Formal social participation protects physical health through enhanced mental health: A longitudinal mediation analysis using three consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE)

Potential Impact of Physical Activity on Measures of Well-Being and Quality of Life in People with Rare Diseases: A Nationwide Cross-Sectional Study in Italy

BACKGROUND

Rare diseases constitute a heterogeneous group of approximately 7000-8000 conditions, distinguished by their low prevalence. Collectively, they present a significant global health challenge, affecting millions of people worldwide. It is estimated that rare diseases affect approximately 10% of the global population, which places a significant burden on individuals, families, and society. It is, therefore, important to consider strategies to improve the overall well-being and quality of life of individuals with rare diseases. One potential avenue for exploration is the incorporation of physical activity (PA). The scope of this study was to ascertain whether PA has a positive impact on measures of well-being and to determine its potential to enhance the quality of life of these individuals.

METHODS

The data were collected via an online survey. The one-way ANOVA test for multiple groups and multivariate Poisson models were employed to identify the significant predictors of the outcomes of interest.

RESULTS

The protective effects of PA become evident with a minimum of six hours of activity per week. Our data confirm that the weekly hours devoted to PA can serve as a significant protective factor for QoL. The study also provided some insights into the motivations behind patients' engagement in PA. These included improving QoL and physical well-being, as well as the desire to interact socially, with the goal of meeting friends or making new acquaintances. Finally, for adults and older adults, engaging in PA can also be a way to control weight.

CONCLUSIONS

It is becoming increasingly clear that individuals with rare diseases stand to benefit greatly from PA, so it is only sensible to educate them on the advantages of an active lifestyle.

Evolution of psychological distress with age and its determinants in later life: evidence from 17-wave social survey data in Japan

BACKGROUND

Psychological distress (PD) is a major risk factor for mental health among middle-aged and older adults and affects their quality of life and well-being. This study aimed to examine the evolution of PD with age and the relative importance of its determinants, issues that have been insufficiently studied.

METHODS

We used longitudinal data obtained from 17-wave social surveys conducted in Japan from 2005 to 2021, to track 34,128 individuals (16,555 men and 17,573 women) born between 1946 and 1955. We defined PD as a Kessler 6 score (range: 0-24) ≥ 5 and estimated fixed-effects regression models to examine the evolution of its proportion with age. We also conducted a mediation analysis to examine the relative importance of specific mediators such as self-rated health (SRH), activities of daily living (ADL), and social participation, in the association between age and PD.

RESULTS

Regression model results confirmed an increase in PD with age. Poor SRH, issues with ADL, and no social participation were key mediators of aging on PD, accounting for 34.2% (95% confidence interval [CI]: 21.0-47.3%), 13.7% (95% CI: 8.2-19.3%), and 10.5% (95% CI: 8.0-13.0%), respectively; consequently increasing PD between 50 and 75 years.

CONCLUSION

The results suggest the need for policy support to encourage middle-aged and older adults to promote health and increase social participation in order to prevent depression while aging.

Association between formal social participation and cognitive function in middle-aged and older adults: a longitudinal study using SHARE data

Formal social participation significantly impacts health and well-being, potentially mitigating cognitive decline, although not consistently across all studies. Existing research often focuses solely on baseline participation levels, and age-related differences have primarily been explored among the Asian population. Therefore, this longitudinal study aims to assess the association between formal social participation and cognition across different age groups in individuals aged 50+ living in Europe and Israel, while capturing the dynamic nature of formal social participation. We use data from three waves (four, six, and eight) of the Survey of Health, Ageing, and Retirement in Europe (SHARE), comprising 85,601 respondents. Linear mixed-effects models were applied. The results show that participation in formal social activities mitigates cognitive decline in middle-aged and older adults, especially among those aged 70 to 79 and 80+. These findings support the need for social policies promoting formal social activities, for lasting cognitive health benefits.

Social participation is associated with a habituated blood pressure response to recurrent stress

Lower cardiovascular reactivity is a proposed marker of motivational dysregulation and is related to a range of adverse behavioural and health outcomes. Social participation is a form of motivated behaviour and represents the frequency in which an individual engages in social activities. Low social participation has recently been linked to lower cardiovascular responses to acute psychological stress. With recent work emphasizing the importance of assessing adaptation of the cardiovascular response to recurrent stress, the aim of the current study is to build on previous work by examining the relationship between social participation and cardiovascular stress response adaptation. This study utilised data from the Pittsburgh Cold Study 3 (PCS 3). Two hundred and thirteen participants (M = 30.13; SD = 10.85) completed a social participation measure and had their systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored across two separate standardized stress testing sessions. The testing sessions consisted of a 20-minute baseline and a 15-minute stress task. Results indicated that higher levels of social participation were associated with greater blood pressure habituation to recurrent stress, extending previous work identifying that social participation was associated with higher cardiovascular responses to stress. The present study identifies that those reporting greater levels of social participation may show enhanced stress tolerance when exposed to recurrent stress.

Social participation classification and activities in association with health outcomes among older adults: Results from a scoping review

AIMS

The aim of this study is to summarize the characteristics of social participation classification and examine the association between activities and health outcomes among older adults.

DESIGN

Scoping review.

DATA SOURCES

Eight databases (Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Embase, ProQuest, Psychological Information Database, PubMed, Scopus and Web of Science) were searched. Reference lists of relevant social participation reviews were also considered.

METHODS

This study applied a five-stage methodological framework. A narrative synthesis summarized social participation classification and activities and their associations with health outcomes among older adults (≥65 years) living at home, in the community or in nursing residences.

RESULTS

Forty-two articles published between 1975 and 2022 were selected. Four classification criteria of social participation were extracted and summarized from these studies. Based on the depth and breadth of social interactions, this review proposed a four-level classification schema. A lower risk of mortality and less visual impairment were associated with participation in level-one, level-three or level-four activities, whereas less depression, less pain and better cognitive function were linked to participation in level-three or level-four activities.

CONCLUSION

Future studies should provide a clear definition, establish classification criteria for participation and properly select activity forms while considering both subjective and objective dimensions.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The results could provide data for designing targeted social participation interventions to improve specific health outcomes among older adults.

IMPACT

This review could help researchers examine the role of social participation activities in specific health outcomes. Moreover, a proposed classification of social participation activities would benefit researchers and community nurses in discerning the similarities and differences among activities.

REPORTING METHOD

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews guideline.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Sociocultural interactions and self-perception of health in older adults from an active participation centre: A qualitative study

INTRODUCTION

Promoting healthy ageing is a global priority. Active Participation Centres are potentially key in fostering psychosocial and emotional health, contributing to a fulfilling and active lifestyle for older adults.

AIMS

The study explores self-perceived health, perceptions of sociocultural participation, emotions that emerged when sociocultural participation, and preferences among older adults engaged in community socio-cultural activities from an Active Participation Centre.

METHODS

We realised a hermeneutic study; interviews with nine older participants were conducted. Hermeneutic considerations were employed for data analysis.

RESULTS

Findings reveal the centre's significance as a therapeutic space, positively influencing emotional well-being, fostering social connections, and offering diverse activity preferences.

CONCLUSION

This study underscores the nuanced interplay between sociocultural engagement and self-perceived health, emphasising the need for holistic approaches to promote well-being among older adults attending Active Participation Centres.

Is Formal Social Participation Associated with Cognitive Function in Middle-Aged and Older Adults? A Systematic Review with Meta-Analysis of Longitudinal Studies

This systematic review with meta-analysis aimed to explore the association between formal social participation and cognitive function in middle-aged and older adults using data from longitudinal studies. A comprehensive search was conducted in Scopus, PubMed, and Web of Science for longitudinal studies that assessed the association between formal social participation and cognitive function in middle-aged and older adults published between January 2010 to 19 August 2022. Risk of bias was judged using the RoBANS tool. Meta-analysis using a random-effects model was computed with odds ratio (OR) and 95% confidence interval (CI) for cognitive decline probability. Sensitivity analyses were made to explore any changes to the pooled statistical heterogeneity and pooled effect size. Certainty of evidence was judged using the GRADE framework. We included 15 studies comprising 136,397 participants from 5 countries. Meta-analyses showed that formal social participation was associated with reduced cognitive decline (OR = 0.78, 95% CI 0.75-0.82, p < 0.001), with very low certainty of evidence. Formal social participation appears to enhance cognition in middle-aged and older adults, but further high-quality research is needed given the very low certainty of evidence.

