Environmental Factors Associated With Social Participation of Older Adults Living in Metropolitan, Urban, and Rural Areas: The NuAge Study

The role of implicit theories of intelligence and personality in older adults' resilience: cognitive functioning and social participation as two mediators

OBJECTIVES

Resilience during old age reflects the capacity to adapt to changes and challenges associated with normative aging and is an important component of successful aging. Belief in the incremental theory of intelligence and personality could help older adults maintain cognitive functioning and social engagement, which may further contribute to their resilience. The current study investigated how implicit theories of intelligence and personality affected older adults' resilience and examined cognitive functioning and social participation as two mediators.

METHOD

A total of 108 older adults aged 60-92 were recruited and completed relevant scales and cognitive tasks. Path analyses were conducted to estimate the expected mediation model.

RESULTS

The incremental theory of intelligence, but not personality, was positively related to older adults' resilience. Both cognitive functioning and social participation mediated the effect of the implicit theory of intelligence in the model without covariates. When background variables were controlled, the mediation effect of cognitive functioning remained significant, while the link between the implicit theory of intelligence and social participation was weakened.

CONCLUSION

Older adults' implicit theory of intelligence plays a significant role in fostering resilience in late adulthood, especially through maintaining older adults' cognitive functioning.

Effect of Physical Performance Levels of Elderly Living in Urban and Rural Areas on Social Participation, Social Functioning, and Quality of Life: A Cross-sectional Study from the Mediterranean Region of Turkey

BACKGROUND

Social interaction is a very important subject for the elderly, especially in the context of active aging.

AIM

This study aims to investigate the effect of physical performance levels of the elderly living in rural and urban areas on social participation, social functioning, and quality of life.

METHODS

A total of 418 volunteer elderly aged 65 and over, living in rural (42.3%) and urban (57.7%) areas, participated in this study. The Mini-Mental State Examination, Short Physical Performance Battery, the World Health Organization Quality of Life Scale for Older Adults, Social Functioning Scale, and the Community Integration Questionnaire were applied to participants.

RESULTS

The scores of social functioning (P = 0.027) and the social network subscale of social participation (P = 0.001) were significantly higher among participants living in urban areas compared to those living in rural areas. Physical performance was positively correlated with social participation (r = 0.404) and social functioning (r = 0.324) at a moderate level (P = 0.000), and with quality of life at a low level (r = 0.158) (P = 0.001). Social participation was positively correlated with social functioning at a high level (r = 0.572) and with quality of life at a moderate level (r = 0.300) (P = 0.000). Social functioning was positively correlated with quality of life at a low level (r = 0.234) (P < 0.01).

CONCLUSION

To increase social participation, social functioning, and quality of life among the elderly, it is necessary to keep physical performance levels higher. In addition, in the planning of social participation, it is crucial to take into account where the elderly live in.

Social participation in the city: exploring the moderating effect of walkability on the associations between active mobility, neighborhood perceptions, and social activities in urban adults

BACKGROUND

Living in urban environments is associated with several health risks (e.g., noise, and air pollution). However, there are also beneficial aspects such as various opportunities for social activities, which might increase levels of social participation and (physically) active mobility that in turn have positive effects on health and well-being. However, how aspects of the environment, active mobility, and social participation are associated is not well established. This study investigates the moderating effect of low vs. high walkability neighborhoods on the associations between active mobility, and social participation and integrates individuals' subjective perception of the neighborhood environment they are living in.

METHODS

Cross-sectional data from 219 adults (48% female, mean age = 46 ± 3.8 years) from 12 urban neighborhoods (six low, six high walkability) were analyzed: First, social participation, active mobility, and subjective neighborhood perceptions were compared between people living in a low vs. high walkability neighborhood via t-tests. Second, multigroup path analyses were computed to explore potential differences in the associations between these variables in low vs. high walkability neighborhoods.

RESULTS

Social participation, active mobility, and subjective neighborhood perceptions didn't differ in low vs. high walkability neighborhoods (p: 0.37 - 0.71). Active mobility and subjective neighborhood perceptions were significantly stronger related to social participation in low vs. high walkability neighborhoods (active mobility in low: ß = 0.35, p < .01 vs. high: ß = 0.09, p = .36; subjective neighborhood perceptions in low: ß = 0.27, p < .01 vs. high: ß = 0.15, p = .18).

CONCLUSIONS

Despite living in neighborhoods with objectively different walkability, participants rated social participation and active mobility equally and perceived their neighborhoods similarly. However, zooming into the interrelations of these variables reveals that social participation of residents from low walkability neighborhoods depends stronger on active mobility and perceiving the environment positively. Positive perceptions of the environment and active mobility might buffer the objectively worse walkability. Future research should focus on underlying mechanisms and determinants of subjective neighborhood perceptions and active mobility, especially in low walkability neighborhoods.

Association between hearing status and social participation in Japanese older adults: A cross-sectional study from the Japan gerontological evaluation study

PURPOSE

Hearing is known to decline with age. As sensitivity to speech declines, conversation becomes more difficult and social interactions are affected, resulting in increased risk of cognitive decline. This study aimed to examine the relationship between hearing status and social participation.

MATERIALS AND METHODS

The study included 21,117 adults aged 65 years or older who responded to a survey in 2019. The survey asked participants about their hearing status and how frequently they participated in certain social activities.

RESULTS

The analysis of the relationship between degree of hearing and social activity showed lower hearing status odds ratios for those who participated more frequently in social activities compared to those who participated less frequently. The odds ratios were as follows, hobby clubs (OR 0.81, 95%CI 0.78-0.84), activities such as teaching skills or passing on experiences to others (OR 0.69, 95%CI 0.65-0.75), and meeting with friends (OR 0.77, 95%CI 0.74-0.79). Compared to those who did not participate in social activities, those who participated in three or more types of groups had significantly lower hearing impairment (OR 0.75, 95% CI 0.72-0.79).

CONCLUSION

Hearing impairment was shown to inhibit participation in activities, including those that require communication with multiple people or smooth communication, those that involve a wide range of ages, and those that involve work and movement. Hearing impairment should be identified and addressed in its early stages to prevent its negative impact on social participation.

Impact of rural settings on the interpersonal and personal processes associated with young people supporting a peer who experienced a traumatic event

INTRODUCTION

There is limited research into informal support processes amongst young people supporting a peer through a traumatic event and how this process occurs specifically within a rural setting.

OBJECTIVE

The aim of this research was to understand how the contextual environment impacts on the personal and interpersonal processes of rural-based young people supporting a peer who experienced a traumatic event.

DESIGN

Qualitative interviews were conducted with 22 young people (aged 14-19), who resided in Gippsland, Victoria, Australia. A substantive theory was developed using Charmaz's (1) Constructivist grounded theory methodology.

FINDINGS

Young people who shared responsibility for supporting their peer went back to life as normal and felt connected to their community, whereas young people who maintained sole responsibility, experienced mental health problems, disconnected from their community and felt like an outsider. The contextual environmental factors (i.e., service accessibility, limited transport, and internet blackspots) impacted both negatively and positively on young people's ability to provide support as well as influenced whether they felt safe share responsibility.

