Community support, social isolation and older adults' life satisfaction: evidence from a national survey in China

OBJECTIVES

Despite the recognized importance of community social service and community built facility for enhancing older adults' life satisfaction, the mechanisms underlying their relationship have not been thoroughly examined. This study aims to complement the existing knowledge by investigating the mediating role of social disconnectedness and loneliness in the association between community support and life satisfaction among older adults.

METHODS

Using data from the 2018 China Longitudinal Aging Social Survey, the study analyzes responses from 9,874 Chinese older adults (mean age = 71.30 years, SD = 7.30). We conducted descriptive statistics and Pearson's correlation to explore the variables. This study also used Mplus 8.0 to conduct a path analysis model that evaluated both the direct and indirect effects of community social service and built facility on life satisfaction. Social disconnectedness and loneliness were included as mediating variables in this model.

RESULTS

The present study results show that both community social service and community built facility are positively associated with life satisfaction among older adults, and community social service is more imporatant for enhancing the life satisfaction. In addition, these associations are mediated by social disconnectedness and loneliness.

CONCLUSION

Our research suggests that strengthening community social service programs and improving the built environment can reduce social disconnectedness and loneliness among older adults, ultimately enhancing their life satisfaction. Specifically, policymakers can invest in targeted interventions to enhance social connectedness and reduce loneliness, with the goal of improving the overall well-being of older adults.

Social Participation of Older Adults in Rural and Urban Areas: A Cross-Sectional Survey in Turkey

Social participation is important in terms of active aging and quality of life during old age. This cross-sectional study aimed to determine the social participation of older adults in rural and urban areas in Turkey. Related factors were similarly identified. The sample comprised 1,224 people over the age of 60, with a mean of 69.78 ± 7.48 years. Among the participants, 61.4% live in urban areas. The data were collected in family health centers through face-to-face interview and the Interview Form, Social Participation Assessment Form, and Social Participation Dimension of the Turkish Version of the Aging Module of the World Health Organization Quality of Life (WHOQOL) Scale. The scores obtained from the social participation dimension of the scale among the elderly in urban areas were higher than those obtained among the elderly in rural areas (p = .002). In addition, older adults in the urban areas who talked on the phone several times a month (p = .025), went to concerts, theater/cinema, museum/exhibition, various visual/musical shows (p = .046), and engaged in gardening (p = .032) obtained higher scores in the social participation dimension than the other participants. Health care professionals should take an advocacy role in building relationships with policy makers and create suitable socialization opportunities for older adults in urban and rural areas.

Applying to a nursing home is a way to maintain control of life-Experiences from Swedish nursing home applicants

BACKGROUND

Swedish social policy enables ageing in place with support from home-based care services despite high age and/or declining health.

AIM

This study aims to describe the daily life experiences behind the decision to apply for a nursing home placement in older adults ageing in place.

MATERIALS AND METHODS

A qualitative design was chosen, and 11 semi-structured interviews were conducted and analysed using inductive qualitative content analysis.

RESULTS

The participants described a feeling of dependence in which they had to ignore their personal privacy when receiving home-based care. They reached a turning point when ageing in place was, for several reasons, no longer considered an acceptable option. This influenced their choice to apply to a nursing home where they expected that they could maintain control over their lives.

DISCUSSION AND CONCLUSION

The results indicate that when enhancing ageing in place it is important to enable older adults to receive support to maintain autonomy in daily activities and to have the opportunity to age in the right place.

Using Photovoice to understand physical and social living environment influence on adherence to diabetes

Within the past several years, a considerable body of research on adherence to diabetes regimen has emerged in public health. However, the focus of the vast majority of these studies has been on the individual traits and attitudes affecting adherence. Still little is known on the role of the social and physical context in supporting or hindering diabetes self-management, particularly from a qualitative standpoint. To address these limitations, this paper presents the findings of a Photovoice study on a sample of 10 type 2 diabetic older adults living in a deprived neighbourhood of an Italian city. The findings reveal that the possibility to engage in diet, exercise and blood sugar monitoring seems to be more affected by physical and social elements of the respondents' environment than by the interviewees' beliefs and attitudes. Both environmental barriers and social isolation emerge as barriers to lifestyle changes and self-care activities related to blood sugar monitoring. The predominance of bonding social capital, the scant level of trust and the negative perception of local health services result in a low level of social cohesion, a limited circulation of health information on diabetes management and, consequently, in poor health outcomes.

Trajectories of Social Participation and Its Predictors in Older Adults: Based on the CLHLS Cohorts from 2002 to 2018

Social participation is a key factor in achieving active aging. This study aimed to explore the trajectories and predictors of social participation changes among older adults in China. The data used in this study are from the ongoing national longitudinal study CLHLS. A total of 2492 older adults from the cohort study were included. Group-based trajectory models (GBTM) were used to identify potential heterogeneity in longitudinal changes over time and investigate associations between baseline predictors and trajectories for different cohort members using logistic regression. Four different trajectories of social participation were reported in older adults, namely, stable (8.9%), slow decline (15.7%), lower score with decline (42.2%), and higher score with decline (9.5%). On multivariate analyses, age, years of schooling, pension, mental health, cognitive function, instrumental activities of daily living, and initial social participation scores significantly impact the rate of change in social participation over time. Four trajectories of social participation were identified in the Chinese elderly population. Management of mental health, physical function, and cognitive function appear to be important in maintaining the long-term social participation of older people in the community. Early identification of factors influencing the rapid decline in social participation and timely interventions can maintain or improve social participation levels in older adults.

