The Association Between Leisure Activity Engagement and Health-Related Quality of Life in Middle-Aged and Older People With HIV

The mediating role of individual evaluation, anxiety, and depression in the association between leisure activity and cognitive function among Chinese older adults

The purpose of this research was to investigate the association between leisure activity and cognitive function in Chinese older adults, and to explore the mediating role of individual evaluation, anxiety and depression. Using cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), Pearson correlation analyses were employed to examine the relationships among various indicators. A multiple mediation model was constructed to investigate the mediating pathways through which leisure activities impact cognitive function in elderly individuals. Leisure activities, individual evaluation, anxiety, and depression were significantly correlated with cognitive function (p < 0.01). Leisure activities not only directly positively impacted cognitive function in elderly individuals (effect = 0.3780; 95% CI = [0.3459, 0.4101]), but also exerted indirect effects through five pathways. Individual evaluation, anxiety, depression, they plays a mediating role in the association between leisure activity and cognitive function in older adults in China. Leisure activities can positively impact cognitive function in elderly individuals by enhancing individual evaluation and subsequently reducing anxiety and depression.

The Role of the Built Environment in Supporting Older Adults' Engagement: A Narrative Literature Review

OBJECTIVE

This literature review aimed to summarize the existing knowledge surrounding the role of the built environment in supporting older adults' physical and social engagement and identify opportunities for future research and design that facilitates older adults' engagement at multiple environmental scales: from interior spaces to neighborhoods.

BACKGROUND

Physical environments can support or impede older adults' physical and social engagement: willful, motivated involvement in meaningful activity or occupation. Research shows that engagement is a core component of health and well-being and relates to positive health outcomes, including reduced disease risk, better mental health, and improved physical and cognitive function. Thus, designing supportive built environments for engagement can yield significant, positive health and well-being impacts.

METHODS

A systematized search of five databases, a hand search, and an iterative screening process identified 55 studies for inclusion in this review. Through inductive thematic analysis, this review summarizes findings regarding the built environment's role in physical and social engagement in older age and design strategies to facilitate engagement and support health and well-being.

RESULTS

Evidence indicates that built environment characteristics can influence older people's physical and social engagement in homes, neighborhoods, and care settings. The thematic analysis of the included studies identified three key themes concerning the relationships of built environment characteristics to older adults' engagement across multiple environmental scales: connection, access, and security.

CONCLUSIONS

Built environments influence older people's physical and social engagement, significantly affecting their health, well-being, abilities, and longevity. Numerous design strategies can support older adults' engagement, but more research is needed.

Health Outcomes of Social Pension Expansion: A Quasi-Experiment Among Older Adults in Hong Kong

A social pension, regarded as a reliable source of income, has the potential to significantly influence the overall wellbeing of vulnerable older adults. This study aimed to extend the understanding of the effects of social pension expansion beyond its economic impacts to encompass recipients' health status. Using three-wave data from a representative sample of older adults, we employed a quasi-experimental assessment model to evaluate the impact of a recent social pension expansion in Hong Kong on health-related consumption and health outcomes among older adults. The results of the triple difference estimations revealed that an increased social pension significantly enhanced older people's engagement in entertainment activities, utilization of healthcare services, and expenditures on preventive health products. Furthermore, the increased social pension was found to have a significant positive effect on mitigating poor self-rated health and poor sleep quality. However, it did not have a significant impact on the prevalence of depression. These findings suggest that social pension expansion should be coordinated with other policy initiatives to comprehensively improve the physical and mental health of older adults.

The impact of life stress, psychological resources, and proactive behaviors on quality of life among people living with HIV

OBJECTIVES

Quality of life (QoL) is an important consideration for people living with HIV (PWH). We investigated the relationship between stress, psychological resources, and proactive behaviors, on QoL (conceptualized as life satisfaction, successful aging, and depressive symptoms) by testing the hypotheses: (1) greater life stress (stress and functional impairment) is associated with poorer QoL; (2) resources (mastery, resilience, and social support) are associated with better QoL, beyond the influence of stress; and (3) proactive behaviors (medication management and leisure activities) mediate the relationship between resources and QoL.

METHODS

Secondary analyses were performed (N = 128 PWH). Participants' mean age was 52.3, 83.6% were male, and 53.9 identified as white. Multivariate regressions were performed within the context of path analyses.

RESULTS

In series 1, greater stress was associated with poorer life satisfaction (p < 0.001), lower self-rated successful aging (p < 0.001), and greater depression (p < 0.001). Functional impairment was associated with lower successful aging (p = 0.017) and greater depression (p = 0.001). In series 2, which accounted for mastery, resilience, social support, as well as demographic covariates, mastery was associated with greater life satisfaction (p = 0.038). In series 3, stress, functional impairment, leisure activities, and ART management were added to the model and social support was associated with engagement in leisure activities (p < 0.001), which was associated with better successful aging (p = 0.006). Fit indices suggested adequate relative fit. In bootstrapped analyses of indirect effects, social support was indirectly associated with successful aging through leisure activities (p = 0.020).

