied in the range 0.67-0.83. The random effects weighted mean odds ratio was 0.81 (95% CI, 0.70-0.94) and statistically significant. There is no heterogeneity between the studies.In addition a number of other physical outcomes were reported in a single study only.Three studies analysed the effect of voluntary work on depression, and reported results that enabled the calculation of standardised mean difference (SMD) and variance. The effect sizes are measured such that a positive effect size favours the volunteers. All reported results indicated an effect favouring the volunteers, primary study effect sizes lied in the range 0.05-0.66. The random effects weighted SMD was 0.12 (95% CI, 0.00-0.23) and statistically significant. There is a very small amount of heterogeneity between the studies.In addition, a number of other mental health outcomes were reported in a single study only.We did not find any adverse effects.There were no appreciable changes in the results across components of risk of bias as indicated by the sensitivity analysis.

Authors' Conclusions

The review aimed to examine effects on all types of physical and mental health outcomes. With the exception of mortality, there was insufficient evidence available. The available evidence, however, does suggest that there is an effect on the mortality of volunteers, although the effect is small. We found evidence that voluntary work reduces the mortality hazard of the volunteers aged 65 and above. The effect corresponds to a 43% chance of the volunteers dying first which should be compared to a fifty-fifty chance (50%) of dying first if the intervention had no effect. The evidence seems robust in the sense that we did not find any heterogeneity between the studies. As the intervention, unlike most other interventions in the social welfare area, is not costly, it could be prescribed to more older adults. In fact as the intervention in contrary to carrying a cost is a productive activity contributing directly to community well-being and has a positive effect on the volunteers it probably should be prescribed universally. However, due to the very nature of the intervention, it is voluntary and it cannot be prescribed. But more people could be encouraged to take up voluntary work if the opportunity was immediately available and visible.

Volunteer service and positive attitudes toward aging among Chinese older adults: The mediating role of health

OBJECTIVE

Attitude toward aging is an important indicator for measuring the wellbeing of older people, and a vital part of active and healthy aging. We aimed to assess the relationship between volunteer service and attitudes toward aging held by older people and to determine the mediating role of health.

METHOD

We analyzed the data of 10,792 Chinese people over age 60 from the 2014 Chinese Longitudinal Aging Social Survey. We used multiple linear regression models and the two-stage least-squares model to explore the correlation between volunteer service and attitudes toward aging. Furthermore, we applied structural equation modeling to test for mediation effects of different aspects of health.

RESULTS

We found that volunteer service was significantly associated with attitudes toward aging (β = 0.335, p < 0.001), while self-assessed health, physical health, and mental health played a mediating role between volunteer service and attitudes toward aging held by older adults.

CONCLUSIONS

In exploring ways to cope with the challenges brought about by the aging of the population, we found that participating in volunteer services not only improves older people's self-assessed physical, and mental health, but also improves their positive attitudes toward aging. Therefore, under the framework of active and healthy aging, volunteer service and participation in social activities can enhance social vitality and welfare, reduce social burden, and improve quality of life.

Volunteering, Subjective Sleep Quality, and Chronic Inflammation: A 5-Year Follow-Up of the National Social Life, Health, and Aging Project

Studies indicate that the benefits of volunteering may extend to biological risk factors in disease development including chronic inflammation, though the pathway through which volunteer activity predicts chronic inflammation remains unclear. The current project focuses on the link between volunteering and C-reactive protein (CRP) as a measure of chronic inflammation, while paying a particular attention to sleep quality as a pathway. Using panel data from the National Social Life, Health, and Aging Project (N = 1,124), the present study examined whether sleep quality operates indirectly linking volunteer activity and CRP (indirect pathway), compensates for the lack of volunteerism (moderation-compensation), or regulates the benefits of volunteering on CRP (moderation-regulation). The findings suggest sleep quality as a compensatory pathway, in that sufficient sleep buffers the inflammatory effect of lack of volunteerism. The findings show that helping others may be beneficial for the helpers in terms of chronic inflammation and sleep quality as interconnected health outcomes.

