A Scoping Review: Social Participation as a Cornerstone of Successful Aging in Place among Rural Older Adults

Geographic Variation of Prevalence of Alzheimer's Disease and Related Dementias in Central Appalachia

Background

Alzheimer's disease and related dementias (ADRD) prevalence varies geographically in the United States.

Objective

To assess whether the geographic variation of ADRD in Central Appalachia is explained by county-level sociodemographics or access to care.

Methods

Centers for Medicare and Medicaid Services Public Use Files from 2015- 2018 were used to estimate county-level ADRD prevalence among all fee-for-service (FFS) beneficiaries with≥1 inpatient, skilled nursing facility, home health agency, hospital outpatient or Carrier claim with a valid ADRD ICD-9/10 code over three-years in Central Appalachia (Kentucky, North Carolina, Ohio, Tennessee, Virginia, and West Virginia). Negative binomial regression was used to estimate prevalence overall, by Appalachian/non-Appalachian designation, and by rural/urban classification. Models were then adjusted for county-level: 1) FFS demographics (age, gender, and Medicaid eligibility), comorbidities; 2) population sociodemographics (race/ethnicity, education, aging population distribution, and renter-occupied housing); and 3) diagnostic access (PCP visits, neurology visits, and imaging scans).

Results

Across the 591 counties in the Central Appalachian region, the average prevalence of ADRD from 2015- 2018 was 11.8%. ADRD prevalence was modestly higher for Appalachian counties both overall (PR: 1.03; 95% CI: 1.02, 1.04) and after adjustment (PR: 1.02; 95% CI: 1.00, 1.03) compared to non-Appalachian counties. This difference was similar among rural and urban counties (p = 0.326) but varied by state (p = 0.004).

Conclusions

The relative variation in ADRD prevalence in the Appalachian region was smaller than hypothesized. The case mixture of the dual eligible population, accuracy of the outcome measurement, and impact of educational attainment in this region may contribute to this observation.

Extending the PROMIS item bank "ability to participate in social roles and activities": a psychometric evaluation using IRT

OBJECTIVE

Our objective was to explore whether the extension of the PROMIS item bank Ability to Participate in Social Roles and Activities (APSRA) with new items would result in more effective targeting (i.e., selecting items that are appropriate for each individual's trait level), and more reliable measurements across all latent trait levels.

METHODS

A sample of 1,022 Dutch adults completed all 35 items of the original item bank plus 17 new items (in Dutch). The new items presented in this publication have been translated provisionally from Dutch into English for presentation purposes. We evaluated the basic IRT assumptions unidimensionality, local independence, and monotonicity. Furthermore, we examined the item parameters, and assessed differential item functioning (DIF) for sex, education, region, age, and ethnicity. In addition, we compared the test information functions, item parameters, and θ scores, for the original and extended item bank in order to assess whether the measurement range had improved.

RESULTS

We found that the extended item bank was compatible with the basic IRT assumptions and showed good reliability. Moreover, the extended item bank improved the measurement in the lower trait range, which is important for reliably assessing functioning in clinical populations (i.e., persons reporting lower levels of participation).

CONCLUSION

We extended the PROMIS-APSRA item bank and improved its psychometric quality. Our study contributes to PROMIS measurement innovation, which allows for the addition of new items to existing item banks, without changing the interpretation of the scores and while maintaining the comparability of the scores with other PROMIS instruments.

Nurturing the Seeds of Participation: Unveiling the Foundational Path for Understanding Aging in Place Barriers and Facilitators From the Perspective of Older Adults Using Mixed Methods and Translational Science

Participation in society is a cornerstone for quality of life, active aging, and aging in place. While the majority of older adults prefer aging in place, health and financial challenges can hinder this vision. Conducted in suburban South Jersey, this study utilized mixed methods, including surveys and interviews with older adult participants. Surveys indicated that satisfaction with participation in the community is influenced by functional ability, healthcare service availability, and information access. Interviewees identified suggestions to overcome barriers (e.g., improve access to community and address ageism). Combined results provide a theory of change which suggests older adults' empowerment in community participation hinges on home living support, participation options aligning with ability and interest, and accessible information on community events. This person-centered planning approach emphasizes the importance of older adult and stakeholder participation in foundational community planning, offering translational foundational tools for evidence-based strategies to engage them in future community action plans (CAPs).

Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains

This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.

Thwarted Belongingness and Depressive Symptoms Among Older Adults: The Moderating Roles of Self-Warmth, Self-Coldness, and Place of Residence

OBJECTIVES

This study investigated whether the relationship between thwarted belongingness and depressive symptoms was moderated by self-warmth and self-coldness and whether the moderating effects were conditional on place of residence (urban versus rural).

METHODS

A sample of 236 Australian adults aged 65 to 97 years (M = 73.63, SD = 6.53) completed the Geriatric Depression Scale, Interpersonal Needs Questionnaire, and Self-Compassion Scale.

RESULTS

The interaction between thwarted belongingness and self-warmth was significant for urban but not rural older adults. For urban older adults, the relationship between thwarted belongingness and depressive symptoms weakened as levels of self-warmth increased. The association between thwarted belongingness and depressive symptoms was significantly stronger for older adults living in rural areas than in urban areas. The relationship between thwarted belongingness and depressive symptoms strengthened as self-coldness levels increased.

CONCLUSIONS

Self-warmth is a protective factor for older adults living in urban areas and experiencing thwarted belongingness. Self-coldness is an additional risk factor for older adults experiencing thwarted belongingness.

CLINICAL IMPLICATIONS

Interventions focusing on increasing self-warmth among urban older adults and decreasing self-coldness among older adults might weaken the relationship between thwarted belongingness and depressive symptoms.

Understanding the home environment of older adults living with dementia: A scoping review of assessment tools

Rigorous assessments to better understand the person-environment interaction are essential to comprehend how neurocognitive disorders influence in-home functioning of older people living with dementia. No recent synthesis identifies validated instruments targeting the human (e.g. caregivers) and nonhuman (e.g. objects) elements of the home environment interacting with this population and used with the perspective of aging in place. Consequently, following Arksey and O'Malley's (2005) scoping review method, 2,182 articles were identified in six databases and in gray literature. Two reviewers independently selected 23 relevant articles describing 19 validated assessment tools targeting elements of the home interacting with older people with dementia, namely: nonhuman environment (n = 13), human environment (n = 3), and person-environment interaction (n = 3). This overview highlights the scarcity of tools addressing the human environment and the person-environment interaction to foster sustainable at-home living for older people with neurocognitive disorders, demonstrating the need to incorporate new evidence-based, holistic methods into dementia home care.

Social participation, loneliness and well-being among older adults in Hong Kong: a longitudinal examination

The present study adopts a longitudinal design to examine the relationship between loneliness, social participation, life satisfaction and social networks among older adults in Hong Kong. The study also explores the mediating effects of social network and social participation on the relationship between loneliness and life satisfaction. A community sample of 200 older adults (153 female) ranging in age from 65 to 93 years (Mage = 76.03) were recruited from 20 elderly centres and NGOs across Hong Kong. The model of loneliness as a predictor of life satisfaction, sequentially mediated by network importance and social participation was significant and explained a total of 21% of the variance in life satisfaction. The present study highlights the importance of social networks and social participation in contributing to the life satisfaction of older adults in Hong Kong.

"You Need to Set a Daily Schedule": Understanding Successful Aging via Three-Sided Viewpoints

This study aimed to identify the constructs related to successful aging in the context of engagement in social and productive activities. A qualitative design was used to explore three viewpoints on the aging period with 9 focus groups (3 each for adults 65 years or older, older adults' family members, and health professionals) and 18 interviews with older adults (older adults Mage = 71.7 years, Standard Deviation = 4.62). The transcripts were analyzed using constructivist grounded theory principles. Three categories were identified for successful aging: (a) engagement with life, including social participation, fixed/flexible schedule, time, and meaningful occupation; (b) self-management abilities, including producing daily schedules, independence, and initiation/striving toward goals; and (c) diversity among older adults, including their views on retirement, being active or not, and their dreams/values/goals. Considering the diverse nature of older adults, recognizing the importance of life engagement and self-management abilities emphasizes the necessity for an occupation-based, self-tailored approach to enable successful aging.

Healthy Aging and its Determinants Among Community-dwelling Older Persons in East Coast, Malaysia: A Multidimensional Assessment

Objectives

Exploring the possibility of healthy aging among older persons is crucial for achieving optimal health in the growing older population. This study aimed to determine the prevalence, pattern, and determinants of healthy aging among older persons in Terengganu, Malaysia.