Modelling Age-Varying Associations among Group Memberships, Neighborhood Connectedness, and Well-Being

Individuals who maintain group memberships in their community tend to experience improved well-being relative to those who participate in few or no groups. There are, however, few investigations targeting variability in the correlates of group membership across the lifespan. The present examination probed age-related variability in the association between group memberships and subjective connectedness as well as well-being. Participants included 3,940 (mean age = 45.61 years, standard deviation [SD] = 15.62) Canadian and American respondents who completed an online survey during August of 2020 (i.e., amidst the COVID-19 pandemic). Time-varying effects modelling was used to estimate coefficients for group membership at each age within the sample. Memberships in social groups positively predicted connectedness, and this association was strongest in middle-to-older age; a similar association was also evident when predicting well-being. Connectedness was also a positive predictor of well-being throughout most ages. These findings build on emerging research conveying how group memberships have significance for people currently in middle-to-older age.

Effects of tai chi, ba duan jin, and walking on the mental health status of urban older people living alone: the mediating role of social participation and the moderating role of the exercise environment

With the global trend of aging, lacking of interpersonal communication and spiritual support and companionship have had a great impact on the mental health of older people living alone. This study examines the multifaceted impacts of engaging in tai chi, ba duan jin, and walking on the mental wellbeing of older people residing alone in urban areas. Additionally, this research aims to explore the association between tai chi, ba duan jin, and walking, and the mental health status of urban older people living alone, by considering the mediating influence of social participation and the moderating influence of the exercise environment. To do so, 1,027 older people living alone in six Chinese cities were investigated using the Physical Activity Rating Scale (PARS-3), the Geriatric Health Questionnaire (GHQ-12), the Social Participation Indicator System Scale, and the Exercise Environment Scale. SPSS 25.0 was utilized for conducting mathematical statistical analysis, specifically for doing linear regression analysis. Additionally, AMOS was employed to develop the study model. We found that a significant negative correlation between tai chi, ba duan jin, and walking and mental health status; among these, tai chi had the greatest impact on the mental health status of urban older people living alone. Social participation mediated the relationship between tai chi, ba duan jin, walking, and mental health status, and the exercise environment had a moderating effect on this relationship. The findings of this study indicate that tai chi, ba duan jin, and walking have a positive impact on the mental health of urban older people living alone, which can be influenced by the mediating efficacy of social participation and the moderating effect of the exercise environment.

Connecting through clicks: A longitudinal examination of internet use and depressive symptoms among middle- and old-aged Chinese

AIM

While prior investigations into the influence of internet engagement on depressive symptoms in middle-aged and older individuals have largely been favorable, concerns persist. Some research posits that internet use may detract from direct interpersonal interactions, elevating depression risks. Here, we scrutinize these contrasting views, endeavoring to delineate the relationship between internet use, social participation, and the ensuing depressive manifestations.

METHODS

We analyzed nationally representative data from three consecutive waves (2013-T1, 2015-T2, 2018-T3) of the China Health and Retirement Longitudinal Study survey. Measures of social participation encompassed formal social participation (i.e., attending clubs for mahjong, chess, sports, or other activities; participation in community organizations, volunteering, or enrolling in training courses) and informal social participation (i.e., interactions with friends or extending assistance to relatives, friends, or neighbors). Structural equation modeling was used to evaluate a focused longitudinal mediation model.

RESULTS

Our dataset comprised 13 671 individuals aged 45 years or older. Baseline internet use was associated with a decrease in depressive symptoms by T3 (c '  = -0.143, SE = 0.055). The longitudinal association between internet use and the alleviation of depressive symptoms was partially mediated by enhanced formal social participation (indirect effecta 1 × b 1  = -0.023, SE = 0.011).

CONCLUSIONS

For developing nations such as China, grappling with a rapidly aging demographic and scarce mental health infrastructure, pioneering initiatives that merge digital and formal social participation might be a valuable component in a multifaceted approach to alleviate late-life depression. Geriatr Gerontol Int 2024; 24: 218-224.

Promoting mental well-being in Western Australia: Act Belong Commit® mental health promotion campaign partners' perspectives

The Act Belong Commit® mental health promotion campaign aims to improve population mental well-being. Based on a social-franchising model, partnerships are sought with organizations offering 'mentally healthy activities' that foster social connectedness and mental well-being. There are four categories of partner organizations sought: Site (government agencies and health services), Associate (organizations with state-wide or national services), Community (local, grass-roots community groups) and Schools. This research explored organizational perceptions of the Act Belong Commit® Partnership Program. A purposive sample of 14 organizational representatives across all four partner categories participated in semi-structured interviews online or face-to-face between July and September 2021. Reflexive thematic analysis was used to identify three main themes: (a) A passion for promoting mental health; (b) Implementation, innovation, adaption and creation (e.g. the ability to adapt, create and deliver activities aligned with the campaign message; and (c) Future sustainability (e.g. recommendations for the sustainability of the programme). The use of reflexive thematic analysis enabled deeper insights into the complexity of the partnerships. Findings describe how the Act Belong Commit® Partnership Program supports mutually desirable objectives and extends the campaign reach. Embedded in a shared belief system that incorporates a passion for good mental health, the model supports the flexibility to adapt, create and deliver fit-for-purpose activities that promote mental well-being in the places where people live, work and play.

Examining the Pathways from General Trust Through Social Connectedness to Subjective Wellbeing

The broad conceptualisation of wellbeing has allowed researchers to establish subjective wellbeing as a valid indicator of social development. However, changing social patterns, norms, and values suggest changes in how social determinants may predict subjective wellbeing. The current analysis tests a serial mediation hypothesis in which social participation and social resources mediate the effect of general trust on subjective wellbeing.

Data from 8725 participants were pooled from the German part of the European Social Survey (ESS) Wave 10. Structural models were estimated to access the path from general trust to subjective wellbeing (SWB). Three separate mediation analyses were performed to test (1) the indirect effect of general trust on SWB through social participation, (2) through social resources and (3) through social participation and social resources. A full-mediation model reveals the direct and indirect paths predicting SWB through general trust, social participation, and social resources. Gender, age, education, and household size were included as control variables.

The full-mediation model suggests significant results for direct paths from general trust to social participation, social resources, and SWB. Direct paths from social participation to social resources and SWB were also significant. However, the path from social resources to SWB became non-significant.

Results highlight general trust as a critical predictor of SWB. The finding that social participation is significant while social resources are not significant in a mediation model suggests that social participation directly affects wellbeing, independent of the effect of social resources. This highlights the importance of social participation in promoting wellbeing.

Educational inequalities in self-rated health and their mediators in late adulthood: Comparison of China and Japan

Education has an impact on health, but the magnitude of the impact may vary across countries. This cross-sectional study compared educational inequalities in health and their mediators in late adulthood between China and Japan, which both face rapid population aging. We studied the same age cohort (63-72 years) based on two nationwide population-based surveys in 2018: the China Health and Retirement Longitudinal Study (N = 5,277) and Japan's Longitudinal Survey of Middle-Age and Elderly Persons (N = 20,001). The relative index of inequality (RII) in education was used to measure educational inequality in self-rated health (SRH). We then examined the extent to which income, smoking, leisure-time physical activity, and social participation mediated educational inequalities in SRH. In both countries, a lower educational level was associated with a higher risk of poor SRH; in China, however, the gradient was flatter. In China, the RII of education was 1.69 (95% confidence interval [CI]: 1.20-2.39) for men and 1.47 (95% CI: 1.06-2.05) for women. In Japan, meanwhile, RII was 2.70 (95% CI: 2.21-3.28) for men and 2.60 (95% CI: 2.13-3.18) for women. Our mediation analysis based on logistic regression models with bootstrapping also found that social participation was a key mediator of educational inequalities in health in both countries. In all, the results underscore that one's relative position in educational inequalities is a reliable predictor of subjective health in late adulthood in both China and Japan.

Examining the social networks of older adults receiving informal or formal care: a systematic review

PURPOSE

To address the care needs of older adults, it is important to identify and understand the forms of care support older adults received. This systematic review aims to examine the social networks of older adults receiving informal or formal care and the factors that influenced their networks.