DISCUSSION

This theory implies that providing pathways to reconnecting with place and community, are essential in guiding young people back to their foundations of support.

CONCLUSION

Integrating these insights can create new service models in rural areas, whilst also creating opportunities to form healthy foundations of support.

Associations Between Childhood Area-Level Social Fragmentation, Maladaptation to School, and Social Functioning Among Healthy Youth and Those at Clinical High Risk for Psychosis

BACKGROUND AND HYPOTHESIS

Although studies have identified social fragmentation as an important risk factor for schizophrenia and other psychotic disorders, it is unknown whether it may impact social functioning. This study investigates whether social fragmentation during childhood predicts maladaptation to school as well as social functioning during childhood and adulthood.

STUDY DESIGN

Data were collected from the North American Prodrome Longitudinal Study. Participants included adults at clinical high risk for psychosis (CHR-P) and healthy comparisons (HC). Maladaptation to school and social functioning during childhood were assessed retrospectively and social functioning in adulthood was assessed at baseline.

STUDY RESULTS

Greater social fragmentation during childhood was associated with greater maladaptation to school (adjusted β = 0.21; 95% CI: 0.02 to 0.40). Social fragmentation was not associated with social functioning during childhood (unadjusted β = -0.08; 95% CI: -0.31 to 0.15). However, greater social fragmentation during childhood predicted poorer social functioning in adulthood (adjusted β = -0.43; 95% CI: -0.79 to -0.07). Maladaptation to school mediated 15.7% of the association between social fragmentation and social functioning. The association between social fragmentation and social functioning was stronger among adults at CHR-P compared to HC (adjusted β = -0.42; 95% CI: -0.82 to -0.02).

CONCLUSIONS

This study finds that social fragmentation during childhood is associated with greater maladaptation to school during childhood, which in turn predicts poorer social functioning in adulthood. Further research is needed to disentangle aspects of social fragmentation that may contribute to social deficits, which would have implications for the development of effective interventions at the individual and community levels.

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.

Increase in the Initial Outpatient Rehabilitation Utilization for Patients With Total Knee Arthroplasty

OBJECTIVES

The objective of this study was to examine the patient characteristics and features associated with the initial rehabilitation utilization with a particular emphasis on outpatient rehabilitation after total knee arthroplasty (TKA) among 2016-2018 Texas Medicare enrollees.

DESIGN

This is a retrospective cohort study. We used chi-square tests to examine the variability in patient demographic and clinical characteristics across the different post-acute rehabilitation settings after TKA. A Cochran-Armitage trend test was used to investigate the yearly trend of outpatient rehabilitation utilization after TKA.

SETTING

Post-acute rehabilitation settings after TKA.

PARTICIPANTS

The target population was Medicare beneficiaries aged ≥65 with an initial TKA in 2016-2018 and complete demographic and residential information (N=44,313).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

We identified whether patients first used (1) outpatient rehabilitation, (2) home health, (3) self-care, (4) inpatient rehabilitation, (5) skilled nursing, or (6) other setting within the 3 months after TKA.

RESULTS

Our results demonstrated an increasing use of the initial outpatient rehabilitation and home health, while the use of skilled nursing and inpatient rehabilitation facilities decreased from 2016 to 2018. The increase in outpatient utilization was significant in 2018 compared with 2016 controlling for distance to the TKA facilities, comorbid conditions, sex, race/ethnicity groups (White, Black, Hispanic, and Others), lower income (Medicaid eligible), Medicare entitlement types, age groups, and rurality (OR 1.23, 95% CI 1.12-1.34). However, the overall utilization rate of the initial outpatient rehabilitation after TKA remained low, increasing from 7.36% in 2016 to 8.60% in 2018.

CONCLUSION

Despite the growing use of the initial outpatient rehabilitation after TKA, the overall rate of outpatient rehabilitation utilization remained low. Our findings raise an important question as to whether certain patient demographics and clinical groups might have limited access to outpatient rehabilitation after TKA.

Key Age-Friendly Components of Municipalities that Foster Social Participation of Aging Canadians: Results from the Canadian Longitudinal Study on Aging

Municipalities can foster the social participation of aging adults. Although making municipalities age-friendly is recognized as a promising way to help aging adults stay involved in their communities, little is known about the key components (e.g., services and structures) that foster social participation. This study thus aimed to identify key age-friendly components (AFC) best associated with the social participation of older Canadians. Secondary analyses were carried out using baseline data from the Canadian Longitudinal Study on Aging (n = 25,411) in selected municipalities (m = 110 with ≥ 30 respondents), the Age-friendly Survey, and census data. Social participation was estimated based on the number of community activities outside the home per month. AFC included housing, transportation, outdoor spaces and buildings, safety, recreation, workforce participation, information, respect, health, and community services. Multilevel models were used to examine the association between individual social participation, key AFC, and environmental characteristics, while controlling for individual characteristics. Aged between 45 and 89, half of the participants were women who were engaged in 20.2±12.5 activities per month. About 2.5% of the variance in social participation was attributable to municipalities. Better outdoor spaces and buildings (p < 0.001), worse communication and information (p < 0.01), and lower material deprivation (p < 0.001) were associated with higher social participation. Age was the only individual-level variable to have a significant random effect, indicating that municipal contexts may mediate its impact with social participation. This study provides insights to help facilitate social participation and promote age-friendliness, by maintaining safe indoor and outdoor mobility, and informing older adults of available activities.

Third Places for Older Adults' Social Engagement: A Scoping Review and Research Agenda

BACKGROUND AND OBJECTIVES

Neighborhood places that facilitate older residents to meet and interact (third places) receive an increasing research interest as studies have consistently shown the benefits of social engagement for older adults' health. This scoping review synthesized the findings of studies examining the role of third places in older adults' social engagement.

RESEARCH DESIGN AND METHODS

Searching 5 databases (CINAHL, Medline, PsycInfo, Scopus, and Web of Science) in October 2021, this study identified quantitative and qualitative studies that examined the relationships between third places and social engagement (interaction and network) among older adults.

RESULTS

A total of 32 studies (12 quantitative and 20 qualitative studies) met the eligibility criteria. These studies examined 4 types of third place, namely, community facilities, local businesses, open/green spaces, and transition spaces. More than two thirds of the studies reviewed found that access to community facilities, local businesses, and open/green spaces were related to older adults' social interaction. For the relationships between third places and social networks, the importance of accessible local businesses and the quality of open/green spaces was supported by fewer studies.

DISCUSSION AND IMPLICATIONS

The findings of quantitative and qualitative studies suggest that local places that are convenient to visit and comfortable to stay in for older adults are likely to enhance their social interaction and network. However, more specific evidence is needed to inform the planning and design of third places. The review discusses future research topics that address the gaps identified in the current literature.