Benefits of Older Volunteering on Wellbeing: An International Comparison

Healthier aging implies lower health service expenditure and the possibility for individuals to make a longer and more valuable contribution to society. Lifestyles, including volunteering, affect our health. The policy implications of the present study are that it aims to broaden the state of knowledge and be useful to public decision-makers: if voluntary activities enhance the integration of older people into society, their participation will help to generate economic resources and improve their own welfare; if, however, health and participation do not show positive synergies, then policymakers must act independently in each of these fields. In this work, we focus on the societies of Chile, Mexico, and Spain because they have significantly aging populations and share common traits but also exhibit important differences. The empirical study employs micro-data from the World Value Survey (1994-1998, 2005-2009, and 2010-2014) and macro-data from the statistics of the OECD (Organization for Economic Co-operation and Development). Micro- and macro-data are merged by national and temporal identifiers. Our main results provide empirical evidence that volunteering might improve every indicator of wellbeing except happiness. Different kinds of activities have different impacts on individual wellbeing. For example, volunteering in activities related to social awareness is positive for male life satisfaction, whereas volunteering in activities related to religious issues is positive for male life satisfaction but also female happiness. In general, voluntary activities have a stronger impact on male wellbeing than female wellbeing.

Factors related to low social participation in older adults: findings from the Fibra study, Brazil

Abstract Objective To investigate the factors related to low social participation in older adults. Method A hierarchical model was drawn using data from 2,251 participants of the Fibra study, aged 65 years or more, without cognitive impairment suggestive of dementia, who were living in seven Brazilian cities. Three blocks of variables were considered: macrostructural, socioeconomic and health conditions. Results Factors related to low social participation were low perceived social support (OR:2.18;CI:0.73-1.53; <0.001), vision impairment (OR:2.04; CI:1.16-3.61;0.014), age over 80 years (OR:2.03;CI:1.22-3.38;0.006), depressive symptoms (OR:1.86;CI:1.29-2.68; <0.001), low cognitive status (OR:1.85;CI:1.20-2.85;0.005) and slowness (OR:1.83;CI:1.26-2.65;0.001). Older adults with those conditions have higher odds to be less socially engaged than their counterparts. Conclusion Personal conditions, such as socioeconomic and health status were predictors of low social participation in older adults. Initiatives aiming at active aging promotion should focus primarily on vulnerable elderly, especially those with health and/or social disadvantages.

Volunteering and mortality risk: a partner-controlled quasi-experimental design

Background

The consensus that volunteering is associated with a lower mortality risk is derived from a body of observational studies and therefore vulnerable to uncontrolled or residual confounding. This potential limitation is likely to be particularly problematic for volunteers who, by definition, are self-selected and known to be significantly different from non-volunteers across a range of factors associated with better survival.

Methods

This is a census-based record-linkage study of 308 733 married couples aged 25 and over, including 100 571 volunteers, with mortality follow-up for 33 months. We used a standard Cox model to examine whether mortality risk in the partners of volunteers was influenced by partner volunteering status-something expected if the effects of volunteering on mortality risk were due to shared household or behavioural characteristics.

Results

Volunteers were general more affluent, better educated and more religious than their non-volunteering peers; they also had a lower mortality risk [hazard ratio (HR)adj = 0.78: 95% confidence interval (CI) = 0.71, 0.85 for males and HRadj = 0.77: 95% CI = 0.68, 0.88 for females]. However, amongst cohort members who were not volunteers, having a partner who was a volunteer was not associated with a mortality advantage (HRadj = 1.01: 95% CI = 0.92, 1.11 for men and HRadj = 1.00: 95% CI = 0.88, 1.13 women).

Conclusions

This study provides further evidence that the lower mortality associated with volunteering is unlikely to be due to health selection or to residual confounding arising from unmeasured selection effects within households. It therefore increases the plausibility of a direct causal effect.