METHODS

A systematic review was conducted by searching six databases from inception to January 31, 2023. The review included primary studies focusing on older adults receiving long-term care, encompassing both informal and formal care. To assess the risk of bias in the included studies, validated appraisal tools specifically designed for different study types were utilized. Network analysis was employed to identify the grouping of study concepts, which subsequently formed the foundation for describing themes through narrative synthesis.

RESULTS

We identified 121 studies relating to the formal and informal care of older adults' networks. A variety of social ties were examined by included studies. The most commonly examined sources of care support were family members (such as children and spouses) and friends. Several factors were consistently reported to influence the provision of informal care, including the intensity of networks, reciprocity, and geographical proximity. In terms of formal care utilization, older age and poor health status were found to be associated with increased use of healthcare services. Additionally, physical limitations and cognitive impairment were identified as factors contributing to decreased social engagement.

CONCLUSION

This review found that older people were embedded within a diverse network. The findings of this review emphasize the importance of recognizing and incorporating the diversity of social networks in care plans and policies to enhance the effectiveness of interventions and improve the overall well-being of older adults.

Mental health around retirement: evidence of Ashenfelter's dip

BACKGROUND

Mental health issues among retirees have become increasingly concerning because the aging population presents a significant challenge globally, particularly in Western countries. Previous studies on this issue are plagued with bias owing to lacking panel data and estimation strategies. This study investigated the depression levels of European adults around the time of retirement.

METHODS

We used data obtained from Waves 1-7 of the Survey of Health, Ageing, and Retirement in Europe (SHARE) to create panel data covering the 2004-2017 period. Wave 3 (SHARELIFE) was excluded from the sample because it provided mismatched information. Fixed-effects (FE) and fixed-effects instrumental variables (FE-IV) models with multiple imputations were employed to examine the impacts of retirement on mental health before and after retirement, where being over pension age (normal and early) was used as the instrument variable.

RESULTS

Our results indicated that retirement based on aspirational motivations (β =  - 0.115, p < 0.001) and positive circumstances (β =  - 0.038, p < 0.001) significantly reduced depression, whereas retiring under negative circumstances could deteriorate one's mental health (β = 0.087, p < 0.001). FE and FE-IV models indicated that overall, retiring reduced retirees' depression (β =  - 0.096, p < 0.001 and β =  - 0.261, p < 0.001, respectively). The results of FE-IV models showed that adults planning to retire in the next two years experienced less depression compared with others in the workforce (λ =  - 0.313, p < 0.01). These adults must have adjusted their lifestyles in response to their impending retirement, thereby evincing Ashenfelter's dip. Two years after retirement, when the "honeymoon" phase was over, retirees may have completely adapted to their new lives and the effect of retirement was no longer important.

CONCLUSIONS

Retirement improves mental health before it happens, but not after. Increasing the pension eligibility age may postpone the beneficial effects of retirement on health. However, policy implications should be tailored according to the unique situations of each country, job sector, and population. Providing flexible schemes regarding retirement timing decisions would be better than a generalized retirement policy.

Depression as a Mediator and Social Participation as a Moderator in the Bidirectional Relationship Between Sleep Disorders and Pain: Dynamic Cohort Study

BACKGROUND

Chronic pain, sleep disorders, and depression are major global health concerns. Recent studies have revealed a strong link between sleep disorders and pain, and each of them is bidirectionally correlated with depressive symptoms, suggesting a complex relationship between these conditions. Social participation has been identified as a potential moderator in this complex relationship, with implications for treatment. However, the complex interplay among sleep disorders, pain, depressive symptoms, and social participation in middle- and old-aged Asians remains unclear.

OBJECTIVE

This study aimed to examine the bidirectional relationship between sleep disorders and pain in middle- and old-aged Chinese and measure the role of depression as a mediator and social participation as a moderator in this bidirectional relationship through a dynamic cohort study.

METHODS

We used data from the China Health and Retirement Longitudinal Study across 5 years and included a total of 7998 middle- and old-aged people (≥45 years old) with complete data in 2011 (T1), 2015 (T2), and 2018 (T3). The cross-lag model was used to assess the interplay among sleep disorders, pain, depressive symptoms, and social participation. Depressive symptoms were assessed by the 10-item Centre for Epidemiological Studies Depression scale. Sleep disorders were assessed by a single-item sleep quality scale and nighttime sleep duration. The pain score was the sum of all pain locations reported. Social participation was measured using self-reported activity.

RESULTS

Our results showed significant cross-lagged effects of previous sleep disorders on subsequent pain at T2 (β=.141; P<.001) and T3 (β=.117; P<.001) and previous pain on subsequent poor sleep at T2 (β=.080; P<.001) and T3 (β=.093; P<.001). The indirect effects of previous sleep disorders on pain through depressive symptoms (β=.020; SE 0.004; P<.001; effect size 21.98%), as well as previous pain on sleep disorders through depressive symptoms (β=.012; SE 0.002; P<.001; effect size 20.69%), were significant across the 3 time intervals. Among participants with high levels of social participation, there were no statistically significant effects of previous sleep disorders on subsequent pain at T2 (β=.048; P=.15) and T3 (β=.085; P=.02), nor were there statistically significant effects of previous pain on subsequent sleep disorders at T2 (β=.037; P=.15) and T3 (β=.039; P=.24). Additionally, the mediating effects of depressive symptoms on the sleep disorders-to-pain pathway (P=.14) and the pain-to-sleep disorders pathway (P=.02) were no longer statistically significant.

CONCLUSIONS

There is a bidirectional relationship between sleep disorders and pain in middle- and old-aged Asians; depression plays a longitudinal mediating role in the bidirectional relationship between them; and social participation moderates the bidirectional relationship between them directly and indirectly by affecting depression. Future interventions may consider the complex relationship between these conditions and adopt a comprehensive treatment regime.

The Impact of Living Arrangements and Social Capital on the Well-Being of the Elderly

This study examines the impact of living arrangements and social capital on the subjective well-being of the elderly, as well as the mutual effects and relationships between the well-being and self-rated health status of the elderly. A total of 369 questionnaires were administered, and the effective recovery rate was 98.10%. The results indicate three key findings: (1) the current location for aging in place, social support, social activities, house ownership, and self-rated health status are indispensable factors affecting the well-being of the elderly. The best location for aging in place was the community, where the elderly's sense of well-being was highest-the next best options were aging at home and institutional care. (2) Elderly people with sole ownership of their homes were more likely to have higher levels of well-being than those owning jointly or who were tenants. (3) There was significant interaction between subjective well-being and self-rated health status.

Neighborhood Governance and Happiness during the COVID-19 Pandemic: An Empirical Analysis of Wuhan's Lockdown

The outbreak of COVID-19 posed a challenge to global governance, residents' happiness, and economic systems around the world. Since the crux of previous research centers on the reactions of both local and national governments, studies on how governance arrangement at the neighborhood level influences people's happiness during the crisis response remain insufficient. This paper aims to explore the relationship between neighborhood governance and residents' happiness based on first-hand data collected during Wuhan's first lockdown. This study highlights the significance of neighborhood governance in crisis response, which includes providing diverse public services, ensuring access to life's necessities, and offering prompt medical treatment. All of these factors are essential for maintaining overall satisfaction with governance and contributing to the happiness of individuals within the community. However, active governance actions do not always lead to favorable results. For example, increased group participation may lead to social conflicts among those involved, ultimately diminishing one's happiness. Furthermore, the COVID-19 pandemic has acted as a risk 'amplifier', exposing and exacerbating pre-existing hukou-based social inequalities in the governance process. The impact of the pandemic on citizen happiness is the cumulative effect of both the immediate social crisis brought on by the pandemic and long-standing structural inequalities. To improve people's happiness and establish inclusive policies, this paper advocates for a 'people-centered' urban governance that enhances public satisfaction and addresses the needs and priorities of migrant populations.