Social participation of older people in urban and rural areas: Canadian Longitudinal Study on Aging

BACKGROUND AND OBJECTIVES

Although the positive influence of social activity on health is now well-established, a complex relationship exists among social participation, personal, social and the environment. Social participation of older adults was examined in rural and urban settings to identify features of the built-environment and perception of neighborhood specific to the locale.

RESEARCH DESIGN AND METHODS

Using cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA), we examined social participation and health of older people (65 + yrs) in relation to the built environment and sociocultural contexts for urban and rural areas. A social participation index was derived from responses on the frequency of participating in 8 social activities over the past 12 months. Personal, household and neighborhood indicators were examined to develop multivariable regression models for social participation in urban and rural cohorts.

RESULTS

No meaningful differences were seen with the frequency of social participation between rural and urban settings; however, the type of community-related activities differed in that a greater proportion of urban participants reported sports and educational/cultural events than rural participants. Service club activities were greater for rural than urban participants. Different neighborhood features were statistically significant factors in explaining social participation in rural than in urban locales, although transportation was a significant factor regardless of locale. Trustworthiness, belonging and safety were perceived factors of the neighborhood associated with higher social participation for rural participants.

DISCUSSION AND IMPLICATIONS

The relationship between home and health becomes stronger as one ages. Social and physical features of built environment specific to urban and rural settings need to be considered when implementing appropriate social activities for older people.

Evaluation of the optimal cutoff number of types of social participation activities in older people

INTRODUCTION

Social participation activities have a close association with health aging. However, the clinical significance of numbers of social participation activities and its cutoff value has not been defined.

METHODS

We recruited 516 people aged ≥55 years. Twelve social participation behaviors modified according to Taiwanese culture were investigated, and the adequacy of cutoff number was determined by the area under the receiver operating characteristic curve (AUC) according to the results of cluster analysis of individual activities and scores of the Brief Symptom Rating Scale-5 (BSRS-5) and the Chinese Happiness Inventory (CHI). Demographic, BSRS-5 and CHI data were then compared according to the candidate cutoff numbers.

RESULTS

The distribution of the numbers of social activities suggested that the highest partition of numbers of social activities was 3 in women and 4 in men. The AUC regarding the cluster of activity types was 0.917, with the highest Youden's J value located between 3 and 4. The AUC regarding the cluster of activity types and scores of the BSRS-5 and the CHI was 0.929, with similar cutoffs. If 3 and 4 were used as cutoffs, the between-group differences of both the CHI and the BSRS-5 were significant. More types of social activities had a different engaging frequency with the 3 and 4 cutoffs.

CONCLUSION

Our findings found an adequate cutoff with better differential power in the psychopathology and happiness of older people that provided a basis for application in intervention and policy formation.

A Profile of Social Participation in a Nationally Representative Sample of Canadian Older Adults: Findings from the Canadian Longitudinal Study on Aging

Social participation has tremendous implications for the physical and mental health of older adults. A growing body of Canadian literature has examined social participation among older adults, including frequency of participation; gender, age, and regional differences in participation; and associations with self-perceived health, loneliness, and life dissatisfaction. The current study adds to this important body of research, using a large, nationally representative sample of adults 45-85 years of age (Canadian Longitudinal Study on Aging [CLSA] baseline data [n = 51,338]), to examine nuanced characteristics associated with social participation (socio-demographics, social support, cognitive ability, mental health, physical conditions), frequency of participation, and the relationship between the aforementioned characteristics and frequency of participation. Findings indicated that compared with those who reported infrequent/no participation, more frequent participation was associated with greater social support, higher cognitive abilities, increased satisfaction with life, fewer depressive symptoms, reduced odds of self-reported mood and anxiety disorders, and fewer self-reported physical conditions. Findings highlight the importance of active social participation, and have important implications for the development and implementation of accessible community programs across Canada.

Developing the Intergenerational Community Survey for older adults: Assessing neighborhood environments, social and physical activities, and health

Many survey instruments have been developed to assess neighborhood environments for their impacts on people's health and daily activities. However, no instruments are available for capturing social interactions with different age groups among older populations. This study introduces a four-phase process of developing a comprehensive Intergenerational Community Survey (ICS) covering six domains: (1) physical activities, walking, and sedentary activities; (2) mental health and quality of life; (3) social activities (e.g. intergenerational and peer interactions) in and outside the neighborhood; (4) neighborhood environments (e.g. safety, streets and sidewalks); (5) supportive services or programs (e.g. intergenerational programs, transportation services); and (6) personal characteristics. Test-retest reliability assessments among 38 community-dwelling older adults (aged 65+) showed fair to good reliability results. ICS can serve as a useful tool to facilitate future research on intergenerational communities and interactions for 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.

Subjective memory complaints and social participation among older adults: results from the health and retirement study

Objectives:This study aims to examine whether subjective memory complaints (SMC) contribute to social participation among older adults.Method:The study sample was 4,713 community-dwelling older adults aged 65 years and older from four waves (2010, 2012, 2014, 2016) of the Health and Retirement Study. Hierarchical linear modeling analysis was used to examine the association of SMC with social participation after controlling for factors influencing social participation. Demographic factors (i.e. age, gender, and perceived socioeconomic status) were entered in block 1, health-related factors (i.e. health conditions, perceived health, instrumental activities of daily living, memory-immediate and delayed, and depressive symptoms) were entered in block 2, environmental factors (i.e. perceived social support and strain from spouse, child, family, and friend) were entered in block 3, and SMC was entered in block 4.Results:The result showed that factors significantly contributing to social participation are age (standardized β = -0.08, p < 0.01), perceived socioeconomic status (β = 0.16, p < 0.001), perceived health (β = 0.15, p < 0.001), instrumental activities of daily living (β = 0.12, p < 0.001), memory-immediate and delayed (β = 0.09, p < 0.001; β = 0.08, p < 0.001, respectively), social support from spouse and friend (β = 0.04, p < 0.05; β = 0.13, p < 0.001, respectively), social strain from friend (β = 0.07, p < 0.001), and SMC (β = -0.05, p < 0.001). The demographic factors explained 9.5%, health-related factors explained 8.5%, environmental factors explained 2.4%, and SMC explained 0.1% of the variance in social participation.Conclusion: This finding suggests that SMC may contribute to social participation in older adults.Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2021.1961123 .

Active Ageing Awareness and Quality of Life among Pre-Elder Malaysian Public Employees

Increasing life expectancy has led to a global rise in late-life diseases. Quality of Life (QOL) is important for healthy life expectancy. The active ageing framework serves as a guide for policymakers to design policies that enhance the QOL of older people. This study aims to determine the association between awareness of active ageing and QOL. The Malay version of the 26-item WHOQOL-BREF questionnaire was utilised along with the 14-item Active Ageing Awareness Questionnaire (AAAQ). A total of 532 participants had a mean (SD) age of 50.2 (5.9), were largely ethnic Malay (96.2%), female (52.8%), and comprised largely of low-income households (65.4%). The median (IQR) AAAQ score was 71.4 (19.1). The hierarchical multiple regression analysis revealed significant positive association between AAAQ and the QOL domains of physical (β = 0.154, p < 0.001), psychological (β = 0.196, p < 0.001), social relationship (β = 0.175, p < 0.001), and environment (β = 0.145, p < 0.001) after adjusting for all covariates. Awareness of active ageing was found to have a positive effect on all domains of QOL among pre-elder employees, and thus, we recommend that policies to improve active ageing awareness should be implemented for healthy life expectancy in ageing populations.

