Physical, Cognitive, Social, and Emotional Mediators of Activity Involvement and Health in Later Life

Early Origins of Frailty: Do Later-Life Social Relationships Alter Trajectories of Decline?

Objectives: Social relationships are widely regarded as salubrious, but do they mediate the influence of childhood experiences on frailty in later life? Drawing from cumulative inequality theory, we assess the influence of childhood experiences and adult relationships on frailty trajectories. Methods: We analyzed data from the Health and Retirement Study to examine the influence of six domains of childhood experiences and social relationships on frailty trajectories over 8 years. Mediation analyses were completed with structural equation models. Results: Risky adolescent behavior, chronic disease, and impairments during childhood are associated directly with higher risk of initial frailty, but not over time. More social roles and higher social support mediate the relationship between childhood experiences and frailty, and the effect of more social roles continues over time. Discussion: This study provides compelling evidence that supportive social relationships mediate the risk and severity of frailty in later life associated with noxious childhood experiences.

A study on the impact of health shocks on subjective wellbeing of middle-aged people and older adults-Evidence from China

Introduction

The health issues that afflict middle-aged people and older individuals are a significant factor that affects their quality of life. It is crucial to investigate the impact of health shocks on the subjective wellbeing of this demographic and the mechanisms that underlie this impact to promote healthy aging.

Methods

This study utilized data from the China Family Panel Study in 2018 and 2020 to analyze the effects of HSs and their categories on the subjective wellbeing of middle-aged people and older individuals using the propensity score matching difference-in-differences method. Additionally, the study explored the mediating role of social participation.

Results

The findings indicate that health shocks, both chronic and acute, diminish the subjective wellbeing of middle-aged people and older adults. Furthermore, these shocks have a more significant negative effect on the subjective wellbeing of individuals aged 60 and above, women in the middle-aged and older demographic, individuals in rural areas who belong to the middle-aged and older age groups, and individuals possessing activities of daily living. The mechanism analysis revealed that health shocks, both chronic and acute, reduce the subjective wellbeing of middle-aged people and older individuals by disrupting partnerships.

Discussion

Lowering the possibility of health shocks, the government should build a strong health management system and improve the health insurance system to enable timely treatment for persons suffering from health shocks. Individuals and families should live healthy lives and engage in social activities to avoid health shocks and improve subjective wellbeing.

The Relationship Between Volunteering and the Occurrence of Loneliness Among Older Adults: A Longitudinal Study with 12 Years of Follow-Up

Informed by the social model of health promotion, this study examined the association between formal volunteering and the occurrence of loneliness among older adults over 12 years of follow-up and whether the association differs by gender. Data came from the Health and Retirement Study (2006-2018). The study sample included 5,000 individuals aged 60 and over who did not experience loneliness in 2006. Self-reported participation in formal volunteer work was classified into three levels: (0) no volunteering, (1) less than 100 hours of volunteering per year, and (2) more than 100 hours of volunteering per year. Cox regression was used to examine the relationship between volunteering level and the onset of loneliness during the 12 years of follow-up. Volunteering more than 100 hours per year was associated with a lower risk of loneliness compared to non-volunteers (HR = 0.55, p = .008). This protective effect was not observed for those who volunteered less than 100 hours per year (HR = 0.84, p = .246). The benefits of volunteering in mitigating loneliness did not differ by gender. Engagement in moderate to high levels of volunteering can protect against loneliness. More volunteering programs can be offered to older adults to reduce loneliness in later life.

Productive Aging Lifestyles: A Latent Class Analysis of Work and Volunteer Patterns over the Retirement Transition

Frank Caro and colleagues' foundational work set the stage for a broad and multifaceted productive aging (PA) literature. Recent PA research has focused on health benefits associated with work and volunteering, respectively. However, these activities are often assumed to have independent associations with health and wellbeing. Less clear is whether and in what ways older adults participate in productive engagement lifestyles including multiple activities over a long period of time. This paper uses latent class analyses and the Health and Retirement Study to examine combined engagement in work and volunteer activities over 12 years between ages 56-68 to (1) identify patterns of work and volunteer activities across the retirement transition, (2) evaluate characteristics of individuals within these patterns, and (3) explore whether particular patterns are associated with markers of health and wellbeing. We describe how our findings inform successful aging by incentivizing socially and individually beneficial PA lifestyles.