Methods

We conducted a community-based cross-sectional study involving older persons aged % 60 years. An interviewer-guided questionnaire, anthropometric measurements, and physical assessments were administered to operationalize healthy aging based on a multidimensional concept.

Results

Among the 765 older persons surveyed, only 14.1% (95% CI: 11.64?"16.59) were classified as healthy agers. Multiple logistic regression analysis revealed that superior intrinsic religiosity (odds ratio (OR) = 3.42; 95% CI: 1.34?"8.73), higher social interaction (OR = 2.82; 95% CI: 1.32?"6.04), larger calf circumference (OR = 2.05; 95% CI: 1.24?"3.38), taking water intake % 5 cups per day (OR = 2.01; 95% CI: 1.23?"3.30), better gait speed (OR = 1.71; 95% CI: 1.04?"2.80), having savings (OR = 1.71; 95% CI: 1.10?"2.66), and normal waist circumference (OR = 1.63; 95% CI: 1.04?"2.55) were found positively associated with healthy aging.

Conclusions

Only one in 10 older persons in the state met all the criteria for healthy aging. Specific aspects of religious status, social interaction, socioeconomic, behavioral, physical, and nutritional factors were found to predict healthy ageing in this population. These important determinants should be considered in developing a well-defined and comprehensive public health policy to promote healthy aging in the nation.

The Built Environment and Social and Emotional Support among Rural Older Adults: The Case for Social Infrastructure and Attention to Ethnoracial Differences

Social and emotional support (SaES) is essential for older adult mental health and is shaped by individual-level factors and the built environment. However, much of the focus on the built environment, and specifically social infrastructure - the physical places that facilitate social interaction and social tie formation - relies heavily on urban settings or samples with limited diversity. Consequently, there is little understanding if social infrastructure matters for the SaES of older adults in rural America, and across race and ethnicity. Therefore, we use social cohesion as a conceptual lens and the community gerontology framework to determine if availability of social infrastructure is associated with SaES among older adults in rural America and if this relationship varies across race and ethnicity. Using data from 110,850 rural older adults from the Behavioral Risk Factors Surveillance System and data from the National Neighborhood Data Archive, we show that among rural ethnoracial minority older adults, higher densities of social infrastructure are associated with higher SaES. This is not true for rural non-Hispanic White older adults. Results highlight the importance of accounting for both social infrastructure as part of the built environment and heterogeneity across race and ethnicity in studies that examine older adult mental and emotional health.

Physical Activity and Social Interaction among Rural Older Adults in Saskatchewan during COVID-19

Physical activity and social interaction among rural older adults are important, particularly during the COVID-19 pandemic when restrictions on physical gatherings were placed. The purpose of this qualitative study was to gain a deeper understanding of rural older adults' experience with physical activity and social interaction during the COVID-19 pandemic. An interpretative phenomenological approach was used to explore the experience of 10 older adults, 67-82 years of age, from rural communities throughout Saskatchewan. Findings revealed that many rural older adults acknowledged the health benefits of physical and social activities and experienced loneliness when COVID-19 restrictions were placed, even when living with a partner. For some, the restrictions placed on physical and social activity provided a welcome break from daily responsibilities. Rural communities, often at a disadvantage, were also perceived by participants as being protected against COVID-19. The resilience demonstrated among rural participants to persevere and adapt to their changing environment during the pandemic was evident in the findings.

Association between social capital and health-promoting lifestyle among empty nesters: The mediating role of sense of coherence

To determine the relationship between social capital, sense of coherence, and health-promoting lifestyles of empty nesters and to clarify the mediating role of the sense of coherence. A total of 452 community-based empty nesters were recruited from February 2023 to May 2023 using a convenience sample from Guiyang, China. Cross-sectional data on older adults' social capital, sense of coherence, and health-promoting lifestyle were collected using questionnaires. Structural equation modeling was constructed using Amos 27.0, and the mediating effect of sense of coherence was tested using the bootstrap method. The results showed that the significant mediating role of sense of coherence between social capital and health-promoting lifestyle (β=0.367, SE=0.066, 95% CI [0.246, 0.509]) explained 52.7% of the total effect of social capital on health-promoting lifestyle. These findings provide a better understanding of how social capital and sense of coherence together to affect health-promoting lifestyles, and they could guide the interventions to promote health-promoting lifestyles among empty nesters.