Examining the effect of peer helping in a coping skills intervention: a randomized controlled trial for advanced gastrointestinal cancer patients and their family caregivers

PURPOSE

At the end of life, spiritual well-being is a central aspect of quality of life for many patients and their family caregivers. A prevalent spiritual value in advanced cancer patients is the need to actively give. To address this need, the current randomized trial examined whether adding a peer helping component to a coping skills intervention leads to improved meaning in life and peace for advanced gastrointestinal cancer patients and their caregivers. Feasibility and acceptability outcomes were also assessed.

METHODS

Advanced gastrointestinal cancer patients and caregivers (n = 50 dyads) were randomly assigned to a 5-session, telephone-based coping skills intervention or a peer helping + coping skills intervention. One or both dyad members had moderate-severe distress. Peer helping involved contributing to handouts on coping skills for other families coping with cancer. Patients and caregivers completed measures of meaning in life/peace, fatigue, psychological symptoms, coping self-efficacy, and emotional support. Patient pain and caregiver burden were also assessed.

RESULTS

Small effects in favor of the coping skills group were found regarding meaning in life/peace at 1 and 5 weeks post-intervention. Other outcomes did not vary as a function of group assignment, with both groups showing small decreases in patient and caregiver fatigue and caregiver distress and burden. High recruitment and retention rates supported feasibility, and high participant satisfaction ratings supported acceptability.

CONCLUSIONS

Although a telephone-based intervention is feasible and acceptable for this population, peer helping in the context of a coping skills intervention does not enhance spiritual well-being relative to coping skills alone.

Neighborhood Physical Disorder and Psychological Distress

Although research documents a link between neighborhood physical disorder and psychological distress, we know little about the extent to which this association varies by age. Utilizing the person–environment fit model and drawing on data from the fourth wave of the Americans’ Changing Lives Survey, we examine the extent to which age influences the association between perceptions of neighborhood physical disorder and psychological distress, as measured by depressive symptoms. We employ both continuous and categorical measures of age to test for a potential moderating effect. Overall findings based on linear regression analyses reveal that the mental distress resulting from the perception of physically deteriorating neighborhood declines with age. Stated otherwise, we find that the psychological distress associated with the perception of neighborhood physical disorder is far less pronounced for the young-old (60 years and above) and late-old (70 years and above) adults as compared with their young middle-aged (40–49 years) and late middle-aged (50–59 years) counterparts.

The Volunteering-in-Place (VIP) Program: Providing meaningful volunteer activity to residents in assisted living with mild cognitive impairment

The Volunteering-in-Place (VIP) Program was developed to provide individualized meaningful volunteer activities matched to interests and capabilities for older adults with MCI in assisted living. The purposes of this single-site pre-test/post-test pilot study were to (1) establish feasibility of the VIP Program based on treatment fidelity (design, treatment, delivery, enactment); and (2) evaluate preliminary efficacy via improvement in psychological health (depressive symptoms, usefulness, purpose, resilience, and life satisfaction) and decreased sedentary activity (survey and Fitbit) at 3 and 6 months. Ten residents participated. The majority was white, female and educated, and on average 88 years old. The VIP Program was feasible and most participants continued to volunteer at 6 months. There were non-significant improvements in depressive symptoms, usefulness, purpose, resilience and recreational physical activity. The results of this study provide support for the feasibility of the VIP Program. Further study is necessary to examine efficacy.

Volunteering is associated with increased survival in able-bodied participants of the English Longitudinal Study of Ageing

BACKGROUND

Volunteering has been linked to reduced mortality in older adults, but the mechanisms explaining this effect remain unclear. This study investigated whether volunteering is associated with increased survival in participants of the English Longitudinal Study of Ageing and whether differences in survival are modified by functional disabilities.

METHODS

A multivariate Cox Proportional Hazards model was used to estimate the association of volunteering with survival over a period of 10.9 years in 10 324 participants, while controlling for selected confounders. To investigate effect modification by disability, the analyses were repeated in participants with and without self-reported functional disabilities.