The Loneliness of Low-Income Older Adults in a Federal Volunteering Program: A Network Perspective

Volunteering has been associated with increased social interactions and reduced feelings of loneliness among older adults. However, a growing number of social network analyses (SNA) conducted in the general population outside of volunteering contexts suggest that lonely individuals tended to interact with other lonely individuals in the network, reinforcing loneliness through peer associations. To better understand the psychosocial impact of peer interactions among older adults within volunteer programs, this study examines how older adults' loneliness is correlated with their peers' loneliness within the Senior Companions Program (SCP). This study collected information on the social networks within an SCP in a Midwest Metropolitan and feelings of loneliness among low-income Russian, Khmer, Somali, Nepali, and English-speaking older volunteers (N = 41). A linear network autocorrelation model (LNAM) was constructed to quantify how volunteers' loneliness is correlated with their peers' loneliness within SCP. The LNAM results indicated that less lonely volunteers tended to make friends with lonelier volunteers (ρ = -.06, p < .05) in SCP even when accounting for statistical controls. The finding that more and less lonely individuals connect indicates an altruistic tendency for less lonely individuals to interact with those who are lonelier. This may be an important pathway by which volunteering addresses loneliness.

Co-Creation and Co-Production of Health Promoting Activities Addressing Older People-A Scoping Review

The global population is aging and the promotion of health and well-being for this generation is essential. Co-creative and co-productive practices can be solutions to welfare challenges in local policies. Therefore, this scoping review aimed to understand the extent and type of evidence in relation to the co-creation and co-production of health-promoting activities addressing older people aged 60+ years and to examine the influence of co-creative and co-productive activities on health and well-being, including influential factors for co-creation and co-production. We searched for peer-reviewed and grey literature in ten scientific and five non-scientific databases. From the 2648 studies retrieved, 18 articles were included in this review. Then, an inductive thematic content analysis was applied to the analysis. Three categories related to co-creative and co-productive activities emerged: "Social and physical activities", "Development of age-friendly environments", and "Discussions of healthy and active aging". Facilitating factors for co-creation and co-production were related to the planning and structure of the process and recognition of participants' time and resources, while the recruitment of participants and their time and resources were the main barriers. Future studies should target co-creative and co-productive interventions to concrete areas and specific sub-groups and be aware of factors influencing a co-creative or co-productive relationship with older people.

The Role of Solitary Activity in Moderating the Association between Social Isolation and Perceived Loneliness among U.S. Older Adults

Social isolation has been recognized as a critical public health problem. As the most vulnerable population, older adults are disproportionately affected by social isolation during the COVID-19 pandemic. The purposes of this study were to examine the association between social isolation and loneliness among U.S. older adults and to explore the moderating effect of solitary activity by using data from the Health and Retirement Study (HRS). Social isolation was measured by six indicators, including marital status, living arrangement, social participation in any clubs or social organizations, and the frequency of social contact with children, family members, and friends. Loneliness was assessed by eleven questions derived from the UCLA Loneliness Scale. Solitary activity included 11 types of activities that respondents could perform alone with limited or no social interaction. Results from the multivariate regression analyses indicated that unmarried status and lower frequency of social contact were associated with more perceived loneliness. Solitary activity significantly moderated the negative effects of the low frequency of social contact with family members on loneliness. The findings implicate that social work programs and interventions can aim to expand social networks and provide more opportunities for solitary activities, particularly for isolated older adults.

Prospective associations between multiple lifestyle behaviors and depressive symptoms

BACKGROUND

Our aim was to analyze the associations between multiple lifestyle behaviors and depressive symptoms.