Impacts of psychological resources, social network support and community support on social participation of older adults in China: Variations by different health-risk groups

Social participation comprises comprehensive interactions between individual health and relevant environmental characteristics, which play an increasingly important role in promoting older adults' health and quality of life. Although many studies have examined impacts of various factors on the social participation of older adults, some internal mechanisms between health characteristics and environmental characteristics have not been revealed. This study aimed to examine the moderating effects of health characteristics on the relationships among psychological resources, social network support, community support and social participation of Chinese older adults. Based on some key health indicators, this study used the two-step cluster algorithm to divide the participants aged over 60 years from the Chinese Longitudinal Aging Social Survey in 2016 (N = 8669) into low (47.2%), moderate (33.8%) and high (18%) health risk groups. A multiple-group structural equation model was then built to examine the effects of psychological resources, social network support and community support on social participation across the three groups. The results suggested that with the increase in health risks, the contributions of psychological resources and community support to social participation decreased from 28.6% to 23.7% and from 61.5% to 50.7%, respectively, while that of social network support increased from 9.9% to 25.6%. These variations suggest that individual health has a significant moderating effect on the psychological and social compensating mechanisms of the social participation among Chinese older adults.

Neighbourhood environmental influences on older adults' physical activities and social participation in Singapore: A photovoice study

Physical activities and social participation have vast health benefits for older adults and are also known to influence each other in everyday lives of older adults. In the quest for healthy ageing in place, it is vital to investigate the role of neighbourhood environmental factors in maintaining and/or initiating physical activities and social participation in older adults. Using the photovoice method, this qualitative research aims to examine how the physical and social neighbourhood environment influences physical activities, social participation, and instances where they occur together among 30 older adults in three Singapore neighbourhoods. A thematic analysis of 820 photographs, their descriptions, and 21 semi-structured individual and group interviews reveals that participants' physical activities and social participation are influenced by neighbourhood features during everyday movements (themes related to walking trips and resting places), and at destination nodes (themes on destinations and events where people often met and/or accessed amenities and services). Environmental qualities grounded in the local context affect older adults' outdoor activities. Physical activities and social participation in older adults may be planned or spontaneous, occurring independently, simultaneously or one after another in supportive neighbourhood environments.

The Role of Social Engagement in Older Adults' Health

The purpose of the current study was to explore the association between social engagement and the health status, cognition, and perceived well-being of older adults using data from the National Health and Aging Trends Study. Descriptive statistics, clustering, and regression modeling were performed to analyze the data. We used the regression model to identify statistically significant relationships between the representative variables and the extent to which participants participated in social activities. The most representative variable for each of the three clusters was selected and fitted to the regression model, which consists of (1) acute health problems and events, (2) cognitive and communication barriers, and (3) chronic conditions contributing to long-term health status. A regression model found that two factors-cognitive and communication barriers and chronic conditions contributing to long-term health status-were statistically significant in determining social engagement in older adults. Health care providers should consider various factors in planning and implementing social programs that can positively engage older adults. [Research in Gerontological Nursing, xx(x), xx-xx.].

Scoping study of definitions of social participation: update and co-construction of an interdisciplinary consensual definition

Background

considering the importance of social participation for quality of life and active ageing in older adults, it is an important target of social and health professionals’ interventions. A previous review of definitions of social participation in older adults included articles up to 2009; new publications and changes in the social context (e.g. social media and the COVID-19 pandemic) justify continuing this work.

Objective

this paper provides an updated inventory and synthesis of definitions of social participation in older adults. Based on a critical review by content experts and knowledge users, a consensual definition is proposed.

Methods

using a scoping study framework, four databases (MEDLINE, CINAHL, AgeLine, PsycInfo) were searched with relevant keywords. Fifty-four new definitions were identified. Using content analysis, definitions were deconstructed as a function of who, how, what, where, with whom, when, and why dimensions.

Results

social participation definitions mostly focused on people’s involvement in activities providing interactions with others in society or the community. According to this new synthesis and input from content experts and knowledge users, social participation can be defined as a person’s involvement in activities providing interactions with others in community life and in important shared spaces, evolving according to available time and resources, and based on the societal context and what individuals want and is meaningful to them.

Conclusion

a single definition may facilitate the study of active ageing and the contribution of older adults to society, socioeconomic and personal development, benefits for older adults and society, self-actualisation and goal attainment.

A bibliometric analysis of Health Promotion International content regarding unions, unionization and collective agreements

A recent article brought together the health benefits of unionization and working under collective agreements. It was noted how Canadian health promotion texts, reports and statements made no mention of unionization and working under collective agreements as promoting health. This was seen as a significant omission and reasons for this were considered. In this article this analysis is extended to consider how contributors to the flagship health promotion journal Health Promotion International (HPI) conceptualize unions, unionization and working under collective agreements as promoting health. Of 2443 articles published in HPI since its inception, 87 or 3.6% make mention of unions, unionization, collective agreements or collective bargaining, with most saying little about their promoting health. Instead, 20 make cursory references to unions or merely see them as providing support and engagement opportunities for individuals. Forty-five depict unions or union members as involved in a health promotion programme or activity carried out by the authors or by government agencies. Only 33 articles explicitly mention unions, unionization or collective agreements as potentially health promoting, representing 1.3% of total HPI content since 1986. We conclude that the health promoting possibilities of unionization and working under collective agreements is a neglected area amongst HPI contributors. Reasons for this are explored and an Organisation for Economic Cooperation and Development report on the importance of collective bargaining is drawn upon to identify areas for health promotion research and action.

The Effects of a Social Participation App on Seniors

BACKGROUND

Advancements in medical care have increased the average life span in many countries, resulting in a generally longer postretirement life span. However, retirees may find it difficult to adapt to retirement. Therefore, encouraging retirees to engage with society is important.