RESULTS

Volunteering was associated with a reduced probability of death from all causes in univariate analyses (HR=0.65, CI 0.58 to 0.73, p<0.0001), but adjustment for covariates rendered this association non-significant (HR=0.90, CI 0.79 to 1.01, p=0.07). Able-bodied volunteers had significantly increased survival compared with able-bodied non-volunteers (HR=0.81, 95% CI 0.69 to 0.95, p=0.009). There was no significant survival advantage among disabled volunteers, compared with disabled non-volunteers (HR=1.06, CI 0.88 to 1.29, p=0.53).

CONCLUSIONS

Volunteering is associated with reduced mortality in older adults in England, but this effect appears to be limited to volunteers who report no disabilities.

The Effect of the Psychological Sense of Community on the Psychological Well-Being in Older Volunteers

Ageing populations across Europe are increasing. Communities have an important role in not only engaging this segment of the population but also in helping them to make them feel “part of something” (local or global) in order to favour their psychological well-being. The purpose of this paper is to study the effects of volunteering and being connected in one’s community on well-being. The present paper will test an older volunteers’ psychological well-being model. 143 older volunteers completed measures of religiousness, sense of global responsibility, psychological sense of community, generativity, motivation to volunteer and a profile of mood states. Data show that a psychological sense of community has a key role in the study of older volunteerism due to its impact on well-being. Service agencies and administrations can develop campaigns to sustain older volunteerism in order to increase well-being and reduce social costs.

Loneliness and mortality among older adults in China

OBJECTIVES

To examine the relationships between loneliness, social and health behaviors, health, and mortality among older adults in China.

METHOD

Data came from a nationally representative sample of 14,072 adults aged 65 and older from the 2002, 2005, and 2008 waves of the Chinese Longitudinal Healthy Longevity Survey. A cross-lagged model combined with survival analysis was used to assess the relationships between loneliness, behavioral and health outcomes, and risk of mortality.

RESULTS

About 28% of older Chinese adults reported feeling lonely, and lonely adults faced increased risks of dying over the subsequent years. Some of the effect was explained by social and health behaviors, but most of the effect was explained by health outcomes. Loneliness both affects and is affected by social activities, solitary leisure activities, physical exercise, emotional health, self-rated health, and functional limitations over a 3-year period.

DISCUSSION

Loneliness is part of a constellation of poor social, emotional, and health outcomes for Chinese older adults. Interventions to increase the social involvement of lonely individuals may improve well-being and lengthen life.

Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers

BACKGROUND

Volunteering has been advocated by the United Nations, and American and European governments as a way to engage people in their local communities and improve social capital, with the potential for public health benefits such as improving wellbeing and decreasing health inequalities. Furthermore, the US Corporation for National and Community Service Strategic Plan for 2011-2015 focused on increasing the impact of national service on community needs, supporting volunteers' wellbeing, and prioritising recruitment and engagement of underrepresented populations. The aims of this review were to examine the effect of formal volunteering on volunteers' physical and mental health and survival, and to explore the influence of volunteering type and intensity on health outcomes.

METHODS

Experimental and cohort studies comparing the physical and mental health outcomes and mortality of a volunteering group to a non-volunteering group were identified from twelve electronic databases (Cochrane Library, Medline, Embase, PsychINFO, CINAHL, ERIC, HMIC, SSCI, ASSIA, Social Care Online, Social Policy and Practice) and citation tracking in January 2013. No language, country or date restrictions were applied. Data synthesis was based on vote counting and random effects meta-analysis of mortality risk ratios.