Is Social Participation Associated with Successful Aging among Older Canadians? Findings from the Canadian Longitudinal Study on Aging (CLSA)

The present study examines various activities of social participation (i.e., church or religious activities; educational or cultural activities; service club or fraternal organization activities; neighbourhood, community, or professional association activities; volunteer or charity work; and recreational activities) as contributing factors to successful aging. Successful aging in this study includes the following: adequate social support, no limitations with respect to Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), no mental illness in the preceding year, no serious cognitive decline or pain that prevents activity, as well as high levels of happiness, and self-reports of good physical health, mental health, and successful aging. Methods: The Canadian Longitudinal Study on Aging (CLSA) is a large, national, longitudinal study on aging. A secondary analysis of the baseline (i.e., 2011-2015) and Time 2 (i.e., 2015-2018) data of the CLSA was conducted on a sample of 7623 older adults who were defined as "aging successfully" at baseline and were aged 60+ at Time 2. Binary logistic regression analyses were employed to examine the association between engaging in various social participation activities at baseline and aging successfully at Time 2. Results: In a subsample (n = 7623) of the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort who were aging successfully at baseline, the prevalence of successful aging at Time 2 was significantly higher among the participants who participated in volunteer or charity work and recreational activities compared to those who were not involved in these activities. After adjusting for 22 potential factors, the results of the binary logistic regression analyses reported that participants who, at baseline, participated in volunteer or charity work and recreational activities had higher age-sex-adjusted odds of achieving successful aging (volunteer or charity work: aOR = 1.17, 95% CI: 1.04, 1.33; recreational activities: aOR = 1.15, 95% CI: 1.00, 1.32). Conclusions: Among six types of social participation activities, people who participated in volunteer or charity work and recreational activities were more likely to achieve successful aging than their counterparts who did not engage in these activities. If these associations are found to be causal, policies and interventions encouraging older adults to participate in volunteer or charity work and recreational activities may support older adults to achieve successful aging in later life.

The Longitudinal Association Between Frailty, Cognition, and Quality of Life in Older Europeans

OBJECTIVES

Evidence on the association between frailty and quality of life (QoL) is mostly limited to cross-sectional studies. Thus, the temporal order and potential mechanisms of this association are largely unknown. Our study examines both the directionality of this association and the role of cognition in this association in longitudinal data.

METHODS

Cross-lagged panel models were employed to examine the temporal relationship between frailty and QoL, as well as cognition's role among 19,649 older adults in Europe. Frailty, QoL, and cognition were assessed using the health deficit index, CASP-12, and 3 standard cognitive tests, respectively.

RESULTS

We observed a bidirectional association between frailty and QoL and their dynamics. High initial levels of frailty predicted poorer QoL later and vice versa (β = -0.151 and -0.052, p < .001). The early change in frailty predicted the late change in QoL, and vice versa (β = -0.093 and -0.061, p < .001). Frailty or its early change drives this interrelationship. Cognition at Wave 5 partially mediated frailty's effect at Wave 4 on QoL at Wave 6 (indirect effect: β = -0.005, 95% confidence interval = -0.006, -0.004).

DISCUSSION

Our findings supported that early prevention of frailty and its risk factors may have more influential protective effects on later physical and mental health, as well as the need for ongoing screening for mental health in aging population. Also, the maintenance of good cognitive performance may help interrupt this possible vicious cycle linking frailty and QoL decline.

Economic development, weak ties, and depression: Evidence from China

OBJECTIVES

Weak ties are becoming mainstream in daily relationships and play an essential role in the improvement of individuals' mental health. Despite growing concerns on depression, inclusion of weak ties is limited. To address the gap, this study empirically shed light on the role of weak ties on individual depression in the context of economic development.

METHOD

A cross-sectional study was conducted based on 2018 China Health and Retirement Longitudinal Study (CHARLS) with a sample of 16,545 individuals. A moderated mediation model is constructed to evaluate the impact of economic development (GDP) on the degrees of depression, the mediating effect of weak ties, and the moderating effect of residents' residence types (living in urban or rural areas).

RESULTS

Economic development exerts a significant direct impact on depression (β=-1.027, p<0.001). Weak ties are significantly negatively correlated with depression (β=-0.574, p<0.001), and act as a mediator between economic development and local individual depression. In addition, the residence type plays a moderating role between economic development and weak ties (β=0.193, p<0.001). That is, living in urban areas would introduce the higher the level of weak ties.

CONCLUSIONS

Higher economic development is largely conducive to alleviating the degrees of depression, weak ties play a mediating role in economic development and depression, and residence types have a positive moderating effect on the economic development and weak ties.

Digital Interventions for Social Participation in Adults with Long-term Physical Conditions: A Systematic Review

This review aims to identify and evaluate digital interventions for social participation in the growing population of adults with long-term physical conditions. Articles were sourced from MEDLINE, EMBASE, CINAHL and PsycINFO databases using subject headings and keywords related to "social participation" and "digital technology". Studies that adopted digital technology interventions to improve social participation in adults with long-term physical conditions were included. Data on study methodology, participant and digital intervention characteristics, and findings related to social participation were extracted. The search yielded a total of 4646 articles and 14 articles met criteria for final review with five randomized controlled trials, two non-randomized clinical trials and seven one-group pretest-posttest clinical trials. Studies were organized based on the digital intervention strategy implemented to improve social participation: group support (n = 4), individual skill training or counseling (n = 6), education and support (n = 3), and mixed intervention (n = 1). The group support interventions developed a social network among participants through videoconference, app, or virtual reality platform. Three studies reported positive improvements in different aspects of social participation. Individual skill training or counseling mainly utilized phone calls to help participants cope with activity participation and interpersonal relationship issues. Only two studies demonstrated benefits for social participation. The education and support intervention, which used messages and website information to increase participants' knowledge and provide support, showed positive findings in three studies. This review suggests digital interventions for improving social participation in adults with long-term physical conditions are feasible and the effectiveness of different strategies may vary.Registration: This review was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO) (registry number: CRD42021254105).

Mental distress links with physical activities, sedentary lifestyle, social support, and sleep problems: A Syrian population cross-sectional study

Background

Mental diseases are very widespread and difficult to treat, affecting around 12% of the global population in 2019. Since social interaction is crucial to human existence and loneliness has been proven to be a significant predictor of depressive symptoms, it stands to reason that social connection problems would also contribute to depression. Physical inactivity seems to weaken and aggravate insulin tolerance alterations, glucose homeostasis, and plasma triglyceride levels, thereby influencing one's mood and happiness. This suggests that physical inactivity may be a significant risk factor for mental illness. This research contributes to our understanding of the mental health situation in Syria by exploring associations between a set of measurable characteristics that may be adjusted.

Methods

An online quantitative cross-sectional study was conducted between March and April 2022 in Syria, using a structured questionnaire that assesses data on behaviors of health, health in general, wellbeing, and adult population quality of life.

Results

Among 1,224 respondents (371 men and 853 women), women have shown higher levels of mental distress, sleep issues, low engagement in structured activities, and a difficult work environment than men. Women experiencing mental anguish have reported being more sedentary, participating in less scheduled activities, and receiving less social support.

Conclusions

There are observable connections between high sedentary time and women experiencing mental distress. The mental health of Syrian women in distress was associated with a lack of participation in both organized activities and physical exercise in their free time. Furthermore, sleep issues and financial troubles were seen in persons with mental diseases of both males and females.

Association between Social Participation and Remaining Teeth and Urban-Rural Difference among Older Adults in China

Oral health is an important part of older adults' general health. The study examined the association between social participation (formal and informal) and remaining teeth and the urban-rural difference based on a national survey of older adults in China. The data of older adults were extracted from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed. A total of 11,948 respondents were ultimately involved, including 6836 urban respondents and 5112 rural respondents. Informal social participation and formal social participation were used to assess social participation. The number of remaining natural teeth was measured. Social participation was significantly associated with remaining teeth among older adults, after adjusting for confounders, a one-level increase in the informal social participation was associated with a decrease in natural teeth by 0.152 (95% CI = -0.274; -0.030) and a one-level increase in the formal social participation was associated with a decrease in natural teeth by 0.370 (95% CI = -0.585; -0.156). In addition, the association between social participation (formal and informal) and remaining teeth was observed among urban older adults, but not rural older adults. A high level of social participation may effectively decrease the risk of oral-health problems for the Chinese older adults. The findings suggest recommendations for an older adults-targeted policy and the practice of oral-health promotion. However, the urban-rural difference should be taken into full consideration in social-participation-driven oral-health promotion interventions.