Exploring Metro and Non-metro Differences in Satisfaction With Services and Community Participation Among Low-Income Personal Assistance Service Users

Personal assistance services (PAS) are supports provided by workers to assist disabled people with their activities of daily living. Access to in-home PAS allows people who need assistance with these activities to live in their own homes and communities, rather than moving to congregate living facilities. Because metro and non-metro areas differ in many ways, we explored the following research questions: (1) Are there differences between non-metro and metro PAS users?, (2) What factors are associated with satisfaction with services?, and (3) What factors are associated with satisfaction with community participation?. We randomly surveyed PAS consumers in five states about their experiences with PAS. To answer the first question, we compared metro or non-metro consumers using independent samples t-tests. We found few statistically significant differences between metro and non-metro respondents. To answer the second and third research questions, we conducted linear regressions predicting our dependent variables. In terms of satisfaction with services, our model explained very little of the variance, other than finding that being partnered or married was significantly, positively related to satisfaction with services. In predicting satisfaction with community participation, the model explained about a quarter of the variance, with having fewer disabilities and higher health status predicting more satisfaction. This research indicates that there are few differences between metro and non-metro low-income PAS consumers and that more research is needed to understand what factors are related to satisfaction with services and community participation in this population.

Factors Associated With Driving Status Among Brazilian Older Adults

This study analyzed the factors associated with driving status among older adults in Brazil. The sample consisted of 15,221 older adults (≥65 years) residing in Brazilian capitals in 2018. The following question established the participants' driving status: "Do you drive a car, motorcycle, and/or another vehicle?" Sociodemographic, health conditions, and health-related behaviors were derived through standard procedures. Poisson regression analysis was performed to estimate prevalence ratios and 95% confidence interval. The prevalence of drivers was 28.83%. We found that being physically active during leisure time and higher daily recreational screen time (>3 h/day) were associated with driving status. Self-perceived negative health and being physically active by commuting showed an inverse association with driving status. The high prevalence of older drivers and the characteristics associated with driving reinforces the importance of public policy strategies for these individuals.

Factors of Functional Disability in the Social Participation of Older Adults Living Alone With Fall Experience

The fall experiences of older adults living alone lead to restrictions in their social participation. This study aimed to examine the factors that influence functional disability in social participation (FSP) among older adults who live alone and have experienced falls. This study used secondary data of 493 older adults living alone who experienced a fall, which were collected from the 2017 National Survey of Older Koreans. Multiple linear regression analyses were performed. Factors, such as old age, sex, economic status, frequency of drinking, and number of acquaintances, significantly related to functional disability in terms of social participation. In addition, poor muscle strength, depression, and cognitive decline comprised predictors of FSP. The findings of this study revealed that it is important to comprehensively evaluate the social participation of older adults who live alone and have experienced falls.

Healthy ageing through participation in community situated activities: A scoping review of assessment instruments to support occupational therapy practice

Introduction

The occupational therapy profession has an essential role to play in healthy ageing that includes enabling participation, a construct that according to The International Classification of Functioning, Disability and Health (ICF), incorporates an environmental context. Environmental barriers and enablers of participation in community‐situated activities for people over the age of 65 have been identified. To support practice, occupational therapists require assessments with demonstrated content validity including comprehensive coverage of the construct. The purpose of this scoping review study was to investigate what instruments are available to assess community participation for people over the age of 65 that included environmental factors.

Methods

A scoping review of the literature was conducted, utilising the Joanna Briggs Institute (JBI) scoping review methodology. The evidence source was review articles and inclusion criteria were that they reviewed instruments to assess participation that could be used for people over the age of 65. Items extracted from included instruments were evaluated against a preset list of community‐participation and environment categories that had been developed from the ICF.

Results

Twenty‐three review studies met inclusion criteria and from these 240 instruments were extracted. Twenty instruments were retained after exclusions and from these, 540 instrument items were extracted. Of these, 280 (47%) were coded as community‐participation, and only 20 (3.4%) as environment items. Fourteen of the instruments included no environment items.

Conclusions

No instrument was identified that comprehensively assessed community participation including the related environmental factors. Such an instrument is required to enable occupational therapy practitioners to support healthy ageing. The development of such an instrument will strengthen the profession's capacity to develop new ways of delivering services to older adults in line with emerging ways that aged care will be delivered and to advance its essential role in healthy ageing.

Ageing in place processes in the neighbourhood environment: a proposed conceptual framework from a capability approach

The concept of "ageing in place" has become increasingly significant in the environmental gerontology literature. Despite its predominance, there have been limited efforts to offer a more comprehensive and nuanced conceptualization of this topic. Definitions found in the literature are often too simplistic and only partially capture the various aspects of older adults' experience while ageing in place. This paper presents a conceptual framework on ageing in place in the context of neighbourhood environment which aims to address this gap by proposing a multi-faceted understanding of ageing in place processes through the lenses of a capability approach, a more comprehensive definition of the concept, and related overarching principles. Building on predominant theories in environmental gerontology, this conceptual framework offers new insights into the interactions between "place" and the "ageing individual". It is meant to offer opportunities for discussion, to suggest new paths of inquiry, and to explore implications for policy and practice.

Associations of functional disability and behavioural risk factors with social participation of older adults: a cross-sectional analysis from the Canadian Longitudinal Study on Aging

OBJECTIVES

To examine: (1) the associations of functional disability and behavioural risk factors with social participation; and (2) whether the association between functional disability and social participation is modified by co-occurrence of behavioural risk factors.

DESIGN

A cross-sectional analysis of data from the Canadian Longitudinal Study on Aging.

SETTING

A national stratified sample of 51 388 individuals living in the 10 Canadian provinces at the time of baseline data collection (2011-2015).

PARTICIPANTS

Participants included men and women aged 45-85 years and residing in the communities in the 10 Canadian provinces.

OUTCOME MEASURES

Social participation was assessed using frequency of participant involvement in eight different social activities in the past 12 months. Responses for each category were converted into number of days per month. Total social participation score (range: 0-180) was based on summing frequencies over all eight activities representing number of social activities per month.

RESULTS

Functional disability was associated with participating in fewer social activities (difference in mean total social participation score, b=-1.1, 95% CI -1.5 to -0.7). In comparison to no behavioural risk factors, presence of any one (b=-2.7, 95% CI -3.1 to -2.3), any two (b=-4.6, 95% CI -5.0 to -4.2), any three (b=-6.3, 95% CI -6.8 to -5.9) and all four (b=-7.8, 95% CI -9.0 to -6.6) behavioural risk factors was associated with lower social participation. The association between functional disability and social participation was modified by the presence of behavioural risk factors with the lowest social participation observed for adults with disability and all four behavioural risk factors (b=-4.3, 95% CI -7.5 to -1.2).