CONCLUSIONS

QoL, as captured by self-rated successful aging, is threatened by stress but positively influenced by social support and engaging in leisure activities. Findings support a model of proactive successful aging for PWH.

Across and Within- Individual Associations Between Everyday Activities and Quality of Life Relevant Measures, in Workers with Type 1 Diabetes

Relationships between activity engagement and health related quality of life (HRQOL) can differ based on the level of analyses. For instance, greater exercise on average may be linked with lower fatigue across individuals (between-person level), whereas the momentary experience of exercise may be associated with increased fatigue within an individual (within-person level). Disentangling the between- and within-person associations between everyday activities and HRQOL outcomes may provide insights for personalized lifestyle-oriented health promotion efforts for individuals with chronic conditions. The purpose of this paper was to examine the between- and within-person relationships between activity engagement and HRQOL relevant measures in a sample of 92 workers with type 1 diabetes (T1D), from whom we collected ecological momentary assessment (EMA) data 5-6 times daily over 14 days. At each EMA prompt, information was collected on the activity participants just engaged in, and HRQOL relevant metrics (e.g. mental health, blood glucose, fatigue, functioning). Momentary reports of "caring for others", and more frequently "caring for others", were both associated with decreased HRQOL. Reporting napping 10% or more of the time during a person's waking hours, but not the momentary experience of napping, was associated with decreased HRQOL. Momentary reports of sleeping were associated with low activity satisfaction relative to other activities, but higher activity importance. Study results provided a quantitative representation of the lived experience of T1D covering multiple types of activity engagement, which potentially has health promotion implications for workers with T1D.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11482-023-10171-2.

The contribution of the smartphone use to reducing depressive symptoms of Chinese older adults: The mediating effect of social participation

Background

Depression is a prevalent mental health disorder. Although Internet use has been associated with depression, there is limited data on the association between smartphone use and depressive symptoms. The present study aimed to investigate the relationship between smartphone use and depressive symptoms among older individuals in China.

Methods

5,244 Chinese older individuals over the age of 60 were selected as the sample from the China Longitudinal Aging Social Survey (CLASS) 2018 dataset. The dependent variable "depression symptoms" was measured using the 9-item Center for Epidemiologic Studies-Depression (CES-D) scale. The study employed multiple linear regression to investigate the relationship between smartphone use (independent variable) and depressive symptoms in older people. Thorough analyses of robustness, sensitivity, and heterogeneity were conducted to ensure the robustness and sensitivity of the findings. Additionally, mediating effect analysis was performed to elucidate the mechanism through which the dependent and independent variables were related.

Results

Empirical study indicated that smartphone use had a negative impact on depressive symptoms among older adults, specifically leading to a reduction in such symptoms. The above-mentioned result was verified through endogenous and robustness tests. The heterogeneity analysis revealed that older individuals aged 70 years and above, male, and residing in urban areas exhibited a stronger association between smartphone use and depressive symptoms. Furthermore, the mediating effect model indicated that political participation, voluntary participation, and active leisure participation mediated the relationship between smartphone use and lower levels of depression symptoms among the older adults. However, passive leisure participation had a suppressing effect on the relationship between smartphone use and reduced depressive symptoms among the older adults.

Limitations

The causal relationship between variables required further investigation with a longitudinal design.

Conclusion

These findings suggested that smartphone use may be considered an intervention to reduce depression symptoms among older people by increasing levels of political participation, voluntary participation, and active leisure participation.

Changes in leisure activities of the elderly due to the COVID-19 in Korea

Recreational activities such as physical and social activities are key components of a healthy life for the elderly. Since the outbreak of Corona 19, leisure facilities such as indoor sports facilities, religious facilities, and cultural facilities have been closed, and group activities such as volunteer activities and clubs are also being held under control. These measures are expected to bring about many changes in the leisure activities of the elderly. In this study, an empirical analysis was made on how COVID-19 caused changes in leisure activities of the elderly using national statistical data. For the data analysis, raw data of the "2019 National Leisure Activities Survey" and "2020 National Leisure Activities Survey" conducted by the Ministry of Culture, Sports and Tourism were used, and data of a total of 5,069 elderly people were analyzed. As for the analysis method, the changes in leisure activities of the elderly before and after COVID-19 in terms of participation rate were compared and analyzed. In addition, the changes in leisure activities of the elderly in terms of the type of leisure activities were examined before and after COVID-19 as well. As a result of the analysis, the participation rate in sports activities, hobbies and entertainment activities, and leisure activities increased, while the participation rates in culture and art viewing and participation activities, sports viewing activities, tourism activities, and social activities decreased. In particular, it was found that the proportion of the elderly spending leisure time centered on active and social activities decreased, and the proportion of the elderly consuming leisure time centered on passive activities increased. As a result, it was found that the leisure activities of the elderly are changing passively due to COVID-19. Leisure support policies for active leisure activities of the elderly are likely to be necessary.