PURPOSE

In this study, a senior social participation mobile software application (SSP-App) was developed to stimulate social participation among seniors with the goal of improving their social participation intentions and behaviors.

METHODS

After developing the SSP-App based on user experiences, a quasi-experimental study was conducted. Participants were recruited from the Keelung Ren'ai Community Center. Next, Random Allocation Software Version 1.0.0 software was used to randomly allocate the participants into experimental and control groups. The 54 participants in the experimental group took part in an SSP-App program, whereas the 53 participants in the control group did not participate in any experimental treatment program. Measurements were conducted at Week 4 (T1) and Week 12 (T2) to evaluate the effects. Data were collected using a demographic datasheet, Geriatric Depression Scale-Short Form, Emotional and Social Support Scale, Social Participation Intention Scale, and Social Participation Behavior Scale. The generalized estimating equations method was used to determine intervention effectiveness.

RESULTS

The SSP-App has six main functions, including an activity partner message board, an activity search function that provides information about different activities, a "Seniors Learning Kiosk" that provides useful information, transportation information, an activity planning and reminder system, and a "First-Aid Station." Most participants in the SSP-App precursor test expressed approval. At T1, effects were observed in social participation intention only. However, at T2, effects were observed in both social participation intention and social participation behavior.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The SSP-App developed in this study uses information and communication technology and multiple strategies covering information provision, social support, education, and reminders. Social participation obstacles must be overcome to effectively provide seniors with social participation opportunities and improve their social participation.

Voices of Experience: What Do Low-Income Older Adults Tell Us About Mobility, Technology, and Social Participation?

Mobility and technology can facilitate in-person and virtual social participation to help reduce social isolation, but issues exist regarding older adults' access, feasibility, and motivation to use various forms of mobility and technology. This qualitative study explores how a diverse group of low-income, urban-living older adults use mobility and technology for social participation. We conducted six focus groups (N = 48), two each in English, Spanish, and Korean at a Los Angeles senior center. Three major themes emerged from thematic analysis: using technology for mobility; links between mobility and social participation; and technology-mediated social participation. Cost, perceived safety, (dis)ability, and support from family and friends were related to mobility and technology use. This study demonstrates the range of mobility and technology uses among older adults and associated barriers. The findings can help establish a pre-COVID-19 baseline on how to make mobility and technology more accessible for older adults at risk of isolation.

Social Participation in Older Adults after Relocation to Long-Term Care Institutions in China: A Qualitative Study

This study used focus group interviews with older Chinese long-term care residents (N = 40), to explore their perspectives and experiences of social participation in long-term care institutions. Based on previously established taxonomy of different activity levels, we found that their social participation centered on level 3 (involvement with others), level 4 (task-oriented activities), and level 5 activities (helping others). Participants indicated that their social participation had changed after relocation. Thematic analysis revealed three main themes: increased spare time, increased presence of peers, and new participation opportunities with lost old hobbies. Focusing on the positive changes after relocation and promoting meaningful activities of different levels may benefit long-term care residents.

Social Participation in the Daily Lives of Frail Older Adults: Types of Participation and Influencing Factors

OBJECTIVES

The advantages of social participation for older adults are well established and have been adopted in aging policy frameworks. However, little is known about the social participation of frail older adults. This research examined the types of social interaction of very frail older adults and the factors influencing this participation.

METHOD

Interviews with 38 very frail older adults were analyzed using Levasseur and colleagues' (Levasseur, Richard, Gauvin, & Raymond (2010). Inventory and analysis of definitions of social participation found in the aging literature: Proposed taxonomy of social activities. Social Science and Medicine (1982), 71, 2141-2149) taxonomy activity levels of involvement with others. A qualitative hybrid approach with inductive and deductive thematic analyses was used.

RESULTS

Participants often disengaged from activities with high involvement with others, preferring activities with less involvement. Low-key participation emerged as an important type of social participation enabling frail older adults to remain engaged in society. Key factors that influenced social participation were functional decline, and the physical (e.g., traffic, the disappearance of local stores) and social environment (e.g., social networks and the presence of meeting places such as community centers).

DISCUSSION

Findings advance our knowledge and recognition of the different ways frail older adults participate in society. Despite their frailty, older adults wish to stay socially active. Focusing on the social environment in the frameworks and policies of Age-Friendly Cities and Communities will benefit these individuals.

Beginning on an age-friendly journey: Barriers to implementing age-friendly initiatives

Objective

To explore the barriers to communities in New Zealand developing age‐friendly initiatives.

Methods

A qualitative participatory approach underpinned this study. Semi‐structured digitally recorded individual interviews were undertaken with 24 government officials, local government steering group members and community representatives from an urban city, provincial city and a rural district. A general inductive data analytic process was undertaken. The consolidated criteria for reporting qualitative research (COREQ) guidelines were followed to ensure rigour in this study.

Results

(a) Being at the beginning, (b) Minimal diversity and (c) Problems getting started were three key issues identified.

Conclusions

New Zealand is in the early stages of becoming age‐friendly. Findings from this study provide a place‐based New Zealand perspective and have influenced central government social policy and practice development, culminating in resources supporting local government and communities to successfully implement age‐friendly initiatives.

Prefrailty: The Relationship Between Daily Activities and Social Participation in Older Persons

OBJECTIVES

To analyze prefrailty's relationship with limitations in activities of daily living (ADLs) and restrictions in social participation.