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

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

Does a reciprocal relationship exist between social engagement and depression in later life?

OBJECTIVES

We examine if reciprocal associations exist between formal and informal social engagement and depression in older adults.

METHOD

We apply dynamic panel-data structural equation models accompanied with the maximum likelihood estimator (ML-SEM) to the seven waves of data of the Korean Longitudinal Study of Aging (KLoSA).

RESULTS

Formal social engagement in and through various voluntary groups exerts both cross-lagged and proximal effects in lessening depressive symptoms. In contrast, informal social engagement with familiar persons exhibits only proximal association with depression. Conversely, depression does not reciprocate a cross-lagged effect on either type of social engagement.

CONCLUSION

The study confirms that formal social engagement in and through various voluntary groups produces a protective effect against depression for older adults across time, supporting the mental health advantage of formal engagement.

Autonomous Shuttle Operating on Highways and Gravel Roads in Rural America: A Demonstration Study

The safe integration of Automated Driving Systems (ADS) into the nation's on-road transportation system, particularly in rural areas, could vastly improve overall quality of life for a rapidly growing segment of the US population. This paper describes findings from the first half (i.e., three of six phases) of a demonstration project called "ADS for Rural America". The goal of this project is to conduct a series of demonstrations that utilizes an autonomous shuttle to show how older adults (≥65 years old) could be transported from their rural homes to other locations in rural areas, as well as an urban center. This paper examines older adults' perceptions of automation before and after riding in an autonomous shuttle and their ratings of anxiety throughout the ride as they experience particular road types and maneuvers. After riding in the shuttle, older adults expressed decreased suspicion, increased trust, and increased reliability of ADS compared to baseline. Older adults reported low levels of anxiety during the 90 min ride in the shuttle. To promote the adoption and acceptance of ADS, older adults should be exposed to this technology.

Moderation of marital status and living arrangements in the relationship between social participation and life satisfaction among older Indian adults

Social participation is considered one of the central components of successful and healthy aging. This study aimed to examine the moderating role of marital status and living arrangement with social participation and its association with life satisfaction of older Indian adults. Samples of 31,464 individuals aged ≥ 60 years were extracted from the Longitudinal Ageing Study in India, wave-1. Descriptive statistics, bivariate analysis, and multivariable linear regression were performed for the analysis. The moderation effect of marital status and living arrangements on the relationship between social participation and level of life satisfaction among Indian older adults were also analyzed. Overall, life satisfaction among older men was relatively higher than older women in this study. Older adults' involvement in social participation [β = 0.39, p < 0.05], being in marital union [β = 0.68, p < 0.001] and co-residing either with spouse [β = 1.73, p < 0.001] or with other family members [β = 2.18, p < 0.001] were positively related to their greater life satisfaction. Interaction of social participation with marital status showed that participating in social activities can boost life satisfaction only among married older people. Further, moderation effect of social participation with living arrangements showed that older adults who were not involved in social participation but living with a spouse or any other household members had higher life satisfaction, and again participation in social activities increased their life satisfaction to a greater level. The establishment of social clubs and advocating social policies oriented toward meaningful social connections are highly needed, especially for older Indians living alone or currently not in a marital union, which will help to enhance their overall life satisfaction.

The impact of social capital on successful ageing of empty nesters: A cross‐sectional study

AIM

To explore the impact of social capital on successful ageing among empty nesters in China.

DESIGN

A cross-sectional study.

METHODS

The data for this study came from the survey of the China Health and Retirement Longitudinal Study (CHARLS) in 2018. Overall, 6098 empty nesters aged 60 years and over were included. Successful ageing was defined according to Rowe and Kahn's model. Social capital includes social trust, social support, reciprocity and social networks. Multivariable logistic regression and a classification and regression tree model were applied to estimate the impact of social capital on successful ageing. For this study, we followed the Reporting of Studies Conducted Using Observational Routinely Collected Health Data (RECORD) reporting guidelines, an extension of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

RESULTS

The successful ageing rate of empty nesters in China was 9.2%. Empty nesters who had a higher level of reciprocal behaviour and caregiving support in several dimensions of social capital and who were members of organizations in their social networks have had higher odds of achieving successful ageing. We also observed interactions with social capital associated with successful ageing, suggesting that special attention should be given to empty nesters who are less educated, have no caregiving support, live in rural areas, have worse self-rated health, are older, do not have reciprocal behaviours and are unmarried.