METHODS

We included 4,725 adults (18-59y), that provided data in routine health evaluations of a hospital in Brazil, followed for a mean period of 3.1 ± 1.6 years. Physical activity, alcohol consumption (measured using Alcohol Use Disorders Identification Test) and tobacco smoking were categorized as: (1) absence of the behavior (inactivity i.e. not complying with 150 min of moderate-to-vigorous PA/week, not smoking, no risky drinking, i.e. AUDIT<5) during baseline and follow-up; (2) Absence during baseline and presence during follow-up; (3) Presence during baseline and absence during follow-up; (4) Presence during both time points. Depressive symptoms were measured with the Beck Inventory was adopted to analyze patterns of depressive symptoms over time (as exposure). C-reactive protein [HS-CRP]) was assessed and its role in the association was tested. Incidence indicators of behaviors and depressive symptoms were created and used as outcomes. We used crude and adjusted Poisson regression analysis.

RESULTS

Fully adjusted models revealed that persistently physical inactive participants (RR:1.71;95%CI:1.33-2.21), those who became physically inactive (1.68;1.19-2.26), with consistently risky drinking (1.62;1.15-2.30), and who became risky drinkers (1.62;1.15-2.30) had higher risk for incidence of elevated depressive symptoms. Vice versa participants with incidence of depressive symptoms over time presented higher risk for physical inactivity (1.44;1.11-1.87) and risky drinking (1.65;1.16-2.34) incidence. HS-CRP did not influence the associations.

LIMITATIONS

Self-reported physical activity, binary tobacco smoking, and non-probabilistic sampling.

CONCLUSIONS

There is a prospective relationship between elevated depressive symptoms and adverse lifestyle behaviors.

"It helps me find balance": older adult perspectives on the intersection of caregiving and volunteering

Caregiving is an increasingly prevalent experience that can negatively impact health and well-being. Volunteerism, long associated with positive benefits for older adults, is one potential strategy that can be used to counteract caregiver stress. A national cohort of existing older adult volunteers was engaged to explore the intersection of volunteering and caregiving through qualitative analysis of respondent comments using the lens of role theory. Survey responses from 533 older volunteers were analyzed. Role conflict and role enhancement themes were examined, with time constraints and reduced energy emerging as the perceived causes of conflict between the caregiver and volunteer roles. Caregivers discussed benefits to their caregiving role, including respite, learning, access to information and resources relevant to caregiving, increased socialization and improved physical and cognitive health. Findings indicate that volunteering can be framed as a health and well-being intervention for caregivers.

The Association Between Patterns of Social Engagement and Conversion From Mild Cognitive Impairment to Dementia: Evidence From the Health and Retirement Study

OBJECTIVES

This study examined the association between patterns of social engagement and conversion from cognitive impairment, no dementia (CIND) to dementia. It also tested whether social engagement is associated with conversion independently from physical and cognitive engagements.

METHOD

Data from 2 waves (2010 and 2014) of the Health and Retirement Study (HRS) were used. The sample consisted of 1227 people who had CIND in 2010. To identify the heterogeneity of social engagement, latent class analysis was utilized. Multinomial logistic regression analysis was utilized to investigate the association between patterns of social engagement and probability of conversion to dementia and death or dropout.

RESULTS

The result showed that patterns of social engagement that represent higher level and more variety of social engagement were associated with lower probabilities of conversion to dementia in 4 years but not with probabilities of death or dropout. The relationship held after controlling for physical and cognitive engagements.

DISCUSSION

Findings implied that promoting social engagement may be protective against developing dementia even for the high-risk group of people with CIND. Future studies should investigate the mechanism behind the relationship between patterns of social engagement and lower probabilities of conversion to dementia.