METHOD

Robust (Fried 0/4; n = 214; M_age = 82.3 years [SD ±2.1]) and prefrail (Fried 1-2/4; n = 191; M_age = 83.8 years [SD ±3.2]) community-dwelling older individuals were included. Frailty scores were obtained from weight loss, exhaustion, gait speed, and grip strength. A total disability index (DI) expressed dependency for basic (b-), instrumental (i-), and advanced (a-)ADLs. Total participation score, being a member, total number of memberships, being a board member, level of participation, membership over time, volunteering, and formal participation represented social participation.

RESULTS

Logistic regression retained age (OR = 1.224; 95% CI = [1.122, 1.335]), sex (OR = 3.818; 95% CI = [2.437, 5.982]), and a-ADL-DI (OR = 1.230; 95% CI = [1.018, 1.486]) as variables significantly related to prefrailty (68.3%; χ² = 68.25; df = 3; p < .001).

DISCUSSION

Subtle limitations in a-ADLs, higher age, and being a man were associated with prefrailty, revealing the possible role of personal and culturally related a-ADLs as red flags for (pre)frailty.

Environmental Characteristics Associated with Older Adults' Social Participation: The Contribution of Sociodemography and Transportation in Metropolitan, Urban, and Rural Areas

Although social participation fosters older adults' health, little is known about which environmental characteristics are related to greater participation in social activities. The Canadian Community Health Survey (n = 2737), a transportation survey, and multiple secondary data sources were used to identify the environmental characteristics associated with older Quebecers' social participation according to living area. Greater social participation was associated with: (1) a higher concentration of older adults (IRR = 2.172 (95% CI 1.600, 2.948); p < 0.001), more kilometers traveled by paratransit (IRR = 1.714 (95% CI 1.286, 2.285); p < 0.01), a lack of medical clinics (IRR = 0.730 (95% CI 0.574, 0.930); p = 0.01), and more funded home adaptations (IRR = 1.170 (95% CI 1.036, 1.320); p = 0.01) in large metropolitan areas; (2) larger paratransit fleets (IRR = 1.368 (95% CI 1.044, 1.791); p = 0.02) and a lower density of road intersections (IRR = 0.862 (95% CI 0.756, 0.982); p = 0.03) in regular metropolitan areas; (3) less social deprivation (IRR = 1.162 (95% CI 1.025, 1.318); p = 0.02) in urban areas; and (4) a higher concentration of older populations (IRR = 2.386 (95% CI 1.817, 3.133); p < 0.001) in rural areas. According to these findings, social participation interventions should target the local environment-for example, by providing more social interaction opportunities for older adults living in younger neighborhoods and by improving access to public transportation, especially paratransit.

Digitalising the Age-Friendly City: Insights from Participatory Action Research

The World Health Organization’s age-friendly city initiative emerged as a response to the intersecting global trends of population ageing and urbanisation. However, a third global trend—digitalisation—has largely been overlooked in research and policy making relating to age-friendly cities and communities. Within the context of a general shift towards online civic participatory activities, this article explores older adults’ digital citizenship in an age-friendly city in the North of England. Drawing on interviews, observations and field notes from design workshops as part of an ongoing participatory action research project, we consider two key questions. First, how does an age-friendly city stakeholder organisation of older adults make use of digital technologies in order to provide digital information and communications? Second, what is the potential of digital audio to increase civic participation in later life and local engagement with age-friendly issues? Our analysis focuses on two domains of the World Health Organization’s age-friendly city framework: Communication and information and civic participation. First, we report on the stakeholder organisation’s efforts to re-design their digital newsletter in order to provide information and communications to older residents about local work on ageing projects. We then outline the organisation’s efforts, in a public setting, to engage with digital audio as a way to increase the participation of older residents with age-friendly topics. We conclude by suggesting the need to re-frame the role of digital technologies within the age-friendly city, broadening the scope from accessibility towards enhancing digital citizenship opportunities.

Out-of-Home Mobility and Social Participation of Older People: a Photo-Based Ambulatory Assessment Study

Research has shown that social participation contributes to older people’s healthy ageing. Out-of-home mobility may promote higher levels of social participation among older people. However, mobility and social participation are sophisticated constructs. Social participation can be distinguished among different levels, such as being alone, being alone surrounded by others, interacting with others or engaging in activities together. Social participation and time spent in out-of-home-mobility can be difficult to remember and therefore difficult to assess. Picture-based ambulatory assessment provides valid and reliable information about people’s mobility as well as their level of participation with high ecological validity. The aim of the study was to investigate older people’s level of social participation and its association with high or low out-of-home mobility. In sum, 23072 pictures (mean per person = 2307; SD = 686.7) involving ten older people (mean age = 75.4 years; SD = 7.5 years) living in southwestern Germany were analysed. They were asked to wear a wearable camera for two consecutive days. Images were automatically captured every 15 seconds. Image analysis shows that study participants spent most of their time alone (at approximately 35% of analysed time). Out-of-home mobility was associated with higher levels of social participation, such as helping others (chi2 = 200,664, df = 5, p < .001). Picture-based ambulatory assessment can assist in the gathering of necessary sophisticated information that is difficult to assess via questionnaires or other similar methods.