CONCLUSIONS

The results of this study show that social capital, especially in terms of reciprocity, caregiving support and organizational membership in a social network, can contribute to the achievement of successful ageing among empty nesters.

IMPACT

This study confirms the impact of social capital on the successful ageing of empty nesters for the first time and provides new ideas for state, community and health care workers to address ageing issues.

NO PATIENT OR PUBLIC CONTRIBUTION

Because of the public database data used in this study, all data were collected by survey agency personnel, so this section is not applicable to this study.

Associations between Perception of Help-Seeking Behaviors and Quality of Life among Older People in Rural Communities: A Cross-Sectional Study

Older people's help-seeking behaviors (HSBs) may be limited because of various factors and are essential in improving healthcare in aging societies. This cross-sectional study investigated the association between perception of HSBs, concrete HSBs, quality of life (QOL), and other variables among people over 65 in rural Japan using standardized questionnaires. Participants were divided into high or low health status index score groups based on a median split. Logistic regression was used to assess the association between perception of HSBs and high QOL while controlling for age, sex, living conditions, annual health checks, having chronic diseases, regular clinic visits, smoking, habitual alcohol consumption, education, living conditions, social support, social capital, socioeconomic status (SES), and health literacy. Participants in the high QOL group were younger (p < 0.001), and had fewer chronic diseases and regular clinic visits than those in the low QOL group (p < 0.001). The multivariate logistic regression model revealed that age, chronic diseases, tobacco usage, family consultation, and consulting primary care physicians negatively predicted QOL. High SES, social capital and support, and HSB intention positively predicted QOL. Self-efficacy and intention regarding HSBs should be investigated to improve health among older rural people.

Psychotherapy for late-life psychopathology – Updates to promote aging in place

Psychopathology in late life does not always meet the criterion for a psychiatric diagnosis. Nevertheless, it affects the aging person, their family, employers, and society as a whole. Making psychotherapy accessible for older adults, allowing aging in place, must overcome barriers of mobility, stigma, and emotional difficulty to ask for help. Hence, dedicated counseling and treatment centers should be established in the local authorities for the older adults and their caregivers. Such a local center is described, providing low-cost psychotherapy within an academic environment, accompanied by research to promote suitable therapy of older adults, as well as training programs for professional therapists, not just psychologists, with unique emphasis on late-life psychopathology. This model should be implemented, the more the merrier.

Pet ownership issues encountered by geriatic professionals: Preliminary findings from an interdisciplinary sample

Pets often factor in older adults’ health behaviors and decisions. However, the degree to which issues related to pet ownership are encountered or addressed by professionals working with this population remains unknown. The aim of this study was to identify specific issues stemming from pet ownership professionals had encountered in their work with older adults, people living with dementia, and care partners. An interdisciplinary (e.g., social services and healthcare) sample (N = 462, 89.13% female, M_age = 53.02, SD_age = 12.18) completed an online survey addressing pet ownership issues encountered in their work. Descriptive statistics, t-tests, and repeated measures ANOVAs were used to analyze quantitative data. A conventional content analysis was used to analyze open-ended responses to an item asking about “other” issues encountered in their work with these populations. The professionals estimated 46.29% of clients had been pet owners, 41.23% regularly asked about pets, and 79.22% had encountered issues related to pet ownership. Specific issues raised to the professionals varied by type of client. The professionals reported older adults most often raised getting pet items into the home and concerns about their pets’ health. The issues most often raised by people living with dementia to the professionals were planning for the pet due to a housing transition and basic pet care. Care partners focused on basic pet care and planning for the pet due to a housing transition. The professionals themselves most often raised the issues of basic pet care, concerns about falling, and the pets’ behavior. Professionals who entered clients’ homes were more likely to raise issues stemming from pet ownership compared to those who reported they did not enter clients’ homes in their current job, t(429.40) = 5.59, p < 0.00001. The eleven new issues identified by the content analysis (e.g., pets impeding care, people refusing care due to the pet) underscored how the health and wellbeing of people and their pets are linked. The results of this study provide strong evidence that professionals do encounter issues related to pet ownership. Including issues stemming from pet ownership into procedures, policies, and programs is likely to have positive impacts on those served by and working in the geriatric workforce.