RESULTS

Forty papers were selected: five randomised controlled trials (RCTs, seven papers); four non-RCTs; and 17 cohort studies (29 papers). Cohort studies showed volunteering had favourable effects on depression, life satisfaction, wellbeing but not on physical health. These findings were not confirmed by experimental studies. Meta-analysis of five cohort studies found volunteers to be at lower risk of mortality (risk ratio: 0.78; 95% CI: 0.66, 0.90). There was insufficient evidence to demonstrate a consistent influence of volunteering type or intensity on outcomes.

CONCLUSION

Observational evidence suggested that volunteering may benefit mental health and survival although the causal mechanisms remain unclear. Consequently, there was limited robustly designed research to guide the development of volunteering as a public health promotion intervention. Future studies should explicitly map intervention design to clear health outcomes as well as use pragmatic RCT methodology to test effects.

Helping hands, healthy body? Oxytocin receptor gene and prosocial behavior interact to buffer the association between stress and physical health

Providing help or support to others buffers the associations between stress and physical health. We examined the function of the neurohormone oxytocin as a biological mechanism for this stress-buffering phenomenon. Participants in a longitudinal study completed a measure of charitable behavior, and over the next two years provided assessments of stressful life events and physician-diagnosed physical ailments. Results indicated that charitable behavior buffered the associations between stressful events and new-onset ailments among individuals with the AA/AG genotypes of oxytocin receptor gene (OXTR) variant rs53576, but not among those with the GG genotype. These results suggest that oxytocin function may significantly affect health and may help explain the associations between prosocial behavior and health. More broadly, these findings are consistent with a role for the caregiving behavioral system in health and well-being.

Giving to others and the association between stress and mortality

OBJECTIVES

We sought to test the hypothesis that providing help to others predicts a reduced association between stress and mortality.

METHODS

We examined data from participants (n = 846) in a study in the Detroit, Michigan, area. Participants completed baseline interviews that assessed past-year stressful events and whether the participant had provided tangible assistance to friends or family members. Participant mortality and time to death was monitored for 5 years by way of newspaper obituaries and monthly state death-record tapes.

RESULTS

When we adjusted for age, baseline health and functioning, and key psychosocial variables, Cox proportional hazard models for mortality revealed a significant interaction between helping behavior and stressful events (hazard ratio [HR] = 0.58; P < .05; 95% confidence interval [CI] = 0.35, 0.98). Specifically, stress did not predict mortality risk among individuals who provided help to others in the past year (HR = 0.96; 95% CI = 0.79, 1.18), but stress did predict mortality among those who did not provide help to others (HR = 1.30; P < .05; 95% CI = 1.05, 1.62).

CONCLUSIONS

Helping others predicted reduced mortality specifically by buffering the association between stress and mortality.

Active aging for individuals with intellectual disability: meaningful community participation through employment, retirement, service, and volunteerism

As individuals with intellectual and developmental disabilities become more engaged in community employment, it will be critical to consider how their employment experience changes as they age. Similar to other seniors, individuals will need to consider whether they want to maintain their employment, reduce their work commitment, or retire completely. If they do choose to retire, what activities will they choose to engage in, and what service or supports might be necessary? This article considers the issues faced by all aging workers in regard to retirement planning and active aging as well as specific strategies for individuals with intellectual and developmental disabilities to remain active and engaged. Recommendations for service options, policy consideration, and future research are also discussed.

Loneliness, health, and mortality in old age: a national longitudinal study

This study examined the relationship between loneliness, health, and mortality using a U.S. nationally representative sample of 2101 adults aged 50 years and over from the 2002 to 2008 waves of the Health and Retirement Study. We estimated the effect of loneliness at one point on mortality over the subsequent six years, and investigated social relationships, health behaviors, and health outcomes as potential mechanisms through which loneliness affects mortality risk among older Americans. We operationalized health outcomes as depressive symptoms, self-rated health, and functional limitations, and we conceptualized the relationships between loneliness and each health outcome as reciprocal and dynamic. We found that feelings of loneliness were associated with increased mortality risk over a 6-year period, and that this effect was not explained by social relationships or health behaviors but was modestly explained by health outcomes. In cross-lagged panel models that tested the reciprocal prospective effects of loneliness and health, loneliness both affected and was affected by depressive symptoms and functional limitations over time, and had marginal effects on later self-rated health. These population-based data contribute to a growing literature indicating that loneliness is a risk factor for morbidity and mortality and point to potential mechanisms through which this process works.