Physical Activity during the Retirement Transition of Men and Women: A Qualitative Longitudinal Study

The retirement transition is a major life change affecting people's lifestyles and behaviors, including those in relation to physical activity (PA), which is a key component of active ageing. Previous research analyzing the effect of retirement on PA levels has shown mixed results, and few studies investigated this issue in a gender perspective, thus, highlighting a need of knowledge in this respect. Aims of this study focused on the experience of PA during the retirement transition were to understand typologies of PA and possible changes in these typologies, to identify behavioural types relative to PA practice and levels, and to distinguish the main drivers and barriers for practicing PA associated with the different behavioural types. A further goal of the study was to investigate the abovementioned aims considering differences between women and men. Analyses were carried out within a three-year qualitative longitudinal study (2014-2016), which explored the individual experience of PA during the transition from work to retirement of 24 women and 16 men in Italy, with interviews carried out one year before and one and two years after retirement. Results show that preferred PA for both women and men was walking, along the transition to retirement. Over time, several participants replaced physically demanding activities with lighter ones. Six behavioural types were identified, describing individuals who incremented, started, or maintained the same level of PA, people who decreased PA levels or stopped it, and individuals who had a fluctuant behavior towards PA, or who had never practiced it. In general, poor health represented the main barrier to PA. For men, the main driver to PA was its effects on body shape, while for women, socialization/networking. In order to stimulate a more effective promotion of PA during the retirement transition, policy implications were discussed in light of the results obtained.

Benefits and barriers: a qualitative study on online social participation among widowed older adults in Southwest China

BACKGROUND

With the development of digital media, online activities are increasingly becoming part of the daily life of older adults. Widowed older adults generally would face changes in social interactions and activities due to widowhood; thus, the importance of online participation may be more prominent in this population. However, a detailed evidence on the experiences of online social participation among widowed older adults is relatively sparse. This study aimed to explore widowed older adults' perceptions regarding online social participation in southwestern China.

METHODS

This study adopted a qualitative approach. Semi-structured, in-depth individual interviews were conducted with 19 widowed older adults between September-December 2020. Thematic analysis was applied to analyse the data.

RESULTS

Two major themes, "benefits" and "barriers" were identified from the original data analysis. Subcategories concerning the theme "benefits" were "benefit perception (convenience, flexible time, supplementation)", "health promotion", "emotional comfort", and "social connection". Subcategories of "barriers" were "worries: personal economic loss", "concerns: security of digital device", "troubles: the diversity of online social participation", and "difficulties: using digital media".

CONCLUSIONS

Social participation of widowed older adults in southwestern China has begun to be integrated into the digital world; however, it remains at an early stage with the simple purpose of engagement. The older adults may face many challenges for online social participation. Although there are barriers and challenges in online social participation, widowed older adults can reap its benefits, which can be used as an important measure to facilitate a fulfilling life and successful ageing. There is no doubt that online social participation will become a trend within the foreseeable future. Family, friends and health care professionals should pay more attention to the needs of online social participation in widowed older adults and provide adequate support for them to achieve a meaningful life.

Barriers and Facilitators to Social Participation in Older Adults: A Systematic Literature Review

Objectives: Social participation has been shown to improve health, well-being, and quality of life in older adults. Previous reviews on social participation have been limited to identifying logistical barriers. The current review sought to examine barriers of social participation more broadly, as well as potential facilitators.Methods: We conducted a systematic review to collate identified barriers and facilitators to social participation in older adults. Seventy-six studies were eligible for inclusion.Results: Four main themes of barriers and facilitators to social participation associated with aging emerged: Demographic factors (such as age and socioeconomic status), Individual/Internal factors (such as motivations and health), Environmental/Infrastructure (such as accessibility, transport, and neighborhood cohesion), and Social Networks (particularly preexisting network size).Conclusions: These findings extended previous reviews to show that personal motivations, preexisting social networks, and neighborhood cohesion play vital roles in improving and maintaining quality social participation. The ability to facilitate this can occur at the individual therapeutic level and at the community level.Clinical implications: The findings highlight the need to consider barriers beyond logistical issues. In particular, healthy aging initiatives may benefit from matching social activities with individual motivations, and preventive measures to establish social networks early in the aging process are important.