Engagement with life and psychological well-being in late adulthood: Findings from community-based programs in Portugal

OBJECTIVES

Human aging is a multidirectional, multidimensional, and multicausal process that reflects biological, psychological, and sociocultural influences, which act in distinct combinations throughout the life-span. Proactivity towards avoiding the usual aging process is needed. This study analyses the long-term effects of participation in Community-Based Programs on psychological well-being.

METHOD

A sample of 150 community-dwelling participants enrolled in Community-Based Programs, aged 55 to 84 years and living in three Portuguese localities were matched by age (55-64, 65-74, 75-84 years), gender, and locality with a comparison group of non-participants. We administered a multidimensional gerontological protocol which included socio-demographic information, measures of health/disease, functional ability, social network, cognitive performance and psychological well-being. Hierarchical regression models were used to test the effects of Community-Based Programs on psychological well-being adjusting for remaining variables.

RESULTS

Overall, psychological well-being is positively associated with household income and satisfaction with health. Nevertheless, in participants, psychological well-being builds predominantly upon social network and is not associated with a moderate inability or cognitive deficits, contrasting with psychological well-being in non-participants. After adjusting for background variables, psychological well-being was positively associated with health satisfaction and social network and negatively related to moderate inability. Further, a significant interaction of participation in Community-Based Programs with age, points out higher levels of psychological well-being in participants contrasting with a downward trend in non-participants. After stratification by age, psychological well-being increases with time attending Community-Based Programs in the oldest (75-84 years) contrasting with the remainder.

CONCLUSIONS

Participation in Community-Based Programs may improve the negative effects of the aging process on psychological well-being. This positive effect as age increases may be linked to a reinforcement of social network, valued more by participants in Community-Based Programs. Furthermore, the programs may act as a healing/maintenance strategy in persons with moderate inability and/or cognitive deficits.

The Relevance of Social Intelligence for Effective Optimization of Retirement and Successful Ageing

Retirement is a psycho social process. It refers to the phase of life when a person leaves his job and withdraws from active working life. Proper optimization of retirement is only possible when a person has pre planned his life with proper finances and saving or the government is providing him with a lot of social security benefits. However, such conditions rarely occur as a person is preoccupied in his pre retirement phases. But proper optimization of retirement can also take place when a person has high social intelligence which affects physical and mental health. Hence, this paper is an endeavor to look into the relevance of social intelligence which helps the people in their retirement process in the people. Thus, a survey was done to find the level of Social Intelligence in the people who are ageing and are going to be retired soon. Around 252 people between 55 to 70 years were studied from Delhi and NCR. The result indicated that middle aged and just retired people had high social intelligence as compared to older adults and the former were also able to optimize their retirement effectively for successful ageing. The older adults were not able to cope up with the various issues of retirement due to low social intelligence. Hence, further studies can be carried out to design proper training for enhancement of social intelligence in aged people for their effective optimization of retirement.

Non-adherence to the World Health Organization's physical activity recommendations and associated factors among healthy adults in urban centers of Southwest Ethiopia

Physical inactivity is a major risk-factor of non-communicable diseases. The World Health Organization has set physical activity recommendations for adults to reduce physical inactivity and its consequences. However, 1.4 billion adults are non-adherent to the recommendation worldwide. The prevalence of non-adherence to this recommendation and its predictors has not been assessed in urban Ethiopia. This study aimed to determine the prevalence of non-adherence to physical activity recommendations and identify its associated factors among healthy adults in urban centers of Southwest Ethiopia. A community-based cross-sectional study was employed from May to June 2021, involving 1191 adults in urban centers of Southwest Ethiopia. Data was collected using Global Physical Activity Questionnaire. Multivariable logistic regression was used to identify factors associated with non-adherence to physical activity recommendations using 95% confidence interval of adjusted odds ratio at P-value of < 0.05.Overall, 61.2% of participants were non-adherent to physical activity recommendations. Older age (AOR = 6.6; 95%CI (2.3-19)), female sex (AOR = 6.1; 95%CI (3.5-10.5)), lower educational status (AOR = 0.5; 95%CI (.28-0.93)), less community engagement (AOR = 2.7;95% CI (1.3-5.5)), lower level of happiness (AOR = 4.7; 95%CI (1.3-16.8)) and physical inactivity of family members (AOR = 2.5; 95%CI (1.4-4.3)) were associated with non-adherence. The prevalence of non-adherence to physical activity recommendations in the study area is high. Age, sex, educational status, community engagement, level of happiness and physical inactivity of family members were predictors of non-adherence to the recommendations. Interventions have to target females and older adults. Community participation and family based physical activity have to be advocated to avert the consequences of physical inactivity.

The temperature of internet: Internet use and depression of the elderly in China

Introduction

Depression has become one of the most prevalent mental illnesses affecting the elderly in aging countries, i. e., in countries of the world whose population is slowly aging. It has become an important topic for scientists and policymakers to analyze how best to improve the elderly's mental health and save them from depression. The aim of this paper was to investigate whether and to what extent internet use may affect depression in the elderly. The heterogeneous effects of internet use on the elderly's depression across age, gender, and occupation were also investigated.

Methods

The data used in the present study were gathered from the China Health and Retirement Longitudinal Study that was conducted in 2018. The propensity score matching technique and the endogenous switch regression model were employed in this study to address potential endogeneity caused by both observed and unobserved factors.

Results

The results of the present study show that the elderly who are relatively young, male, well educated, live in an urban area, or have a small family are more likely to use the internet. The elderly who have healthy eyes or good eyesight, those who are not employed in the agricultural sector, or those who are retired, and those who are not eligible to receive any subsistence allowance or drink wine have a higher probability of using the internet. We also find that internet use significantly reduces the elderly's depression status by 3.370 points, which is roughly equivalent to a reduction of 37.19%. Heterogeneity analysis on internet use reveals that the health effect is particularly effective for agricultural workers, female, or the older elderly.

Conclusion

The results of the present study highlight the significant welfare effects brought about by the development of internet infrastructure. To improve the mental health of the elderly, the government should encourage them to adopt the internet. In particular, the needs of the elderly who are older, female, or have agricultural work should be paid more attention to motivate them to use the internet more to alleviate depression.

Exploring the longitudinal clustering of lifestyle behaviors, social determinants of health, and depression

Lifestyle behaviors such as exercise, sleep, smoking, diet, and social interaction are associated with depression. This study aimed to model the complex relationships between lifestyle behaviors and depression and among the lifestyle behaviors. Data from three waves of the Midlife in the United States study were used, involving 6898 adults. Network models revealed associations between the lifestyle behaviors and depression, with smoker status being strongly associated with depression. Depression, smoker status, age, time, and exercise were some of the most central components of the networks. Future lifestyle intervention research might prioritize specific behaviors based on these associations and centrality indices.

Opening the black box of the relationship between neighborhood socioeconomic status and mental health: Neighborhood social-interactive characteristics as contextual mechanisms

Previous studies have linked low neighborhood socioeconomic status (NSES) to mental health problems. However, few studies have investigated the mechanisms underlying this association and most focused on the association with negative indicators of mental health, such as symptoms of depression or anxiety. This paper investigated whether neighborhood social characteristics (social interaction, trust, safety, organization participation, and attachment) mediate the association between NSES and mental health. We combined Danish register data with survey data from the North Denmark Region Health Survey 2017. Mental health was assessed with the Rand 12-item Short-form Survey (SF-12). The sample consisted of 14,969 individuals nested in 1047 neighborhoods created with an automated redistricting algorithm. We fitted multilevel structural equation mediation models and used a Monte Carlo simulation method to estimate confidence intervals for the indirect effects. NSES was positively associated with mental health. Neighborhood trust significantly mediated this relationship, accounting for 34% of the association after controlling for other mediators. These results indicate that higher levels of mental health in more affluent neighborhoods are partially explained by higher levels of trust. Improving neighborhood trust could mitigate sociogeographic inequalities in mental health.