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 .

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

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

Experiences of Disabled Older Adults in Tokyo's Adult Day Care Centers during COVID-19-A Case Study

The COVID-19 pandemic resulted in social isolation among elderly people with disabilities. Adult daycare (ADC) is an important community care option for socialization among people with disabilities. However, their experiences with ADC remain underexplored. Thus, this study investigated the experiences of community-dwelling disabled elderly with ADC from the perspective of socialization. Four older women from Tokyo with disabilities, availing of one ADC service, were interviewed across two sessions between November 2020 and January 2021. The transcribed interviews and field notes were analyzed qualitatively. This yielded eight categories: two pertaining to context ("restricted social interaction outside of ADC", "feeling simultaneously grateful and ashamed of oneself as a recipient of care services"), and six pertaining to experience with ADC ("take a catastrophic defensive posture in situations where one's perception of value is shaken", "express oneself positively to justify one's daily life", "have trouble knowing what to do", "put oneself in a shaded exchange relationship", "examine the value of elderly people in need of care in society", and "savor regular contact with others"). Ensuring the use of ADC as a safe place for interaction while considering pandemic-related needs is important to develop policy and practical responses to restricted socialization during COVID-19.

Older People's Help-Seeking Behaviors in Rural Contexts: A Systematic Review

Help-seeking behavior (HSB) is vital for older people to sustain their health. As people in aging societies increasingly demand management of their multiple symptoms, communities should encourage HSBs. In rural communities, insufficient healthcare and human resources influence older people’s health. However, no related comprehensive evidence exists so far. This study investigates the present condition of older people’s HSBs in rural contexts in aging societies. We conducted a systematic review by searching six databases (PubMed, Cochrane Library, EMBASE, Medline, and Web of Science) for original studies regarding HSBs of older people in rural contexts published until January 2022. Extracted articles were analyzed based on participants, settings, HSB causes and contents, and older people’s HSB outcomes in rural contexts. Sixteen studies were included in the systematic review: seven investigated the associations between HSBs and participants’ backgrounds, and three the quality of life. Six studies investigated HSB perception, diagnosis, clarifying HSB contents, professional care trend, self-rated health, and mortality. Unlike few studies investigating the association between HSBs and health-related outcomes, this systematic review explains the current evidence regarding rural older people’s HSBs. Due to insufficient evidence from longitudinal studies in clarifying interventions for effective HSBs, future studies should use observational and interventional designs.

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

Background

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

Objective

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

Methods

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

Results

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

Conclusion

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

Social Participation Benefit in Elderly Patients With Diabetes: A Scoping Review

Aims: To conduct a scoping review on the proportion of social participation in elderly patients with diabetes and related factors to clarify what is known and what needs to be addressed in the future. Methods: Literature searches were conducted using MEDLINE, Web of Science, CINAHL, CiNii, and Ichu-shi. Articles that surveyed social participation in elderly patients with diabetes were included. Social participation was defined as participation in community activities/groups (exercise, sports, hobbies, volunteer activities, neighborhood associations, senior citizens associations, and political and religious organizations). Results: The mean age of the subjects was 67 years, and 42% were women. The percentage of social participation was 13%–36%. Moreover, factors contributing to social participation included self-management of treatment, lifestyle, mobility, subjective assessment of health, and quality of life. Conclusion: This study showed the percentage of social participation in elderly patients with diabetes and related factors. Further study is required to evaluate the causal relationship, the mechanism between social participation and contributing factors, the relationship between social participation and other outcomes, and several stratified analyses in elderly patients with diabetes.