Optimizing aging: A call for a new narrative

Decades of research have shown that biological and psychosocial aging are not as predetermined as had been thought for a long time. Yet, despite a large and growing evidence base, most individuals still hold negative views of aging that keep them from optimizing their chances for healthy and productive aging. Given this general background, this article has three major objectives: (a) to show that the 3 big misconceptions at the heart of the public's negative views of aging can be refuted based on scientific evidence; (b) to illustrate that changing individuals' views of aging calls for the development of a new narrative on aging, one that incorporates the increasing diversity of the aging population; and (c) to discuss how psychologists can contribute to creating this new narrative on aging. We argue that growing old(er) in the United States is not the same old business anymore and that psychologists are uniquely positioned to contribute to the social and cultural transformation that population aging and increasing diversity in the U.S. society require. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Psychometric Properties of the Self-Healing Assessment Scale for Community-Dwelling Older Adults

Self-healing, an intrinsic healing capacity, helps individuals’ bodies and minds to regain wholeness and is significant in the pursuit of one’s own healthy ageing and independence. This study was intended to develop and preliminarily test the reliability and validity of the self-healing assessment scale (SHAS) for community-dwelling older adults, and was conducted in three phases. Phase 1: The definitions of self-healing were synthesized from our knowledge of the literature regarding the ontology of self-healing and panels of 25 experts. The initial version of the 12-item questionnaire was developed by the in-depth interviews of focus groups and panels, and the content was validated by six experts. Phase 2: A cross-sectional survey, including a total of 500 community-dwelling older adults with a mean age of 71.76, was then conducted for the preliminary reliability and validity test. The content validity indices were satisfied. Twelve items were retained, and three factors were identified, namely, physical and mental state, socioeconomic and environmental status, and independent lifestyle, which explained 65.8% of the variance under explorative approval. Phase 3: the standardized factor above 60 obtained by confirmatory factorial analysis indicated good convergent validity. The relationship between self-healing and health-related quality of life was confirmed via concurrent validity testing. The SHAS can facilitate the evaluation of factors associated with community-dwelling older adults’ self-healing capacity. Programs tailored to enhance self-healing capacity should be designed, implemented, and inspected regarding their effectiveness in older adults.

Gender-related differences in the relationship between social and activity participation and health and subjective well-being in later life

A growing body of work suggests that social and activity participation (SAP) may contribute to health and well-being. Studies examining the effects of these activities largely focused on healthy older adults and older adults with more resources, not on frail older adults. On the latter, there is a lack of information about which activities contribute most and whether their effects vary between men and women given the gender-differentiated social roles. To address these gaps we extracted longitudinal data from the D-SCOPE frailty program for 380 participants aged 60 years or older residing in Belgium. Structural equation models tested the relationships between six levels of SAP based on a taxonomy of social activities (Levasseur et al., 2010) - from level 1 (for oneself) to level 6 (for others) - on longitudinal changes in physical and mental deterioration, well-being, and gender differences within these relationships. Results first show that older adults at risk of frailty benefit longitudinally from participating in activities in terms of their physical deterioration and well-being. Second, socially oriented activities were significantly associated with lower levels of physical deterioration and higher levels of subjective well-being (SWB), and volunteering with higher levels of SWB. Heterogeneity of activities, regardless of level on the taxonomy of social activities, seems to benefit SWB and counteract physical deterioration. Third, gender differences were confirmed by two activities for women (alone, task-oriented) and three activities for men (alone, being with others, task-oriented e.g. associational membership). Results imply that the activity itself may play a more important role than the nature of social involvement and social interaction in relation to health and wellbeing.

Nursing Home Residents Aged over 80-A Cross-Sectional Analysis on Which Activity Traits Correlate to Positive Affect

Admission to a care facility is assumed to enhance depressive symptoms and dependent behavior in old age. In this context, the relevance of participation in activities that make everyday life in a care facility more pleasant has been pointed out. This study examines if there is a relationship between participation in different activities as well as the frequency of this participation and the positive affect of nursing home residents aged over 80. Data from the unique cross-sectional representative study ‘Quality of life and subjective well-being of the very old in North Rhine-Westphalia’ in Germany (n = 150, aged 90.15 years in average) were used. The data were collected between 08/2017 and 02/2018 using computer-assisted personal interviewing. The variability in and frequency of activity participation functioned as independent, and positive affect as dependent variable. Multiple regression analysis was performed. Residents’ predicted positive affect significantly increased with a higher variability in activity participation. There was no independent effect of frequency in participation. Our findings indicate that there is a significant and positive relationship between participating in a high number of different activities and the overall positive affect of residents aged over 80 years. This does not hold true for the frequency of participation.