Cross-sectional associations of personal efforts and beliefs and depressive symptoms among older adults in India

Whilst there is growing evidence on the increased vulnerability of older adults to depression, there is limited research on potentially mitigative factors against symptoms of depression at a population level. This research examined associations of possible protective factors (personal efforts and beliefs) and depressive symptoms among older adults in India. This cross-sectional study used data from the Longitudinal Aging Study in India with 31,464 respondents aged 60 years and above. Depressive symptoms were assessed using the 10-item Centre for Epidemiologic Studies Depression Scale. Multivariable linear regression was used while exploring the associated factors of depressive symptoms. The mean score of depressive symptoms was 2.94 (CI 2.92, 2.96). Older adults who engaged in moderate [aCoef: −0.11, CI −0.18, −0.05], vigorous [aCoef: −0.09, CI −0.16, −0.03], or both types of physical activity [aCoef: −0.10, CI −0.19, −0.02] had lower likelihood of depressive symptoms in comparison to those who were physically inactive. Older adults who participated in social activities were less likely to have depressive symptoms [aCoef: −0.44, CI −0.50, −0.39] compared to their socially inactive counterparts. Further, older adults who perceived religion as very important [aCoef: −0.29, CI −0.41, −0.17], who had high life satisfaction [aCoef: −0.78, CI −0.82, −0.73], who had good self-perceived health [aCoef: −0.29, CI −0.33, −0.25] and those who had high self-perceived social standing [aCoef: −0.39, CI −0.47, −0.31] had lower likelihood of depressive symptoms in comparison to their respective counterparts. Physical activity, social participation, voluntary work and financial contribution to family, religiosity, life satisfaction, self-perceived health and self-perceived social standing are associated with lower likelihood of depressive symptoms among community-dwelling older adults in this study. Future longitudinal studies should explore these factors that can guide interventions against depression in old age.

Peer Group Support Intervention to Reduce Cardiovascular Disease Risk for African American Men According to Life's Simple 7 in Faith-Based Communities

BACKGROUND AND PURPOSE

Adverse cardiovascular health disparities persist for African American men. Although changing health behaviors is perhaps one of the most effective methods to prevent cardiovascular disease (CVD)-related deaths, previous behavior change programs targeting single or multiple CVD risk factors in target groups have had mixed success. The purpose of this pilot study was to determine whether a multi-faceted peer group intervention model based on American Heart Association's Life's Simple 7 was feasible, safe, acceptable, and efficacious in producing meaningful risk reduction for African American men.

METHODS

A convenience sample of 24 African American men with at least one CVD risk factor participated quasi-experimental study having peer intervention vs. nonequivalent comparison groups, with pretest-posttests at two church sites in Minneapolis, MN (MPLS) and Washington, D.C. (DC). Feasibility, safety, acceptability, and potential efficacy were assessed by examining completion of peer group sessions, adverse events, attendance, attrition, within and between-group changes in measures using nonparametric statistics.

RESULTS

All twenty-four men completed the study with no study-related adverse symptoms and medical events. The peer groups had moderate to high attendance, and the peer program evaluation was highly positive among participants. Between baseline and 6-months, there were significant differences between the intervention and the comparison group in cholesterol levels and weights (p = .041, p = .034, respectively) at one site (DC). There were no significant between-group changes at the other site (MPLS).

IMPLICATION FOR PRACTICE

The multi-faceted peer support intervention was feasible, acceptable, and shown to have potential efficacy to reduce CVD risk for highly motivated African American men. Future studies with a larger sample size are needed to test the effectiveness of this intervention model to reduce CVD risk among African American men.

Social activity as mediator between social support and psychological quality of life among people with rare diseases: A national repetitive cross-sectional study

BACKGROUND

Considerable proportion of people with rare diseases (RDs) have suffered from severe mental health problems. However, specific attention on the psychological quality of life (QoL) of people with RDs is sparse. Evidence documented the benefits of social support and social activity on recipients' mental health and overall QoL, but no corresponding study answered how both social support and social activity work on the psychological QoL among people with RDs. This study aims to report the psychological QoL and evaluate the mediating role of social activity between social support and psychological QoL among people with RDs.

METHODS

Data were from two national repetitive cross-sectional surveys, conducted in China in February 2016 and February 2018. In this study, eligible people were those aged 18 or above and had clinical-diagnosed RDs. Psychological QoL was measured by the subdomain of World Health Organization Quality of Life: Brief Version. Social support was measured by the Medical Outcomes Study Social Support Survey. Social activity was measured with seven items selected from the measurement on leisure activities used by the Chinese General Social Survey. Using the mediation model, we assessed the direct and indirect (via social activity) association between social support and psychological QoL, both on overall and subtypes of RDs. We controlled for a variety of potential socioeconomic and demographic confounding factors.

RESULTS

Of the 2403 adults studied, their average score of psychological QoL was 42.49 out of 100. The psychological QoL was directly associated with received emotional/information support (coefficient = 0.159, 95% CI = [0.093, 0.231], p < 0.0001) and positive social interaction (coefficient = 0.159, 95% CI = [0.097, 0.221], p < 0.0001). The psychological QoL was indirectly (via social activity) associated with received tangible support (coefficient = -0.035, 95% CI = [-0.046, -0.025], p < 0.0001) and positive social interaction (coefficient = 0.056, 95% CI = [0.040, 0.074], p < 0.0001). Above results by subtypes of RDs were also reported.

LIMITATIONS

The causal inference was not able to be investigated due to the cross-sectional study design.

CONCLUSION

People with RDs suffered from a low psychological QoL. Social activity mediated the association between social support and psychological QoL, but its mediating role depended on the subscales of social support as well as the subtypes of RDs. Customized measures based on the type of RDs and support that will be provided could perhaps improve the psychological QoL of people with RDs directly and indirectly.

Effects of Social Participation and Its Diversity, Frequency, and Type on Depression in Middle-Aged and Older Persons: Evidence From China

Background

Depression is one of the greatest public health problems worldwide. The potential benefit of social participation (SP) on mental health has been widely acknowledged. Nevertheless, a few studies have used propensity score matching (PSM) to reduce the influence of data bias and confounding variables. This study explored the effect of social participation on depression among middle-aged and older Chinese persons through a PSM method, considering the frequency, type, and quantity of SP. Effects were compared among different age groups, genders, and places of residence.

Methods

The datasets were obtained from the 2018 wave of the China Health and Retirement Longitudinal Study. A total of 9,404 respondents aged 45 and above were included in the study. PSM and ordinary least squares methods were used to estimate the effect of social participation on depression.

Results

PSM estimation results showed that SP had a significantly positive effect on decreasing depression scores (p < 0.001) by 0.875-0.898 compared with persons without SP. All types of SP had a significantly positive effect (p < 0.001), and participating in community activities had the largest effect (β = -1.549 to -1.788, p < 0.001). Higher frequency of participation and more types of SP promoted lower depression scores; subgroup analyses revealed that the promotion effect was significantly greater among women, those aged ≥75 years, and those living in urban areas.

Conclusion

PSM indicated that SP could alleviate the depression of middle-aged and older Chinese persons. Targeted measures should be adopted to promote SP and thereby improve mental health and promote healthy and active aging.

Association between physical activity, sedentary time, participation in organized activities, social support, sleep problems and mental distress among adults in Southern Norway: a cross-sectional study among 28,047 adults from the general population

Abstract

Background

Identification of modifiable factors associated with poor mental health is crucial to develop targeted and effective intervention strategies for prevention of mental distress and illness in the general population. Thus, the aim of the present study was to examine the association between low level of leisure-time physical activity, high sedentary time, low participation in organized activities, low social support, sleep problems, and mental distress in a large sample of Norwegian adults.

Methods

A cross-sectional study was completed by 28,047 adults (≥18 years old) in southern Norway by filling out an online self-report questionnaire. Multivariable binary logistic regression models, stratified according to gender and adjusted for age and perceived financial situation, were used to examine possible associations between unhealthy lifestyle behaviors, participation in organized activities, social support, and mental distress.

Results

Our results showed an increased odds of having mental distress among men reporting low leisure-time physical activity (OR: 1.18; 95%CI: 1.03–1.37), high sedentary time (1.32; 1.16–1.51), low involvement in organized activities (1.43; 1.25–1.64), low social support (2.55; 2.18–2.99), and sleep problems (7.29; 6.35–8.37) compared to the rest of the male population. For women, the results showed increased odds of mental distress among those reporting high sedentary time (1.25; 1.11–1.39), low involvement in organized activities (1.60; 1.42–1.80), low social support (2.71; 2.39–3.06), and sleep problems (5.78; 5.15–6.50) compared to the rest of the female population. For both men and women, results also indicated that mental distress was increased among younger adults and among those reporting financial difficulties compared to the rest of the population.