The Influence of Interpersonal Behaviors and Population Density on Grip Strength of Elderly People: An Analysis of the Direct vs. Indirect Effects via Social Participation

The impact of social participation (SP) on the health of the elderly has been widely recognized, and urban-rural differences in social participation have attracted attention. However, few studies discussed the impact of social participation on specific health indicators and the further subdivision of urban-rural differences. This research aims to use the dimensions of interpersonal behaviors and population density rather than simple urban-rural distinctions to justify community differences and compare these differences' direct and indirect effects on grip strength. This study used 15,871 respondents aged over 50 years from the China Health and Retirement Longitudinal Study (CHARLS). An SEM (Structural Equation Modeling) analysis was used to explore the joint effect of interpersonal behavior and population density on social participation and the consequent impact on changes in grip strength and compare the differences among different genders, ages, wealth levels, and family relationships. The results indicated that community differences characterized by interpersonal behavior and population density have direct effects on grip strength and indirect effects on it through social participation. The conclusion is that the frequency of social activities, such as mah-jong and dancing in the Metropolitan Fringe and county-level cities is higher than that in Metropolitan centers. The high frequency of these activities has a positive and indirect impact on grip strength, and community differences have a more significant impact on women's social participation than men. However, the direct effect of community differences as defined by interpersonal communication and population density on grip strength is greater than the indirect effect of other factors through social participation.

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

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

Solving Social Problems in Aging Rural Japanese Communities: The Development and Sustainability of the Osekkai Conference as a Social Prescribing during the COVID-19 Pandemic

Social prescribing is critical during the coronavirus disease 2019 (COVID-19) pandemic. Social prescribing refers to non-medical interventions related to culture and traditions; they are increasingly being proposed to address wider determinants of health as well as help patients improve health behaviors and manage their conditions effectively. Traditional and cultural behaviors in the community can be utilized for effective social prescribing. Due to the pandemic, social participation opportunities have decreased, resulting in the absence of Osekkai, a traditional Japanese behavior. A driver of Osekkai is the Osekkai conference; it is the model through which Osekkai is implemented in communities to bring resources and individuals together to address community needs. This research aims to clarify the Osekkai conference’s development process and how it can solve social problems, thereby leading to the creation of sustainable communities. We conducted semi-structured interviews with Osekkai conferences’ participants and organizers during the COVID-19 pandemic. We used thematic analysis to achieve the research aims. A total of 12 participants were interviewed. Five themes were developed from the thematic analysis: driver of the Osekkai conference’s development, trajectory of continuity, chain of Osekkai, changes in communities and participants, and sustainability of the conferences. This study showed how reviving traditional behaviors helps face initial difficulties. It described these increasing traditional behaviors in terms of social prescribing that changes the community’s and citizens’ social capital. Reviving traditional behaviors created new challenges and solutions during the pandemic.

Support for the higher-order factor structure of the WHODAS 2.0 self-report version in a Dutch outpatient psychiatric setting

PURPOSE

Previous studies of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) interview version suggested a second-order model, with a general disability factor and six factors on a lower level. The goal of this study is to investigate if we can find support for a similar higher-order factor structure of the 36-item self-report version of the WHODAS 2.0 in a Dutch psychiatric outpatient sample. We aim to give special attention to the differences between the non-working group sample and the working group sample. Additionally, we intend to provide preliminary norms for clinical interpretation of the WHODAS 2.0 scores in psychiatric settings.

METHODS

Patients seeking specialized ambulatory treatment, primarily for depressive or anxiety symptoms, completed the WHODAS 2.0 as part of the initial interview. The total sample consisted of 770 patients with a mean age of 37.5 years (SD = 13.3) of whom 280 were males and 490 were females. Several factorial compositions (i.e., one unidimensional model and two second-order models) were modeled using confirmatory factor analysis (CFA). Descriptive statistics, model-fit statistics, reliability of the (sub)scales, and preliminary norms for interpreting test scores are reported.

RESULTS

For the non-working group, the second-order model with a general disability factor and six factors on a lower level, provided an adequate fit. Whereas, for the working group, the second-order model with a general disability factor and seven factors on a lower level seemed more appropriate. The WHODAS 2.0 36-item self-report form showed adequate levels of reliability. Percentile ranks and normalized T-scores are provided to aid clinical evaluations.

CONCLUSION

Our results lend support for a factorial structure of the WHODAS 2.0 36-item self-report version that is comparable to the interview version. While we conjecture that a seven-factor solution might give a better reflection of item content and item variance, further research is needed to assess the clinical relevance of such a model. At this point, we recommend using the second-order structure with six factors that matches past findings of the interview form.