Cognitive Benefits of Activity Engagement among 12,093 Adults Aged over 65 Years

Objective: The present study includes two aims: (1) to understand patterns of activity engagement among older Chinese adults; (2) to further investigate associations between activity engagement and cognitive abilities in this population. Methods: Latent class analysis was applied to answer the aforementioned research questions across different age ranges while controlling for confounding variables (age, health, socioeconomic status (SES), and living alone). Specifically, five latent classes (non-active, working-active, comprehensive-active, physical-active, and less-active) were identified. Furthermore, associations between the classes of activity engagement and cognition were examined separately in three age groups: less than 80 years (young-old group), 80–99.5 years (old-old group) and more than 100 years (oldest-old group) of age. Results: Compared with Non-active older individuals, the other classes with a higher probability of engagement in various activities generally showed higher cognitive abilities (including general cognition, orientation, calculation, recall, and language), but not all patterns of active engagement in daily life were positively associated with better cognitive status across different age ranges. In particular, differences in the individuals’ cognitive abilities across the four active latent classes were especially obvious in the old-old group as follows: the Comprehensive-active class had higher general cognitive and recall abilities than the other three active classes and higher calculation and language abilities than the Working-active class. In addition, significant sex differences were observed in activity patterns, cognition, and their associations in the young-old and old-old groups. Culture-specific programs should be customized to subgroups of different ages and genders by providing different training or activity modules based on their related dimensions of cognitive decline.

Development and testing of a frailty-focused communication (FCOM) aid for older adults

The concept of frailty as it pertains to aging, health and well-being is poorly understood by older adults and the public-at-large. We developed an aging and frailty education tool designed to improve layperson understanding of frailty and promote behavior change to prevent and/or delay frailty. We subsequently tested the education tool among adults who attended education sessions at 16 community sites. Specific aims were to: 1) determine acceptability (likeability, understandability) of content, and 2) assess the likelihood of behavior change after exposure to education tool content. Results: Over 90% of participants "liked" or "loved" the content and found it understandable. Eighty-five percent of participants indicated that the content triggered a desire to "probably" or "definitely" change behavior. The desire to change was particularly motivated by information about aging, frailty and energy production. Eight focus areas for proactive planning were rated as important or extremely important by over 90% of participants.

A Latent Deprivation Perspective: Mechanisms Linking Volunteering to Mental Health in Later Life

This study tests the hypothesis that the latent deprivation model (LDM) can be extended to volunteer work, by exploring the extent to which two potential latent benefits of volunteer work—purpose in life and perceived social status—mediate the negative relationship between volunteerism and mental health (measured as depressive symptoms). Structural equation modeling with the full-information maximum likelihood (FIML) was adopted to model a sample of 5887 respondents from the Health and Retirement Study (HRS). The outcome was depressive symptoms; the independent variable was volunteering; and the mediators were “purpose in life” and “perceived social status.” Findings show that purpose in life and perceived social status partially mediated the relationship between volunteering and depressive symptoms, with purpose in life having a more substantial effect than perceived social status. Implications for future research and practice are also discussed.

A Group-Based Walking Study to Enhance Physical Activity Among Older Adults: The Role of Social Engagement

OBJECTIVES

The aim of this study was to explore social engagement and social comparisons as mechanisms to increase physical activity among older adults.

METHODS

Participants (N = 60, mean age = 65.7) were randomly assigned to one of two conditions. Participants in the treatment condition used the application to track their daily walking steps and interact via text messages with their group members for 4 weeks. Participants in the control group used the application only to track their own walking steps. Outcome variables included mean weekly steps, exercise self-efficacy, and social engagement.

RESULTS

The results revealed that participants in the experimental condition significantly increased their mean weekly steps and social engagement from the pretest to the posttest whereas the control group did not. These effects were maintained at the 1-month follow up.

DISCUSSION

The study expands our understanding of the motivational role of social engagement and social comparison in increasing PA among older adults.