CONCLUSIONS

Individuals with functional disabilities and behavioural risk factors are more likely to experience restrictions in social participation. Public health interventions that encourage healthy lifestyle behaviours may help mitigate the impact of functional disabilities on social participation in the ageing population.

Where Maps Lie: Visualization of Perceptual Fallacy in Choropleth Maps at Different Levels of Aggregation

This paper proposes a method for quantitative evaluation of perception deviations due to generalization in choropleth maps. The method proposed is based on comparison of class values assigned to different aggregation units chosen for representing the same dataset. It is illustrated by the results of application of the method to population density maps of Lithuania. Three spatial aggregation levels were chosen for comparison: the 1 × 1 km statistical grid, elderships (NUTS3), and municipalities (NUTS2). Differences in density class values between the reference grid map and the other two maps were calculated. It is demonstrated that a perceptual fallacy on the municipality level population map of Lithuania leads to a misinterpretation of data that makes such maps frankly useless. The eldership level map is, moreover, also largely misleading, especially in sparsely populated areas. The method proposed is easy to use and transferable to any other field where spatially aggregated data are mapped. It can be used for visual analysis of the degree to which a generalized choropleth map is liable to mislead the user in particular areas.

Place of Residence and Cognitive Function in Older Adults in China: The Mediating Role of Social Participation

Background: Cognitive impairment is a severe health problem faced by older adults and their families, as well as the countries in which they live. Differences in place of residence may contribute to differences in the cognitive function of older adults, and the mediating effect of social participation has rarely been studied in China. Methods: A total of 10,014 older adult participants were included, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Place of residence was described as either a city, town, or rural area. The frequency of participation in organized social activities and visits and interactions with friends was used to assess both formal and informal social participation. The Chinese version of a Mini-Mental State Examination (MMSE) was used as a measure of cognitive function. The mediation analysis was conducted using Hayes' process version 3.4 on SPSS (IBM, Armonk, NY, USA). Results: Place of residence had a negative effect on cognitive function in older adults. The mediating functions of both informal (a1b1 = 0.199) and formal (a2b2 = -0.056) social participation indicate a suppression effect on the part of informal social participation and a partial mediation effect on the part of formal social participation in terms of the association between place of residence and cognitive function in older adults. Promoting both informal and formal social participation seems to be an important strategy for preventing a decline in the cognitive function of older adults, especially for those living in rural areas.

Relationships between Participation in Volunteer-Managed Exercises, Distance to Exercise Facilities, and Interpersonal Social Networks in Older Adults: A Cross-Sectional Study in Japan

This study aimed to examine the factors related to participation in volunteer-managed preventive care exercises by focusing on the distance to exercise facilities and interpersonal social networks. A postal mail survey was conducted in 2013 in Kasama City in a rural region of Japan. Older adults (aged ≥ 65 years) who were living independently (n = 16,870) were targeted. Potential participants who were aware of silver-rehabili taisou exercise (SRTE) and/or square-stepping exercise (SSE) were included in the analysis (n = 4005). A multiple logistic regression analysis revealed that social and environmental factors were associated with participation in SRTE and SSE. After adjusting for confounding variables, exercise participation was negatively associated with an extensive distance from an exercise facility in both sexes for SRTE and SSE. Among women, participation in SRTE was negatively associated with weak interpersonal social networks (odds ratio (OR) = 0.57), and participation in SRTE and SSE was negatively associated with being a car passenger (SRTE, OR = 0.76; SSE, OR = 0.60). However, there were no significant interactions between sex and social and environmental factors. Our findings suggest the importance of considering location and transportation to promote participation in preventive care exercise.

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.

Exploring Factors Associated with Functional Change and Predictors of Participation Improvement-A Two Years Follow-Up on People with Depression

The purpose of this study is to understand the functional status distribution and to explore the factors associated with changes in functional status and social participation in people with depression using two-year follow-up data. Subjects were selected from the Taiwan Databank of Persons with Disabilities (TDPD) if they had an evaluation date between July 2012 and 31 December 2017. We used data for 1138 individuals with multiple evaluation records and who were diagnosed with depression. The WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) was the primary functional status measure. Other factors selected from the TDPD included social demographic data, living situation, employment status, economic status, and educational level. The results show scores in all dimensions of the WHODAS 2.0 declined over two years, especially in the domains of cognition, household activities, social participation, and total WHODAS 2.0 score. Aging groups showed poor recovery in cognition, getting along with others, and household activities. People living in suburban areas showed poorer recovery than people living in rural and urban areas in cognition, self-care, and general function (total score of WHODAS 2.0). Employment was also strongly associated with functional recovery in household activities, social participation, and general function. The original scores for cognition and getting along with others showed a significant negative relationship with social participation improvement. Our results can be used by policy makers to provide resources and conduct investigations, and by clinicians when making rehabilitation plans.

Personhood in aloneness and in affinity: satisfactory social participation among home care recipients

Background: Social participation can be described as engaging in activities that provide interaction with others, and support for social participation may reduce loneliness and improve health. However, there is limited knowledge about social participation in a home care context.Aim: To explore the perceptions and experiences of community-dwelling older adults with regard to aspects related to social participation in a home care context.Materials and methods: Seven home care recipients, aged 79-94 years, from two Swedish municipalities participated in semi-structured interviews. The interviews were analyzed using qualitative content analysis. Results: The study identified the central theme, Personhood in aloneness and in affinity, as important in accomplishing satisfactory social participation. The results incorporated cultivating personal interests and navigating occupations, as well as having one's needs seen and experiencing mutuality in social encounters.Conclusions: The study nuances existing knowledge about social participation among older home care recipients, and the findings strengthen the importance of framing a home care environment where recipients can cultivate personhood and be recognized as valuable individuals with relevant needs. Significance: This study extends current understandings of the variety and richness of the social participation and occupational engagement enjoyed by older home care recipients, to be considered in research and practice.

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.

Social participation and barriers to community activities among middle-aged and older Canadians: Differences and similarities according to gender and age

AIM

This study described and compared participation with community activities and perceived barriers among middle-aged and older Canadians by gender and age group (45-64, 65-74, 75-84, ≥85 years).

METHOD

Using the cross-sectional 2008-2009 Canadian Community Health Survey - Healthy Aging, we considered the frequency of involvement in eight community activities and the presence of 10 perceived personal and environmental barriers.

RESULTS

Although frequency was globally similar for women and men (15.2 vs. 14.5 activities per month; P < 0.01), adults aged 65-74 years had higher participation (16.0 activities per month) than adults aged 45-64, 75-84 and ≥85 years (P < 0.01). Barriers showed wider gender and age gaps than participation to community activities. Notably, health condition limitations were the most reported barrier aged ≥65 years, and environmental barriers were generally greater for women than men, particularly transportation problems (P < 0.01), except ≥85 years.