Constructing and negotiating social participation in old age: experiences of older adults living in urban environments in the United Kingdom

The age-friendly cities and communities movement has focused on how to better support older adults to age well within urban environments. Central to ‘ageing well’ and ‘active ageing’ agendas is ensuring that older adults can participate in meaningful forms of social participation. The benefits of social participation in old age have been well documented, and research amongst community-dwelling older adults has explored some of the neighbourhood qualities that facilitate or impede such forms of engagement. However, understandings of how older adults construct and negotiate social participation within everyday urban environments have been largely unexplored. To address this gap, we present results from 104 interviews conducted with older adults living in three cities and nine neighbourhoods in the United Kingdom (UK). The findings explore three themes generated from the research: ‘constructing meaningful social participation in old age’, ‘negotiating access to social participation’ and ‘navigating home and community’. Across these themes, the paper describes how experiences of social participation in old age involve a number of inter-connected physical, psychological and social processes experienced by individuals across a range of environmental settings including the home, outdoor spaces and community facilities. The paper concludes by discussing the implications of the findings for practice, specifically in the delivery of age-friendly communities.

The effects of small-scale physical and social environmental interventions on walking behaviour among Dutch older adults living in deprived neighbourhoods: results from the quasi-experimental NEW.ROADS study

PURPOSE

Improving the physical and social conditions of residential neighbourhoods may increase walking, especially among older people. Evidence on the effects of physical and social environmental interventions, and particularly the combination of both, on walking behaviour is scarce. We evaluated the effects of a small-scale physical environmental intervention (designated walking route), a social environmental intervention (neighbourhood walking group) and the combination of both on walking behaviour of older adults living in deprived neighbourhoods.

METHODS

Survey data of 644 older adults residing in four deprived neighbourhoods of Rotterdam, the Netherlands, were used to compare changes in walking behaviour over time (weekly minutes spent recreational walking, utilitarian walking and total walking) of those exposed to 1) a designated walking route (physical condition), 2) walking groups (social condition), 3) walking routes and walking groups (combined condition), and 4) no intervention (control condition). Measurements took place at baseline (T0), and 3 months (T1) and 9 months (T2) after the intervention. Data were analysed on a multiple imputed dataset, using multi-level negative binomial regression models, adjusting for clustering of observations within individuals. All models were adjusted for demographic covariates.

RESULTS

Total time spent walking per week increased between T0 and T1 for all conditions. The Incidence Rate Ratio (IRR) for the physical condition was 1.46 (95% CI:1.06;2.05) and for the social intervention 1.52 (95%CI:1.07;2.16). At T2, these differences remained significant for the physical condition, but not for the social condition and the combined condition. These findings were mirrored for utilitarian walking. No evidence was found for an effect on recreational walking.

CONCLUSION

Implementing small scale, feasible, interventions in a residential neighbourhood may increase total and utilitarian walking behaviour among older adults.

Area effects on the level and development of social exclusion in later life

Social exclusion in later life is associated with decreased quality of life and poorer health outcomes. Reducing the number of people at risk of exclusion is a key theme in European social policy, but there is limited understanding of the relationship between neighbourhood characteristics, personal attributes and the level and development of social exclusion in later life. In this paper, cross-classified multilevel growth curve models for predicting exclusion are fitted to seven waves of data from the English Longitudinal Study of Ageing, collected between 2002 and 2015, allowing for the investigation of causal mechanisms linking area characteristics and exclusion in later life, including access to services and amenities, participation in civic, cultural and leisure activities and relationships with friends and family. Results show that living in a deprived area is associated with increased levels of exclusion, and this explained the higher levels of exclusion found for urban compared with rural areas. Population turnover among local residents did not impact on exclusion levels, but length of residence and the degree to which a person feels attached to their neighbourhood did, with ageing in place and stronger attachments predicting lower levels of social exclusion. In terms of individual characteristics, men, those in poor health, people with low levels of wealth or education, and those aged 80 or older, were more likely to experience increased levels of exclusion, while retirement and marriage provided a protective effect. The paper contributes new insights into the pathways through which characteristics of both individuals and neighbourhoods predict social exclusion in later life, and concludes by discussing the policy implications raised by the research.

Measuring Social Participation in the Health and Retirement Study

BACKGROUND AND OBJECTIVES

Large data sets have the potential to reveal useful information regarding social participation; however, most data sets measure social participation via individual items without a global assessment of social participation.

RESEARCH DESIGN AND METHODS

We used data from the Health and Retirement Study (HRS) to assess whether 8 items from questionnaire pertaining to social participation (religious attendance, caring for an adult, activities with grandchildren, volunteering, charity work, education, social clubs, nonreligious organizations) formed a reliable, cohesive scale and to explore the predictive validity of this scale. We included respondents 65 years and older in the HRS who returned the psychosocial questionnaire in 2010 and 2012 with responses to the social participation items (n = 4,317 and n = 3,978). Three scales were explored: SoPart-30 using the original scoring; SoPart-10 using modified scoring; and SoPart-5 using dichotomous scoring.

RESULTS

Five items were retained as a single factor for each scale, and graded response models and Mokken scale analysis confirmed the scale items with the SoPart-10 scale having the highest reliability (alpha = 0.74).

DISCUSSION AND IMPLICATIONS

Results suggest that a scale derived from the social participation items in the HRS may be useful in characterizing general social participation levels and identifying modifiable factors that can promote it in older populations.

Ageing, old age and older adults: a social media analysis of dominant topics and discourses

Whilst representations of old age and older people in traditional media have been well documented, examinations of such representations within social media discourse are still scarce. This is an unfortunate omission because of the importance of social media for communication in contemporary society. In this study, we combine content analysis and discourse analysis to explore patterns of representation on Twitter around the terms ageing, old age, older people and elderly with a sample of 1,200 tweets. Our analysis shows that ‘personal concerns/views’ and ‘health and social care’ are the predominant overall topics, although some topics are clearly linked with specific keywords. The language often used in the tweets seems to reinforce negative discourses of age and ageing that locate older adults as a disempowered, vulnerable and homogeneous group; old age is deemed a problem and ageing is considered something that needs to be resisted, slowed or disguised. These topics and discursive patterns are indeed similar to those found in empirical studies of social perceptions and traditional media portrayal of old age, which indicates that social media and Twitter in particular appears to serve as an online platform that reproduces and reinforces existing ageist discourses in traditional media that feed into social perceptions of ageing and older people.