Older Adults' Perceptions of the Usefulness of Technologies for Engaging in Physical Activity: Using Focus Groups to Explore Physical Literacy

Insufficient physical activity (PA) levels observed among older adults remain extremely high and pose a danger to developing and maintaining their physical literacy (PL). Each person’s level of PL partly depends on their physical and cognitive skills, confidence level, and degree of motivation to practice PA daily. New technologies, such as exergames and wearable fitness trackers, may enable older adults to increase their PL, stimulating uptake and ongoing PA participation. Objective: This focus group study aims to describe older adults’ perceptions of the use of technologies to engage in physical exercise programs. Methods: Fifteen participants were randomly selected from a sample of 40 older adults who completed a randomized controlled trial that investigated the benefits of using technology in the context of group-based exercise programs. Separate post-intervention focus groups were performed with an exergaming group, a conventional physical training group, and a no training group (control). Data were mapped onto constructs from the four domains of PL: affective, physical, cognitive, and behavioral. Results: Generally, participants expressed positive perceptions about the benefits of using technology to engage in PA. These positive feelings outweighed the costs and the lack of familiarization with technology. Common themes for the three groups emerged from the discussions and included familiarization with technology, using fitness tracker to monitor PA, previous exposure to technology, and interaction with peers, staff members, and relatives. In particular, participants from the exergaming group explored the ideas of training their cognitive skills while using the exergame accessories, exercising in an alternative way, competitive versus cooperative play, changes in sense of humor, skill transferability from game to real environment, progressions of the exercise intensities, and the potential use of exergames for rehabilitation. Conclusions: Participants in this study reported positive perceptions about implementing technology into exercise. Emphasizing the benefits of using technology in group-based exercise programs may increase older adults’ PL levels and their future technology adoption. The potential implementation of technology into conventional exercise programs should focus on older adults’ lifelong values, biopsychosocial conditions, and the possibility of reducing age-related risk of injuries and chronic diseases.

Environment patterns and mental health of older adults in long-term care facilities: the role of activity profiles

Objectives: This study adopts the International Classification of Functioning, Disability and Health (ICF) model to determine extent to which the clustered patterns of long-term care (LTC) environment and activity participation are associated with older residents' mental health. Method: This study enrolled a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis and latent class analysis were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the hypothesized relationships. Results: Three environment profiles (Low-, Moderate-, and High-Support Environment) based on physical, social, and attitudinal environment domains and two activity profiles (Low- and High-Activity Participation) across seven activity domains were identified. Compared to the Low-Support class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in those two classes were more likely to be in the "High Activity Participation" class, which in turn, exhibited better mental health. Conclusion: Environment and activity participation directly relate to older residents' mental health. Activity participation also mediates the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents' mental health.

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.

The Relation of Volunteering and Subsequent Changes in Physical Disability in Older Adults

Objectives

To describe the association between initiating volunteering and changes in physical disability in older adults, and whether intensity and gender modify this relationship.

Methods

Employing propensity score weighted regression adjustment, we calculate changes in disability using a sample of U.S. adults (n = 7,135) in the Health and Retirement Study (1996-2012) not volunteering at baseline but later initiating volunteering (1-99 hr/year or 100+ hours per year) or remaining a nonvolunteer.

Results

Relative to continuous nonvolunteers, low-intensity volunteering is related to 34% lower disability in the low-intensity group (average treatment effect [ATE] = -0.12) and 63% lower in the higher-intensity group (ATE = -0.23). For men, progression was lower only in the highest intensity group (ATE = +0.02), but women experienced similarly less progression of disability (38%-39%) at either level of new engagement (ATE = -0.17 and -0.18).

Discussion

Initiating a new volunteer role in later life is related to decreased progression of disability, at low or high levels for women and only at higher levels for men. This study suggests that volunteer intervention programs may represent a major public health strategy to delay the progression of physical disability for older adults.

Does Becoming A Volunteer Attenuate Loneliness Among Recently Widowed Older Adults?