CONCLUSION

The results highlight that further study of social participation and barriers among older adults must consider gender and age differences. The differences are important to consider for designing population interventions aiming at improving social participation among aging Canadians. Geriatr Gerontol Int 2021; 21: 77-84.

Social participation needs of older adults living in a rural regional county municipality: toward reducing situations of isolation and vulnerability

BACKGROUND

Social participation is restricted for approximately half the older adult population but is critical in fostering community vitality, promoting health, and preventing disabilities. Although targeted through interventions by community organizations, healthcare professionals and municipalities, little is known about the needs of older adults to participate socially, especially in rural areas. This study thus aimed to identify and prioritize the social participation needs of older adults living in a rural regional county municipality.

METHODS

A participatory action research was conducted in a rural regional county municipality (RCM) in Quebec, Canada, with a convenience sample of 139 stakeholders, including older adults, caregivers, healthcare and community organization managers, healthcare and community organization workers, community partners and key informants.

RESULTS

Facilitators and barriers to social participation are related to personal factors (e.g., health, interests, motivation), the social environment (e.g., availability of assistance or volunteers) and the physical environment (e.g., distance to resources, recreational facilities and social partners). Nine older adults' needs emerged and were prioritized as follows: 1) having access to and being informed about transportation options, 2) being informed about available activities and services, 3) having access to activities, including volunteering opportunities, suited to their interests, schedule, cost, language and health condition, 4) being accompanied to activities, 5) having access to meeting places near home and adapted to their health condition, and 6-9 (no preferred order) being reached when isolated, being personally invited and welcomed to activities, having a social support network, and being valued and recognized. Differences emerged when prioritizing needs of older adults with disabilities (greater need for assistance, accessibility and adapted activities) and older adults living in a rural area (greater need for transportation).

CONCLUSIONS

To promote active participation in the community, the social participation needs of older women and men living in rural areas must be addressed, especially in regard to transportation, information, adapted activities, assistance and accessibility. The first part of this action research will be followed by community selection and implementation of initiatives designed to ultimately foster their social participation.

Association of Built Environments With Frequency of Going Outdoors Among Older Community-Dwelling Adults in Japan

Built environmental factors are important for encouraging outdoor activity among community-dwelling older adults. A total of 214 participants aged 59-94 years were recruited from local cities in Japan. A mixed-effects multivariate linear regression model was conducted for the analysis. Parks that are easy to get to and car availability were positively associated with the number of days per week with any outdoor exposure. Further, the ability to conduct activities of daily living had a significant effect on the use of safe parks and walking areas and the number of days per week with outdoor time. The findings suggest that subjectively assessed neighborhood-built environments, such as readily available safe parks, walking areas, and car availability, are important for encouraging outdoor activity among older community-dwelling adults in Japan. For those with a limited ability to conduct daily activities, the safeness of parks and walking areas are most important.

Social Activities and Health-Related Quality of Life in Rural Older Adults in South Korea: A 4-Year Longitudinal Analysis

During later life, inadequate social interactions may be associated with worse quality of life in older adults. Rural older adults are prone to developing unhealthy lifestyles related to social activities, which can lead to a poorer quality of life than that enjoyed by older adults living in urban areas. This study aimed to describe longitudinal changes in social activity participation and health-related quality of life among rural older adults, exploring potential associations with changes to in-person social activity over four years. We used prospective community-based cohort data from the Korean Social Life, Health, and Aging Project (KSHAP) collected between December 2011 and January 2016. The sample included 525 older adults who completed the measure of health-related quality of life. Our results showed a significant change in health-related quality of life according to changes in participation in meeting with friends. Even though an individual's participation in other social activities did not show significant differences in health-related quality of life, our findings imply that in-person social activities may be an important resource to encourage participation in physical activities and to develop other positive outcomes, such as a sense of belonging or satisfaction with later life, among rural older adults.

Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data

This study compared the relationship between social participation, including work, and incidence of functional decline in rural and urban older people in Japan, by focusing on the number and types of organizations older people participated in. The longitudinal data of the Japan Gerontological Evaluation Study (JAGES) that followed 55,243 individuals aged 65 years or older for six years were used. The Cox proportional hazards model was employed to calculate the hazard ratio (HR) of the incidence of functional decline over six years and the stratification of rural and urban settings. In this model, we adjusted 13 variables as behavioral, psychosocial, and functional confounders. The more rural and urban older people participated in various organizations, the more they were protected from functional decline. Participation in sports (HR: rural = 0.79; urban = 0.83), hobby groups (HR: rural = 0.76; urban = 0.90), and work (HR: rural = 0.83; urban = 0.80) significantly protected against the incidence of decline in both rural and urban areas. For both rural and urban older people, promoting social participation, such as sports and hobby groups and employment support, seemed to be an important aspect of public health policies that would prevent functional decline.

The Correlation of Self-efficacy and Social Support with Social Participation: A Cross Sectional Study among the Elderly

There is ample evidence that a key contributor to healthy aging is social participation; thus, identifying its determinants can help to improve it. The current study aimed at assessing the relationship between social support and general self-efficacy with social participation. This cross-sectional study was conducted on 456 (male: 237, female: 219) older adults, aged 60-74 years, who were the member of community centers in Tehran, Iran, in 2016. The multi-stage cluster sampling method was employed to select the participants. Primarily, Tehran was divided into five areas (i e, North, South, East, West, and Center). Then, two community centers were randomly selected from each area. Participants with the ability to perform their daily activities independently were enrolled in the study. Participants responded to four self-report questionnaires: socio-demographic, social participation, social support, and general self-efficacy. The majority of the participants were within the age range of 62–68 years with the maximum proportion of social participation (mean ± standard deviation (SD): 37.69 ± 8.34). Findings of the current study indicated that gender, education level, reading books, newspapers, or magazines (p <0.001), living area, living arrangement, and occupational status (p<0.05) were associated with social participation. Multiple linear regression adjusted for living area, sex, and educational level showed that self-efficacy (β= .08; p<.001) and social support (β= .64; p<.001) predicted social participation. Findings showed the importance of social support and self-efficacy in social participation. Also enhancing the literacy of seniors should be given priority.

Access to Services in Rural Areas from the Point of View of Older Population-A Case Study in Finland

Independence and having control over one’s own life are important factors for residential satisfaction. In rural areas, the mobility of people is based on owning a private car, due to the lack of public transport. Furthermore, planning in rural municipalities is highly car oriented. Small municipalities with shrinking and aging populations have many challenges to ensure access to services for their residents. This paper focuses on a case study of a small municipality with less than 2000 inhabitants. The objective of the study was to enhance sustainable change in shrinking rural areas and maintain them as good places to live even in the future. Access to local services and social activities is a major challenge for older people, who no longer have the possibility to use their own car. The problem with relocation is the lack of suitable apartments for older people. A dense and walkable municipal centre with accessible apartments may help municipalities provide for their older populations. Moreover, in Finland, second homeowners are an important resource for small municipalities. Spaces for social intercourse between residents and between permanent residents and second homeowners may enhance vitality and community building in these municipalities.