Rural old-age social exclusion: a conceptual framework on mediators of exclusion across the lifecourse

Social exclusion amongst rural-dwelling older adults and the role of the diversity of people and places in mediating the construction of that exclusion has not been adequately investigated or conceptualised in the international literature. Consequently, how ageing in a rural community can function to disadvantage or protect older people remains poorly understood. With the aim of advancing conceptual understanding on rural old-age social exclusion, this article explores how exclusion is manifest in the lifecourse experiences of rural-dwelling older adults and the role of mediating factors in the construction of exclusion in different kinds of rural places. The analysis draws on ten rural case-study sites across Ireland and Northern Ireland, encompassing five kinds of rural communities: dispersed rural; remote rural; island rural; village rural; and near-urban rural. Data come from 106 interviews with older people ranging in age from 59 to 93 years. Rural old-age social exclusion is confirmed as a multi-dimensional construct, involving: social relations; service infrastructure; transport and mobility; safety, security and crime; and financial and material resources. This analysis demonstrates that social exclusion for rural-dwelling older people is multi-layered, and its prevalence and form is shaped by four mediating factors: individual capacities; lifecourse trajectories; place; and macro-economic forces. The findings are used to present a conceptual framework that emphasises the role of mediating forces on rural old-age social exclusion.

Extracurricular Involvement in High School and Later-Life Participation in Voluntary Associations

Objectives

Scholars have identified participation in voluntary associations as a central component of civic engagement for younger and older people alike. However, there has been little longitudinal examination of how such participation potentially fluctuates across multiple periods of the life course, as well as the extent to which involvement in youth is associated with participation in later life.

Method

We used data from the Wisconsin Longitudinal Study-which is among the oldest and most comprehensive cohort studies in the United States to date. Respondents reported their voluntary association participation periodically between the ages of approximately 36 and 72 years. Data collected from high school yearbooks were used to examine whether histories of extracurricular involvement in adolescence were associated with patterns of voluntary association participation across adulthood.

Results

Results from growth curve models indicated that, on average, voluntary association participation peaked in midlife and declined into the 60s and early 70s. Nevertheless, levels of participation were consistently higher among individuals with greater extracurricular involvement in high school, and the rate of decline in participation from midlife to young-old age was also less steep for these individuals.

Discussion

Findings support conceptualizing voluntary association participation among older adults as part of life course trajectories of participation, with influences originating as early as adolescence.

Associations Among Neighborhood Characteristics, Mobility Limitation, and Social Participation in Late Life

OBJECTIVES

Although emerging research suggests neighborhood characteristics can support and restrict social participation in older adults, further research regarding a wider range of neighborhood characteristics and interactions between individual and neighborhood characteristics is needed. This study explored associations between neighborhood characteristics and frequency of participation in three social activities among older adults and interactions between neighborhood characteristics and mobility limitation as they relate to participation.

METHOD

Data from the 2008 wave of the Health and Retirement Study linked with American Community Survey data were used. Participants included community-dwelling adults aged 65 years or older. Analysis involved multivariate logistic regression.

RESULTS

High proportion of neighborhood residents aged 65 and older was associated with increased odds of more frequent participation in all three activities. High population density was associated with increased odds of club attendance. High neighborhood social cohesion was associated with increased odds of attending nonreligious meetings. Interactions between walking limitation and population density or social cohesion related to increased odds of participation.

DISCUSSION

Findings suggest that improving older adults' ability to participate in community life and age in place requires strategies that consider how neighborhood and individual characteristics interact and how these characteristics may differentially affect types of participation.

Productive aging via volunteering: Does social cohesion influence level of engagement?

This study investigated whether neighborhood social cohesion influenced volunteer intensity over two years. The sample was drawn from Health and Retirement Study respondents who completed the 2010 or 2012 Psychosocial and Lifestyle Questionnaire (n = 12,929). Results showed that compared to nonvolunteers, a one-unit increase in neighborhood social cohesion increased the odds of moderate (OR: 1.07, p < .05) and high volunteering (OR: 1.10, p < .001). However, other productive roles, social contact, and education were significant in distinguishing high intensity from moderate volunteering while neighborhood social cohesion was not. Social workers should consider the neighborhood environment when recruiting volunteers.

Relationships between the neighborhood environment and depression in older adults: a systematic review and meta-analysis

ABSTRACTBackground:While depression is a growing public health issue, the percentage of individuals with depression receiving treatment is low. Physical and social attributes of the neighborhood may influence the level of depressive symptoms and the prevalence of depression in older adults.

METHODS

This review systematically examined the literature on neighborhood environmental correlates of depression in older adults. Findings were analyzed according to three depression outcomes: depressive symptoms, possible depression, and clinical depression. Based on their description in the article, environmental variables were assigned to one of 25 categories. The strength of evidence was statistically quantified using a meta-analytical approach with articles weighted for sample size and study quality. Findings were summarized by the number of positive, negative, and statistically non-significant associations by each combination of environmental attribute - depression outcome and by combining all depression outcomes.

RESULTS

Seventy-three articles met the selection criteria. For all depression outcomes combined, 12 of the 25 environmental attribute categories were considered to be sufficiently studied. Three of these, neighborhood socio-economic status, collective efficacy, and personal/crime-related safety were negatively associated with all depression outcomes combined. Moderating effects on associations were sparsely investigated, with 52 articles not examining any. Attributes of the physical neighborhood environment have been understudied.