Conclusion

Our results showed an association between unhealthy lifestyle behaviors, low participation in organized activities, low social support and mental distress, and that the strength of the association varied substantially. These findings provide increased knowledge about the relationship between modifiable lifestyle factors and mental health which should have implications for future public health efforts.

Participation Predicts Cognitive Functioning in Older Adults Using the PART-O Transformed Scores Systems

Participation has been shown to be a protective factor for cognition in older adults, but instruments to assess it are limited. The main objective was to determine the validity of two scoring systems (direct vs transformed) for the Participation Assessment with Recombined Tools-Objective (PART-O) by applying structural equation modeling to the relationship between the subscales and the cognitive functions, in a sample of 245 people over 60 years of age. The transformed scores model showed stronger relationships and larger explained variance in overall participation (55.4% vs 37.4%), especially in the Social Relations subscale (31.4% vs 14.6%). Participation was a direct predictor of cognitive functions in both models. Age and depression inversely influenced participation in the transformed scores model. The proposed score transformation for the PART-O provides a more appropriate measurement of the older adults' participation. Participation has a mediating role in the relationship between cognition and both age and depression.

Lower social participation partly explains the association between perceived neighbourhood crime and depressive symptoms in European adults aged 50 years or older: A longitudinal mediation analysis

Neighbourhood crime likely increases the risk of developing depression among older adults. However, little is known about the underlying behavioural and social pathways. We examined the association between perceived neighbourhood crime and depressive symptoms and whether this relationship was mediated by health behaviours (physical activity, smoking, and alcohol consumption) and social participation. Furthermore, we explored differential vulnerability across age, gender, education and household wealth. Data were drawn from six waves of longitudinal data (from 2004/2005 to 2017) of approximately 15,000 adults aged 50 years and older, derived from the multi-national Survey of Health, Ageing and Retirement in Europe. Perceived neighbourhood crime and covariates were measured at baseline, time-variant mediators and depressive symptoms across all waves. Confounder-adjusted mediator and outcome models were fitted with mixed-effects models. Total association was decomposed into direct and indirect pathways applying causal mediation analyses with Monte-Carlo simulations. Perceived crime was associated with higher risk of depressive symptoms; 4.6% of the effect was mediated via lower engagement in social activities (b = 0.005; 95% CI: 0.001-0.009). No mediation was detected through physical activity, smoking or alcohol consumption. Exploratory analyses revealed that the mediating role of social participation was more pronounced among participants with low household wealth (b = 0.012; 95% CI: 0.004-0.023; 7.3% mediated). Lower engagement in social activities partly explained the association between perceived neighbourhood crime and depressive symptoms in adults aged 50 years or older. Policies targeting disadvantaged communities to prevent crime and support social participation might be beneficial for population mental health, especially among financially vulnerable older residents.

Compensatory Connections? Living Alone, Loneliness, and the Buffering Role of Social Connection among older American and European Adults

OBJECTIVE

The growth of solo living has important implications for the rising "loneliness epidemic" among older adults. This study considered whether two forms of social connectedness-extra-household core discussion networks and social participation-buffer the loneliness associated with living alone.

METHOD

Our study used data from two surveys (National Social Life, Health, and Aging Project; Survey of Health, Ageing and Retirement in Europe) encompassing 20 developed Western countries in 2009/2010 and 2015/2016 (n = 110,817). Harmonizing measures across data sets, we estimated survey-specific and pooled longitudinal regression models with interaction terms.

RESULTS

High levels of social connectedness only moderately buffered the loneliness associated with living alone in later life. Findings were largely consistent across regions of Europe and the United States, though the buffering patterns were most robustly identified for widowed solo dwellers.

DISCUSSION

Extra-household connections are partial compensators, but do not seem to fully replace the ready companionship afforded by residential co-presence in later life. Future research is needed to understand whether the efficacy of compensatory connections differs by gender, race/ethnicity, and across more diverse global regions.

Trust, Sociability, and Quality of Life of Sub-Saharan African Migrants in Germany

Poor social integration is associated with poor quality of life among minority groups. The current study hypothesized that trust and sociability may significantly explain the quality of life performance among Sub-Saharan African migrants in Germany. Data from 518 migrants were analyzed. Hierarchical multiple linear regression models were calculated to assess the predictive effect of trust and sociability on aggregate quality of life. Results show that general trust and sociability explained about 21% of the variance in quality of life score (adjusted R ² = .206; p < .001) for the total sample. Socioeconomic and demographic features suggested an added predictive effect of about 8% for total sample (adjusted R ² = .279; p < .001), 10% for male (adjusted R ² = .322; p < .001) and 4% for female (adjusted R ² = .211; p < .001). The results support trust and sociability as essential in connecting to a new environment and enhancing the quality of life.

Validation of a Kazakhstani Version of the Mental Health Continuum-Short Form

Positive mental health and well-being are significant dimensions of health, employment, and educational outcomes. Research on positive mental health and well-being requires measurement instruments in native languages for use in local contexts and target populations. This study examines the psychometric properties of the Kazakhstani version of the Mental Health Continuum—Short Form (MHC-SF), a brief self-report instrument measuring emotional, social, and psychological well-being. The sample included 664 University students (425 females) purposefully selected in three higher education institutions in South, East, and Central Kazakhstan. Their average age was 20.25 and ranged from 18 to 43. Participants completed a Kazakhstani version of the MHC-SF online. Statistical analyses to evaluate the structural validity, reliability, and measurement invariance of the Kazakhstani version of the MHC-SF were performed. The results confirmed the superiority of the bifactor model (i.e., three separated factors of well-being plus a general factor of well-being) over the alternatives. However, most of the reliable variance was attributable to the general well-being factor. Subscale scores were unreliable, explaining very low variance beyond that explained by the general factor. The findings demonstrated the measurement invariance of the MHC-SF across gender and age. Overall, these findings support the use of the Kazakhstani version of the MHC-SF to examine a general factor of well-being and the measurement invariance of the instrument across gender and age groups. However, the results advise against the interpretation of the subscale scores as unequivocal indicators of emotional, social, and psychological well-being.

Twenty-One Reasons for Implementing the Act-Belong-Commit-'ABCs of Mental Health' Campaign

While there has been increased attention worldwide on mental health promotion over the past two decades, what is lacking in many countries around the globe is practical knowledge of what constitutes a population-wide mental health promotion campaign, and how such a campaign can be implemented. This paper provides such knowledge based on the development, implementation and evaluation of the Act-Belong-Commit campaign, the world's first comprehensive population-wide public mental health promotion campaign which was launched in 2008 in Western Australia. Given the learnings from the full-scale implementation and evaluation of the campaign in Western Australia and its expansion nationally and internationally, along with the continuing and expanding evidence base for the campaign constructs, we crystallise 21 reasons why jurisdictions who wish to achieve the goals of the WHO and adopt the recommendations of the European framework on mental health and wellbeing should consider adopting or adapting Act-Belong-Commit when considering implementing a public mental health promotion campaign.

When Movement Moves: Study Protocol for a Multi-Method Pre/Post Evaluation Study of Two Programmes; the Danish Team Twin and Cycling Without Age

Physical activity (PA) can improve physical, mental, and social health, leading to quality of life (QoL). However, some are unable to participate independently due to age-related impairments or disabilities. This study protocol presents the design, methods, outcomes, strengths and limitations of the study “When Movement Moves” (WMM). WMM investigates whether indirect PA in a social context, where persons are unable to participate independently, can result in outcomes similar to those of independent PA, by evaluating the effects of disabled’s, elderly, volunteers’, relatives’ and nursing staff’s participation in either the running programme (Team Twin) or cycling programme (Cycling Without Age). Both programmes seek to enhance QoL through indirect PA in a social context, making PA possible for elderly and disabled persons through PA conducted by abled-bodied volunteers. WMM is a multi-method 12–16-week pre/post evaluation with quality of life, physical, mental and social health as main outcomes. Pre/post measurements consist of questionnaires, clinical examinations, and physical and cognitive appraisal. Throughout, interviews and participant observations will be conducted. Combined results will provide essential knowledge on the effects and experiences of indirect PA. Explorative data will pave the way for further research. Findings may inform policies, guidelines and health promotion among the elderly and disabled.