Neighborhood Walkability in Relation to Knee and Low Back Pain in Older People: A Multilevel Cross-Sectional Study from the JAGES

Few studies have focused on a relationship between the built environment and musculoskeletal pain. This study aimed to investigate an association between neighborhood walkability and knee and low back pain in older people. Data were derived from the Japan Gerontological Evaluation Study (JAGES) 2013, a population-based study of independently living people ≥65 years old. A cross-sectional multilevel analysis was performed, of 22,892 participants in 792 neighborhoods. Neighborhood walkability was assessed by residents' perceptions and population density. Dependent variables were knee and low back pain restricting daily activities within the past year. The prevalence of knee pain was 26.2% and of low back pain 29.3%. After adjusting for sociodemographic covariates, the prevalence ratio (PR) of knee and low back pain was significantly lower in neighborhoods with better access to parks and sidewalks, good access to fresh food stores, and higher population densities. After additionally adjusting for population density, easier walking in neighborhoods without slopes or stairs was significantly inversely correlated with knee pain (PR 0.91, 95% confidence interval 0.85-0.99). Neighborhoods with walkability enhanced by good access to parks and sidewalks and fresh food stores, easy walking without slopes or stairs, and high population densities, had lower prevalences of knee and low back pain among older people. Further studies should examine environmental determinants of pain.

Beyond the bus stop: where transit users walk

OBJECTIVES

Extending the health benefits of public transit requires understanding how transit use affects pedestrian activity, including pedestrian activity not directly temporally or spatially related to transit use. In this study, we identified where transit users walked on transit days compared with non-transit days within and beyond 400m and 800m buffers surrounding their home and work addresses.

METHODS

We used data collected from 2008-2013 in King County, Washington, from 221 non-physically-disabled adult transit users, who were equipped with an accelerometer, global positioning system (GPS), and travel diary. We assigned walking activity to the following buffer locations: less than and at least 400m or 800m from home, work, or home/work (the home and work buffers comprised the latter buffer). We used Poisson generalized estimating equations to estimate differences in minutes per day of total walking and minutes per day of non-transit-related walking on transit days compared with non-transit days in each location.

RESULTS

We found that durations of total walking and non-transit-related walking were greater on transit days than on non-transit days in all locations studied. When considering the home neighborhood in isolation, most of the greater duration of walking occurred beyond the home neighborhood at both 400m and 800m; results were similar when considering the work neighborhood in isolation. When considering the neighborhoods jointly (i.e., by using the home/work buffer), at 400m, most of the greater duration of walking occurred beyond the home/work neighborhood. However, at 800m, most of the greater duration of walking occurred within the home/work neighborhood.

CONCLUSIONS

Transit days were associated with greater durations of total walking and non-transit related walking within and beyond the home and work neighborhoods. Accordingly, research, design, and policy strategies focused on transit use and pedestrian activity should consider locations outside the home and work neighborhoods, in addition to locations within them.

Social participation in older women and men: differences in community activities and barriers according to region and population size in Canada

BACKGROUND

Social participation is a modifiable health determinant influenced by physical and social aspects of the environment. Little is known about aging women's and men's community activities and barriers according to region and population size. This study compared social participation, desire to participate more, and perceived barriers of aging women and men by Canadian region and population size.

METHODS

A secondary analysis of the 2008-2009 cross-sectional Canadian Community Health Survey - Healthy Aging was done with 16,274 respondents aged 65+. Respondents were grouped into five regions [Atlantic, Quebec, Ontario, Prairies and British Columbia] and five population size groups [rural (< 1000 inhabitants); small urban (1000-29,999); medium urban (30,000-99,999); large urban (100,000-499,999); and metropolitan (≥500,000) areas]. Social participation was estimated by monthly frequencies of engagement in community activities. If they desired to participate more, respondents were asked to identify barriers to their participation from a list of 13 reasons.

RESULTS

There were no differences in total social participation between regions but Prairies and Quebec respondents had the highest and lowest frequency, respectively, of activities with family and friends (5.4 and 4.3 activities/month; p = 0.01). Medium urban centers had the highest participation and metropolises, the lowest (17.4 vs 14.3 activities/month; p < 0.01). About one fourth of all respondents wanted to participate more, regardless of region or population size. Overall, women wanted to participate more than men (26.6 vs 20.7%; p < 0.001), especially in Ontario (28.3 vs 21.1%; p < 0.001) and British Columbia (30.1 vs 22.9%; p < 0.001). Men in Quebec were less likely than men in other regions to report "personal responsibilities" as a barrier to participation (p < 0.001). Men were more likely than women to report being "too busy", especially in rural areas (27.1 vs 6.5%; p < 0.001). Rural women were more likely than rural men to be constrained by transportation problems (15.1 vs 1.2%, p < 0.001). Unavailability of activities was more of a constraint in rural areas than metropolises (13.6 vs 6.0%, p < 0.001).

CONCLUSIONS

Overall, there were no practical differences between women's and men's social participation. However, unavailability of activities and transportation problems suggest that local initiatives and further research on environmental characteristics are required to foster aging Canadians' participation.

Transfer of Promotion Effects on Elderly Health with Age: From Physical Environment to Interpersonal Environment and Social Participation

An important goal of building "age-friendly communities" is to help the elderly to access more opportunities for social participation and better health. However, little is known about the complex relationships between neighborhood environment, social participation, and elderly health. This study examined the mediating role of social participation in the area of neighborhood environment affecting elderly health and explored the discrepancy among different age groups in 43 neighborhoods of Shanghai. Both neighborhood environment and social participation had significant positive effects on elderly health in all the samples. Meanwhile, social participation served as a mediator of the relationship between interpersonal environment and elderly health. Furthermore, remarkably, health promotion effects transferred from the physical environment to interpersonal environment and social participation with age; the influence of physical environment on elderly health decreased with the increase of age, while the influence of interpersonal environment and social participation on the health of the elderly increased with the increase of age. This study found that physical environment, interpersonal environment, and social participation had different effects on elderly health of different ages. Different policies should be applied toward improving the interpersonal environment, optimizing of physical environment, and guiding the community activities.

Caractéristiques environnementales favorisant la participation sociale: une enquête auprès d'aînés québécois

We document and compare the environmental characteristics potentially associated with social participation of older Quebecers, according to the level of rurality. A survey was carried out among older Quebecers aged 65 and over recruited by different senior groups and through social media. The Questionnaire their potential for social participation, developed from a systematic literature review, was completed by respondents. According to the 515 older participants, 71.5 years old on average, environmental characteristics linked to social participation, as well as user-friendliness of the city and neighborhood, are more favorably perceived in metropolitan and urban areas than rural areas. However, access to public transportation and the welcoming and openness of local residents are more appreciated by rural respondents. These results support the presence of inequalities in social participation according to level of rurality and offer some leads for action.

Assessing urban-rural differences in the relationship between social capital and depression among Ghanaian and South African older adults

Introduction

Research has demonstrated benefits of social capital on depression, but variations in this relationship by geographic characteristics such as urbanicity have rarely been investigated.