Improving quality of life in ageing populations: what can volunteering do?

The year 2011 was declared the 'European Year of Volunteering' to recognise the contribution volunteers make to society. Such cross-national events reflect the high profile of volunteering and political imperatives to promote it. The purpose of this review is to provide a comprehensive review of current knowledge (articles published between 2005 and 2011) regarding the role of volunteering in improving older people's quality of life (QoL) and to identify areas requiring further research. Volunteering was defined as an activity that is freely chosen, does not involve remuneration and helps or benefits those beyond an individual's immediate family. Our search identified 22 studies and 5 review articles that addressed the benefits of volunteering on older people's quality of life. Most of the research had been conducted in the United States, Canada and Australia using data from longitudinal studies. The majority of the studies concluded that there is a positive association between older people's quality of life and engagement in volunteering. Due to the study designs and the heterogeneity of the research, causality is difficult to demonstrate and the knowledge the studies bring to the subject is variable. This review shows that volunteering may help to maintain and possibly improve some older adults' quality of life. However, there are still major gaps in our understanding of who actually benefits, the social and cultural context of volunteering and its role in reducing health and social inequalities.

Does the Relation between Volunteering and Well-Being Vary with Health and Age?

Previous studies have established a positive association between organizational volunteering and well-being. In the current study, we examined whether the relations between organizational volunteering and positive affect, negative affect, and resilience are modified by respondents' age and number of chronic health conditions. This study used cross-sectional data from the 2008 Arizona Health Survey of residents 18 years old and older ( N = 4,161). Multiple regression analyses provided no support for the hypothesis that age moderates the association between volunteer status and positive affect, negative affect, and resilience. In contrast, there was a significant ( p < .05) interaction between volunteer status and chronic health conditions on positive affect and resilience. Consistent with the compensatory hypothesis, as number of chronic health conditions increased, the relations between volunteering and positive affect and resilience scores increased. Implications of these findings for increasing volunteering among adults with multiple chronic health conditions are discussed.

Correlates of volunteering among aging Texans: the roles of health indicators, spirituality, and social engagement

OBJECTIVES

This study aimed to identify participant characteristics associated with volunteering among older adults.

METHODS

Based on data from the 2008 Aging Texas Well (ATW) Indicators Survey, we examined the degree to which demographic factors, health status, spiritual participation, and community involvement are associated with volunteering among adults aged 60 years or older (n = 525).

RESULTS

Rates of volunteering varied by race/ethnicity: non-Hispanic Whites (56.4%), African Americans (51.1%), and Hispanics (43.2%). Bivariate analyses showed that non-Hispanic White older adults were more likely to participate in formal volunteering activities, while their African American and Hispanic counterparts tended to participate in informal volunteering activities. Logistic regression analyses revealed that volunteering was less observed among Hispanics (OR = 0.48, 95% CI 0.29-0.78). Volunteering was more observed among those who reported providing informal care (OR=1.93, 95% CI 1.14-3.28), having very good or excellent mental health (OR = 1.90 and 2.07, 95% CI 1.09-3.32 and 1.20-3.55, respectively), having weekly or daily spiritual participation (OR = 2.15 and 2.35, 95% CI 1.28-3.63 and 1.29-4.28, respectively), perceiving community involvement very important (OR = 2.37, 95% CI 1.55-3.62), and being very satisfied with the community interaction (OR = 1.81, 95% CI 1.15-2.85).

CONCLUSIONS

Given the positive associations of mental health, spirituality, and social engagement with volunteering among older adults, system-level efforts to increase the sense of community among older adults and recognize their roles as volunteers will be helpful in recruiting and retaining older volunteers.