CONCLUSION

This review provides support for the potential influence of some neighborhood attributes on population levels of depression. However, further research is needed to adequately examine physical attributes associated with depression and moderators of both social and physical neighborhood environment attribute - depression outcome associations.

Disability, residential environment and social participation: factors influencing daily mobility of persons living in residential care facilities in two regions of France

Background

Despite the context of individualization of public policies and promotion of independent living, residential care facilities (RCFs) (called “établissements medico-sociaux” in France) still represent the main system used by disabled people. Through a study of their daily mobility, this article proposes a geographical approach to the examination of factors influencing the social participation of disabled persons with motor impairments who live in residential care facilities.

Methods

The data were collected in three stages from several sources. We first carried out 24 semi-directive interviews among supervisory staff in all the institutions in two regions of France (Greater Paris and Upper Normandy) to better understand the nature of services offered by medico-social facilities. We next did field work in greater detail in 10 of these institutions. We selected residents by random sampling. These first stages then allowed us to study the mobility of residents and record their perceptions. We conducted participant observation and interviews with 81 disabled residents within the 10 RCF.

Data analysis enabled consideration not only of the role of the residential environment in people’s daily mobility, but the role of the institutions as well.

Results

We identified three typical profiles of mobility practices depending on the facilities: “the islanders”, living in isolated facilities far from public transportation, or in so-called “difficult” neighborhoods; people who alternate individual and group mobility in a more or less large area; and “the navigators” who have high mobility over a very large area, often living in facilities located in urban areas. The study also enabled an analysis of the obstacles and facilitators inside and outside the residential facilities. These place restrictions on social participation by disabled adults. However, possibilities for individual negotiation may enable bypassing some obstacles.

Conclusions

The three ideal-type profiles of mobility analyzed constitute adaptations to the environment by residents and the institution. The research techniques used and the presentation of data (in the form of diagrams) enabled a better understanding of the mobility of severely disabled adults living in an institution, a population that is rarely studied.

Photovoicing the neighbourhood: Understanding the situated meaning of intangible places for ageing-in-place

Ageing-in-place is considered important for the health of older adults. In this paper, inspired by a constructivist approach to ageing-in-place, we unravel professionals' and older adults' constructions of ageing-in-place. Their perspectives are studied in relation to a policy that aims to develop so-called 'lifecycle-robust neighbourhoods' in the southern part of the Netherlands. We conducted a photovoice study in which 18 older adults (70-85 years) living independently and 14 professionals (social workers, housing consultants, neighbourhood managers and community workers) were asked to photograph and discuss the places they consider important for ageing-in-place. Based on a theoretically informed analysis of the data, we found that professionals primarily consider objective characteristics of neighbourhoods such as access to amenities, mobility and meeting places as important enablers for older adults to remain living independently. Analysis of older adults' photographs and stories show that they associate ageing-in-place with specific lived experiences and attachments to specific, intangible and memory-laden public places. We conclude that exploring these experiences helps to increase current knowledge about place attachment in old age.

Meanings of ‘lifecycle robust neighbourhoods’: constructing versus attaching to places

In Western welfare states, notions of age-friendly communities and ageing-in-place are increasingly important in new health policies. In the Netherlands, care reforms are modifying the former welfare state to be more participatory; local governments are seeking collaborative solutions. Municipalities and housing, care and welfare organisations in the southern part of the country developed the concept of ‘lifecycle robust neighbourhoods’, envisioned as places where older people can age-in-place. Although many scholars have used the concept ageing-in-place in their studies of neighbourhoods, we aim to unravel this concept further by exploring how this particular ageing policy plays out in practice. This paper explores what the development of ‘lifecycle robust neighbourhoods’ means in relation to notions of ageing-in-place and age-friendly communities. We used ethnography (interviews, observations and focus groups) to reveal how, on the one hand, the policy makers, housing, care and welfare directors and representatives of older people, as developers of ‘lifecycle robust neighbourhoods’ and, on the other hand, older people, give meaning to places to age-in-place. It becomes clear that ageing-in-place has a different meaning in policy discourses than in practice. While developers mainly considered place as something construable, older people emotionally attached to place through lived experiences.

Social exclusion of older persons: a scoping review and conceptual framework

As a concept, social exclusion has considerable potential to explain and respond to disadvantage in later life. However, in the context of ageing populations, the construct remains ambiguous. A disjointed evidence-base, spread across disparate disciplines, compounds the challenge of developing a coherent understanding of exclusion in older age. This article addresses this research deficit by presenting the findings of a two-stage scoping review encompassing seven separate reviews of the international literature pertaining to old-age social exclusion. Stage one involved a review of conceptual frameworks on old-age exclusion, identifying conceptual understandings and key domains of later-life exclusion. Stage two involved scoping reviews on each domain (six in all). Stage one identified six conceptual frameworks on old-age exclusion and six common domains across these frameworks: neighbourhood and community; services, amenities and mobility; social relations; material and financial resources; socio-cultural aspects; and civic participation. International literature concentrated on the first four domains, but indicated a general lack of research knowledge and of theoretical development. Drawing on all seven scoping reviews and a knowledge synthesis, the article presents a new definition and conceptual framework relating to old-age exclusion.