Methods

Using survey data on 4,209 Ghanaian and 3,148 South African adults aged 50 and above from the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE), exploratory and confirmatory factor analyses were conducted to extract dimensions of social capital from survey items. Structural equation models with the extracted factors were then used to estimate the associations between social capital and depression in each sample and assess differences between urban and rural settings with measurement and structural invariance tests.

Results

Factor analyses suggested three dimensions of social capital representing community engagement, sociability, and trust. Urbanicity did not substantially modify the effects of social capital on depression in either setting, but urban-rural differences in the measurement and level of social capital were observed. Urban Ghanaian older adults were less socially integrated and trusting than older rural residents (standardized mean difference: -0.28, -0.24, and -0.38 for community engagement, sociability, and trust, respectively) while urban South African older adults appeared less engaged in community activities but significantly more trusting and socially active informally than older rural residents (standardized mean difference: -0.33, 0.30, and 0.17 for community engagement, sociability, and trust, respectively). Moreover, while trust was associated with a lower risk of depression in South Africa overall, sociability and trust were associated with an increased risk of depression in Ghana.

Conclusions

Results indicate that the composition and average levels of social capital differ between urban and rural older adult residents in Ghana and South Africa although urban-rural differences in the strength of the association between social capital and depression were not substantial. Furthermore, the associations between social capital and depression are context-specific and are not uniformly beneficial.

Help From and Help to Neighbors Among Older Adults in Europe

Neighborhoods can be a valuable source of social support particularly for older adults. Such support can be mutual; however, the influential factors in giving and receiving are unclear. This study investigated neighborhood help among the older European population using representative data for 17 countries from the Survey of Health, Ageing and Retirement in Europe (SHARE). The analyses were based on 104,059 observations of 39,113 respondents aged 50 years and older. In general, ~6% of all respondents provided recently neighborhood help, and 4% received help. Moreover, the results indicate a high degree of reciprocity in giving and receiving neighborhood help. However, the situation varied widely among age groups and countries. Our multilevel results suggest that the provision and receipt of help are driven by personal characteristics (age, sex, education, income, and retirement), health resources (subjective health, activities of daily living, and instrumental activities of daily living), living situation (homeownership, location, and length of time in a residence), social factors (marital status, partner, parents, and children), and contextual factors (gross domestic product, social expenditures, poverty rate, Gini index, population density, country-centered satisfaction with life, living, and relationships).

“We need more things for us”: Being low income and underoccupied in older age

Background.

Low-income older adult populations have increased vulnerability to occupational engagement barriers and poor health outcomes while aging in community settings.

Purpose.

The purpose of this study was to examine the relationship between community navigation and well-being for low-income older adults.

Method.

Community-dwelling older adults ( N = 10) were recruited for this multimethod observational cohort study, which employed GPS data, measures of well-being, and semistructured interviews across 12 months. Grounded theory processes were followed to analyze and integrate the qualitative, quantitative, and spatial data.

Findings.

Findings were three patterns of community navigation. In particular, patterns of being chronically underoccupied were noted for this low-income population. Specific place-based challenges are explained along with strategies used to mitigate these challenges.

Implications.

Supporting community navigation, especially social interaction opportunities, can maximize well-being; and older residents’ occupational participation may be unnecessarily curtailed by geographic, economic, and social factors beyond their control. Community navigation strategies should be considered holistically by occupational therapists as part of interventions supporting aging in place.

An Age-Friendly University (AFU) assists with technology learning and social engagement among older adults and individuals with developmental disabilities

As an Age-Friendly University (AFU), University of Akron is striving to support lifelong learning. A collaborative research effort developed between aging researchers at the university and a government-sponsored pilot program aimed to provide learning opportunities for older adults (OA) and engagement for individuals with developmental disabilities (IDD). The present study assessed the success of a pilot program to increase comfort with technology and community engagement. OA and IDD participants met twice a month for 9 months to discuss how to use technology (e.g., an IPad). We assessed satisfaction, perceived changes in comfort with technology, perceived changes in connection with others, and motivations for participating with questionnaires and a structured interview. On average, participants reported very high satisfaction with the group, and moderate increases in comfort with technology and how connected they feel to others as a result of participating in the group. The most common motivations for participation were related to values, strengthening social ties, seeking to learn, and bringing joy to others. These findings suggest that the pilot was successful at improving community engagement. The involvement of the university in the assessment of this pilot program situates the university as an age-friendly partner for community efforts to support lifelong learning.

Associated factors with physical activity and social activity in a sample of Brazilian older adults: data from the FIBRA Study

OBJECTIVE

This study investigates associated factors to participation in four domains of physical activity and social activities among 2344 community-dwelling older adults (72.3 ± 5.5 years; 65.6% female) without cognitive impairment, residents in six Brazilian cities.

METHOD

An adapted version of Minnesota Leisure Time Activity Questionnaire was used to measure physical activity in four different domains. An inventory of social activities was developed for research. Age, gender and family income were assessed by self-report. Comparisons of frequencies and logistic regression analyzes were performed.

RESULTS

All sociodemographic variables were affecting the activity engagement profile of the sample. Have higher family income showed association with high level of leisure time, occupational and transportation physical activity, result supported by the literature. The gender associated with high level of activity varied according to the specific domain of the analyzed activity indicator. Have less age proved to be associated with higher level of activity in all indicators associated with age, highlighting the increasing age as the major barrier to performance physical and social activities in old age.

CONCLUSIONS

Allow the active involvement of older people is the great challenge of public policies that promote active aging.

"The people make it fun, the activities we do just make sure we turn up on time." Factors influencing older adults' participation in community-based group programmes in Perth, Western Australia

Rapid ageing in western societies is placing increasing strain on health and social care services. In response, governments and health agencies have sought to promote healthy ageing through a range of interventions, many of which aim to enhance social engagement and participation among older people. Such interventions are based on evidence that being socially engaged through participation in various activities leads to better physical, mental and psychosocial health outcomes. The research reported here employed focus groups and individual interviews to address research aims: (a) identify enablers and barriers to participation in community-based group activities among a sample of older people (n = 35, median age 71 years) living in a local government area in the northern suburbs of Perth, Western Australia, and (b) examine how these factors differ between those who regularly participate and those who do not. Our research highlighted four themes: Friendship and Function; Availability and Accessibility; Competing Responsibilities and Priorities; and Changing of the Guard. In particular, this research highlighted the importance of group activities in offering social support as a platform to develop friendships. The findings also indicated that opportunities for social interaction should be embedded in the structure of the group, beyond that which may occur incidentally during activities. This is important, given that while interest may motivate older people to join a group, a sense of belonging and connectedness generated through the group is more likely to maintain their attendance. Barriers included limited availability of local programmes, limited accessibility related to programme scheduling, and lack of programmes relevant to those who do not find traditional seniors' centres appealing. Recommendations include incorporating social engagement as an outcome measure when evaluating the efficacy of programmes targeting older people, and encouraging local governments to work with seniors' centres in developing activities attractive to a broader cohort of older people.