Older adults' experiences of maintaining social participation: Creating opportunities and striving to adapt to changing situations

BACKGROUND

Social participation concerns the possibility of engaging in activities in interaction with others or society at large and contributes to the health and well-being of older adults. In contrast, a lack of social participation is associated with loneliness. It is, therefore, important to understand what strategies older adults use to maintain social participation.

AIM

To explore and describe older adults' experiences of maintaining social participation.

MATERIALS AND METHODS

Nine older adults, aged 69-92 years, participated in interviews that were analysed through qualitative content analysis.

RESULTS

The overall findings reflect how older adults create opportunities for social participation by developing strategies and striving to adapt to changing situations, emphasizing how maintaining social participation is an active process. Preserving social participation requires motivation and an effort to take initiative to cultivate social relations, maintain community bonds, engage in social events and activities and stay connected with society.

CONCLUSIONS AND SIGNIFICANCE

These results may extend our understanding of strategies that older adults use, as well as the challenges they face when striving to adapt to new circumstances. This study may have implications for the practice of how to support older adults' social participation.

The impact of a power mobility device on occupational participation and quality of life for people with chronic diseases: A scoping review

Introduction

The aim was to explore occupational participation and quality of life (QoL) for power mobility device users with chronic disease.

Methods

Arksey and O’Malley’s framework for scoping reviews was used. Six data bases were searched using keywords: wheelchair, scooter, QoL and participation. Data were extracted with coding and thematic analysis performed.

Results

Forty-one articles met the inclusion criteria. An overarching theme of enhanced QoL was identified with subthemes of (i) independence, (ii) enabling participation in instrumental activities of daily living, (iii) enhanced social participation and leisure, (iv) environmental barriers to occupational participation, (vi) power mobility device (PMD) performance concerns impacting occupational participation and (vii) overcoming risk of harm through PMD training.

Conclusion

The scoping review identified a heterogeneity of study designs and outcome measures, which makes comparison between studies difficult. For people with chronic diseases, PMDs improve independence in occupational participation, particularly in IADL, social participation and leisure. Unfortunately, improved QoL was often inferred, without the use of an outcome measure. Areas which impacted occupational participation for PMD users were environmental barriers and a lack of PMD training. Further research is needed to understand the impact of a PMD on QoL and occupational participation for those with chronic disease.

Psychosocial Working Conditions and Social Participation. A 10-Year Follow-Up of Senior Workers

Social participation is important for health, and it is well known that high strain jobs impact negatively on mental and physical health. However, knowledge about the impact of psychosocial working conditions on social participation from a long-term perspective is lacking. The purpose of this study was to investigate the associations between different job types and social participation from a long-term perspective. A comprehensive public health questionnaire "The Scania Public Health Survey", was used, and psychosocial working conditions were measured with a Swedish translation of the Job Content Questionnaire. Based on data from 1098 working respondents aged 55 at baseline and a 10-year follow-up when the respondents were not working, the analyses revealed that social participation varied by job type. Jobs with high decision latitude, as in active and relaxed jobs, seem to predict high social participation, even after cessation of employment. Besides that, the result suggests that high social participation during working life is a predictor of high social participation from a long-term perspective which promotes healthy aging. Incentives for working longer are strongly related to good working conditions. A supportive work environment with possibilities for employees to participate in decision making, i.e., high control, is vital for a sustainable working life. This may contribute to an extended working life and may also support social participation prior to retirement as well as after retirement and thus to healthy aging.

Community Participation by People with Chronic Obstructive Pulmonary Disease

Little is known regarding community participation in individuals with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore community participation in individuals with COPD and to determine whether there is an association between community participation and activity-related outcome variables commonly collected during pulmonary rehabilitation assessment. We also sought to investigate which of these variables might influence community participation in people with COPD. Ninety-nine individuals with COPD were enrolled (67 ± 9 years, FEV₁: 55 ± 22% predicted). We assessed community participation (Community Participation Indicator (CPI) and European Social Survey (ESS) for formal and informal community participation), daily physical activity levels (activity monitor), exercise capacity (6-minute walk test), breathlessness (Modified Medical Research Council, MMRC scale), self-efficacy (Pulmonary Rehabilitation Adapted Index of Self-Efficacy) and anxiety and depression (Hospital Anxiety and Depression Scale). Higher levels of community participation on the CPI were associated with older age and greater levels of physical activity (total, light and moderate-to-vigorous) (all r_s = 0.30, p < 0.05). Older age and more moderate-to-vigorous physical activity independently predicted greater community participation measured by CPI. Higher levels of depression symptoms were associated with less formal and informal community participation on ESS (r_s = -0.25). More formal community participation on ESS was weakly (r_s = 0.2-0.3) associated with older age, better lung function, exercise capacity and self-efficacy, and less breathlessness. Self-efficacy, exercise capacity, and age independently predicted formal community participation in individuals with COPD. Strategies to optimize self-efficacy and improve exercise capacity may be useful to enhance community participation in people with COPD.

Physical Multimorbidity and Social Participation in Adult Aged 65 Years and Older From Six Low- and Middle-Income Countries

OBJECTIVES

Multimorbidity is common among older adults from low- and middle-income countries (LMICs). Social participation has a role in protecting against negative health consequences, yet its association with multimorbidity is unclear, particularly in LMICs. Thus, this study investigated the relationship between physical multimorbidity and social participation among older adults across 6 LMICs.

METHOD

Cross-sectional, community-based data including adults aged 65 years and older from 6 LMICs were analyzed from the WHO Study on Global AGEing and adult health survey. The association between 11 individual chronic conditions or the number of chronic conditions (independent variable) and social participation (range 0-10 with higher scores indicating greater social participation; dependent variable) was assessed by multivariable linear regression analysis.

RESULTS

14,585 individuals (mean age 72.6 [SD 11.5] years; 54.9% females) were included. Among individual conditions, hearing problems, visual impairment, and stroke were significantly associated with lower levels of social participation. Overall, an increasing number of chronic conditions was dose-dependently associated with lower levels of social participation (e.g., ≥4 vs 0 conditions: β = -0.26 [95% CI = -0.39, -0.13]). The association was more pronounced among males than females.

DISCUSSION

Older people with multimorbidity had lower levels of social participation in LMICs. Future longitudinal studies are warranted to further investigate temporal associations, and whether addressing social participation can lead to better health outcomes among older people with multimorbidity in LMICs.

Co-occurrence of Behavioral Risk Factors of Non-communicable Diseases and Social Determinants among Adults in Urban Centers of Southwestern Ethiopia in 2020: A Community-Based Cross-Sectional Study

Background

Non-communicable diseases are priority global health problems. Smoking, harmful alcohol consumption, physical inactivity, and an unhealthy diet are four behavioral risk factors of these diseases. Studies in Ethiopia have focused on establishing associations between these factors and incommunicable diseases.

Objective

To assess the prevalence, co-occurrence, and social determinants of behavioral risk factors of non-communicable diseases among adults in urban centers of southwestern Ethiopia.

Methods

This study employed a cross-sectional design. Multistage sampling and the Kish method were used. The WHO's STEPS instrument was used for data collection. Proportions and other descriptive measures are used to describe the data. Bivariate and multivariate logistic regression was run to assess associations. Associations between dependent and independent variables were determined using AORs, 95% CIs, and significance level of P=0.05.

Results

A total of 1,191 adults participated in the study for a 93.3% response rate. In sum, 4.8% of participants were smokers and 15.6% indulge in harmful drinking. Prevalence of physical inactivity was 60.45%, and 94.8% consumed insufficient fruit and vegetables. Regarding co-occurrence of these factors, 65.5% of participants had two or more behavioral risk factors. Female sex (AOR 3.1, 95% CI 1.8-5.5), no formal employment (AOR 1.9, 95% CI 1.02-3.7), greater wealth (AOR 2.44, 95% CI 1.1-5.1), not having a friend who does physical exercise (AOR 2.7, 95% CI 1.5-4.7), having friends who do not drink (AOR 0.20, 95% CI 0.09-0.44), and participating in community activities (AOR 2.95, 95% CI 1.4-6.0) were associated with co-occurrence of behavioral risk factors of non-communicable diseases.

Conclusion

The prevalence and co-occurrence of behavioral risk factors of non-communicable diseases in the study area are alarming. Several factors were associated with co-occurrence of these factors. Community-based interventions have to be implemented considering family settings. Special focus has to be given to physical inactivity and fruit and vegetable consumption.