Objectives

Loneliness is a significant public health concern, particularly for those who have lost a spouse through widowhood. This study examines whether becoming a volunteer at the time of widowhood is associated with reduction of these risks.

Method

A pooled sample of 5,882 married adults age 51+, drawn from the 2006-2014 waves of the Health and Retirement Study, was used to estimate regression models of the relationship between becoming widowed (relative to staying continuously married) and loneliness, and whether the associated loneliness of having lost a spouse is moderated by starting to volunteer (<2 hr, 2+ hr/week).

Results

Our results show that for those who become widowed, loneliness is significantly higher than those who stay continuously married. However, starting to volunteer 2+ hr per week is related to attenuated loneliness among the widowed such that widows who volunteer at that intensity have levels of loneliness similar to those of continuously married individuals volunteering at the same intensity.

Discussion

This study suggests higher intensity volunteering may be a particularly important pathway for alleviating loneliness among older adults who have recently become widowed. Results are discussed in light of theory, future research, and potential interventions.

Intersections of Home, Health, and Social Engagement in Old Age: Formal Volunteering as a Protective Factor to Health After Relocation

This study aims to further our understanding of formal volunteering as a protective mechanism for health in the context of housing relocation and to explore race, gender, and education as moderators. A quasi-experimental design evaluated the effects of volunteering on older adults' health (self-report health, number of instrumental activities of daily living [IADLs], and depressive symptoms) among individuals who relocated but did not volunteer at Time 1 ( N = 682) in the Health and Retirement Study (2008-2010). Propensity score weighting examined health differences at Time 2 between 166 volunteers (treated) and 516 nonvolunteers (controlled). Interaction terms tested moderation. Individuals who moved and engaged in volunteering reported higher levels of self-rated health and fewer IADL difficulties compared to the control group. Race moderated the relationship between volunteering and depressive symptoms, while gender moderated the relationship between volunteering and self-assessed health. Formal volunteering protects different dimensions of health after relocation. Volunteering was particularly beneficial for females and older Whites.

Activity Patterns and Health Outcomes in Later Life: The Role of Nature of Engagement

Background and Objectives

The health benefit of activity participation at older ages is documented in the current literature. Many studies, however, only explored the health benefits of engaging in a few activities and did not examine mechanisms connecting activity participation to health. We investigated the pathway between activity and health by testing the mediation role of the nature of engagement (physical, cognitive, and social) on physical, mental, and cognitive health of older adults.

Research Design and Methods

We analyzed data of 6,044 older adults from the 2010 and 2012 Health and Retirement Study linked with 2011 Consumption and Activity Mail Survey. We used latent class analysis to identify the patterns of participating in 33 activities as well as patterns of nature of engagement, and examined how these patterns were associated with cognition, depressive symptoms, and self-rated health in later life.

Results

Meaningful patterns of activity (high, medium, low, passive leisure, and working) and the nature of activity engagement (full, partial, and minimal) were identified. High and working groups, compared to the passive leisure group, showed better health and cognition outcomes. The nature of engagement mediated the relationship between activity patterns and health, especially for older adults who were either full or partially engaged.

Discussion and Implications

The nature of engagement may play a more important role than the activity itself in relation to health. Identifying the heterogeneity in activity engagement in later life is critical for tailoring interventions and designing programs that can improve the health of older adults.

The Association Between Cognitive Impairment and Patterns of Activity Engagement Among Older Adults

This study aims to assess the association between cognitive impairment and activity engagement patterns. Data from the 2012 Health and Retirement Study were used. A total of 3,943 participants aged 65 or older were included in analyses. Latent class analysis and multinomial logistic regression analysis were used. Four activity engagement profiles were identified: high activity (31.2%), active leisure (18.9%), passive leisure (28.2%), and low activity (21.7%). People in the high activity group engaged in all activities more than people in any other group, whereas people in the low activity group did not actively engage in most activities. Multinomial logistic regression analysis showed that cognitive impairment had an independent effect on the probability of being assigned to the low activity group compared to other groups. Cognitive impairment was associated with inactivity in a variety of activities. Future studies should examine supportive factors, which facilitate active patterns among people with cognitive impairment.