Physical and social environmental changes to promote walking among Dutch older adults in deprived neighbourhoods: the NEW.ROADS study

BACKGROUND

Physical activity is important for healthy ageing, and daily walking is seen as a feasible way to be active at older ages. Yet, many older persons, particularly in lower socioeconomic groups and residing in deprived neighbourhoods, are insufficiently active. Creating a physical and social neighbourhood environment that is more supportive for walking has the potential to improve walking behaviour. Current evidence of the impact of changes to the physical and/or social environmental on walking behaviour is scarce. The aim of the NEW.ROADS study is to design, implement and evaluate changes to the physical and social environment for the purpose of increasing walking behaviour among older residents of deprived neighbourhoods.

METHODS

Physical and social environmental interventions were developed by matching scientific evidence on environmental determinants of walking, with input from the target population and stakeholders, and ongoing neighbourhood activities. Specifically, a neighbourhood walking route was designed and marked, and neighbourhood walking groups were organised. These environmental interventions were evaluated in a four-armed experimental study. In addition, the design of the study to evaluate the effect of these environmental changes on walking behaviour is described.

DISCUSSION

Designing and implementing environmental interventions is a complex endeavour, challenged by limited available theory and evidence. Input from the target population and professional stakeholders is essential, but may also put constraints on the evaluation.

TRIAL REGISTRATION

NTR3800 (registered 9/1/2013).

Associations of neighborhood environment with brain imaging outcomes in the Australian Imaging, Biomarkers and Lifestyle cohort

INTRODUCTION

"Walkable" neighborhoods offer older adults opportunities for activities that may benefit cognition-related biological mechanisms. These have not previously been examined in this context.

METHODS

We objectively assessed neighborhood walkability for participants (n = 146) from the Australian Imaging, Biomarkers and Lifestyle study with apolipoprotein E (APOE) genotype and two 18-month-apart brain volumetric and/or amyloid β burden assessments. Linear mixed models estimated associations of neighborhood walkability with levels and changes in brain imaging outcomes, the moderating effect of APOE ε4 status, and the extent to which associations were explained by physical activity.

RESULTS

Cross-sectionally, neighborhood walkability was predictive of better neuroimaging outcomes except for left hippocampal volume. These associations were to a small extent explained by physical activity. APOE ε4 carriers showed slower worsening of outcomes if living in walkable neighborhoods.

DISCUSSION

These findings indicate associations between neighborhood walkability and brain imaging measures (especially in APOE ε4 carriers) minimally attributable to physical activity.

Neighbourhood environment, physical activity, quality of life and depressive symptoms in Hong Kong older adults: a protocol for an observational study

INTRODUCTION

The neighbourhood environment can assist the adoption and maintenance of an active lifestyle and affect the physical and mental well-being of older adults. The psychosocial and behavioural mechanisms through which the environment may affect physical and mental well-being are currently poorly understood.

AIM

This observational study aims to examine associations between the physical and social neighbourhood environments, physical activity, quality of life and depressive symptoms in Chinese Hong Kong older adults.

METHODS AND ANALYSES

An observational study of the associations of measures of the physical and social neighbourhood environment, and psychosocial factors, with physical activity, quality of life and depressive symptoms in 900 Hong Kong older adults aged 65+ years is being conducted in 2012-2016. The study involves two assessments taken 6 months apart. Neighbourhood walkability and access to destinations are objectively measured using Geographic Information Systems and environmental audits. Demographics, socioeconomic status, walking for different purposes, perceived neighbourhood and home environments, psychosocial factors, health status, social networks, depressive symptoms and quality of life are being assessed using validated interviewer-administered self-report measures and medical records. Physical functionality is being assessed using the Short Physical Performance Battery. Physical activity and sedentary behaviours are also being objectively measured in approximately 45% of participants using accelerometers over a week. Physical activity, sedentary behaviours, quality of life and depressive symptoms are being assessed twice (6 months apart) to examine seasonality effects on behaviours and their associations with quality of life and depressive symptoms.

ETHICS AND DISSEMINATION

The study received ethical approval from the University of Hong Kong Human Research Ethics Committee for Non-Clinical Faculties (EA270211) and the Department of Health (Hong Kong SAR). Data are stored in a password-protected secure database for 10 years, accessible only to the named researchers. Findings will be submitted for publication in peer-reviewed journals.

Is volunteering in later life impeded or stimulated by other activities?

Purpose:

Volunteering among older adults has received increasing attention from researchers, policy makers, and associations. However, there remains a lack of knowledge in how volunteering is impacted by other activities in the lives of older adults. In order to understand activity engagement in later life, insights into the extent to which activities compete with or complement each other are necessary.

Methods:

Data for the present research were derived from the Belgian Aging Studies ( N = 23,768). The main objective is to uncover the activities that impede or stimulate actual volunteering and/or the likeliness to volunteer at an older age.

Results:

Structural equation models indicate a strong positive correlation between altruistic types of activities and actual volunteering. Furthermore, older adults active in personal leisure activities are more drawn to be potential volunteers.

Implications:

The article demonstrates that the activity level of older people is not sufficient to understand volunteering, that is, a distinction between the types of activities is essential.

Municipality and Neighborhood Influences on Volunteering in Later Life

This article explores the relationships between municipality features and volunteering by older adults. In the literature, strong evidence exists of the influence of place on older people’s health. However, the question how neighborhoods and municipalities promote or hinder volunteer participation remains under-explored. Data for the research are derived from the Belgian Aging Studies. We estimate logistic multilevel models for older individuals’ engagement in volunteering across 141 municipalities in Belgium ( N = 67,144). Analysis shows that neighborhood connectedness, neighborhood satisfaction, home ownership, and presence of services predict voluntary engagement at older ages. The findings support that perceptions and quality of social resources that relate to neighborhoods may be important factors to explain volunteering among older adults. Moreover, the findings suggest that volunteering in later life must be considered within a broader framework.