The Association between the Self-Management of Mild Symptoms and Quality of Life of Elderly Populations in Rural Communities: A Cross-Sectional Study

Maintaining people’s health based on their help-seeking behavior (HSB) regarding mild symptoms is essential. An effective HSB, especially self-management, can facilitate the attainment of appropriate healthcare resources and affect health outcomes such as quality of life (QOL). However, clear evidence regarding the relationship between self-management, mild symptoms, and QOL is unavailable. Therefore, this cross-sectional study investigated this association in a rural elderly population. The participants, aged over 65 years, were living in rural communities. The primary outcome of QOL was examined using the EuroQol 5-Dimension 5-Level (EQ-5D-5L). After adjusting for propensity score matching, 298 participants in the self-management usage group were matched with 298 in the group not using self-management. The most frequent HSB trend was consulting with primary care physicians, followed by self-care, consulting with families, utilizing home medicines, and buying medicines. The EQ-5D-5L scores were statistically higher in the self-management usage group than in the other group. The HSBs with a trend of using self-management were related to a high QOL. Self-management of symptoms along with other HSBs can improve elderly HSBs in rural contexts. Educational interventions and system development for HSBs in rural contexts could be effective in enhancing the QOL of rural elderly populations.

Service Use Objectives among Older Adult Day Care Clients with Disability in Japan

Quality assurance in long-term care settings requires outcome evaluation reflecting client-specific needs of service use. This study aimed to explore the clients’ needs of adult day care (ADC). Data of 360 clients from 11 ADC agencies in Japan were analyzed. Clients’ needs for ADC use were evaluated by their respective ADC staff using 17 items of four domains: “social participation,” “hygiene and health,” “exercise and eating habits,” and “family support.” The prevalence of four domain needs was calculated and the relationship between physical independency and the presence of needs in the four domains was examined by the chi-squared test. A total of 291 (80.8%) clients had one or more needs while 69 (19.2%) clients had none. The social participation need was most prevalent (270, 75.0%) and 249 clients (69.1%) had combination needs, including social participation, along with another domain. “Feeling like revisiting the ADC” was the most common need (60.6%); it was more frequently needed by those with a higher level of independence (p = 0.003). The study findings suggest that an outcome measure relevant to social participation can be considered as the most common benefits of ADC use. However, ADCs with clients who are more dependent should consider hygiene, nursing, and family support needs.

Aging in Place: Challenges of Older Adults with Self-Reported Cognitive Decline

Background

An emergent concern related to the aging and the increased risk of cognitive decline is the institutionalization of older adults. Evidence has shown that aging in place leads to many benefits, including higher quality of life. In order to support older adults, it is imperative that we understand the challenges people with changes in cognition face while aging in place.

Methods

A total of sixteen older adults with self-reported cognitive decline and six informal caregivers of individuals reporting cognitive decline, all of whom are living in independent residences, participated. Focus group sessions with semi-structured interviews were conducted, followed by thematic qualitative data analyses.

Results

Thematic analyses led to the identification of six challenges to aging in place, including: 1) memory decline, 2) emotional challenges/low mood, 3) social isolation/loneliness, 4) difficulty with mobility and physical tasks, 5) difficulties with activities of daily living/instrumental activities of daily living, and 6) lack of educational resources on cognitive change.

Conclusion

The themes identified in the current study represent common challenges in aging in place for older adults with self-reported cognitive decline. Identification of these themes allows for important next steps, which can focus on supports through targeted interventions.

A Space-Time Analysis of Rural Older People's Outdoor Mobility and Its Impact on Self-Rated Health: Evidence from a Taiwanese Rural Village

With the aggravation of rural aging, the well-being and self-rated health level of older people in rural communities are significantly lower than those in urban communities. Past studies hold that mobility is essential to the quality of life of the elderly, and well-being depends on their own adaptation strategies in the built environment. Therefore, this study combines three key factors related to active aging: environment, health and mobility, and assumes that the elderly with good health status will have environmental proactivity and a wider range of daily mobility in a poor rural built environment. This study attempts to track daily mobility by using a space-time path method in time geography and then to explore the relationship between outdoor mobility and older people's self-rated health. A 1-week mobility path survey for 20 senior citizens of Xishi Village, a typical rural village in Taiwan, was conducted by wearing a GPS sports watch. A questionnaire survey and in-depth interviews were done to provide more information about the seniors' personal backgrounds and lifestyles. The results show that when the built environment is unfit to the needs of daily activities, half of the participants can make adjustment strategies to go beyond the neighborhoods defined by administrative units. Correlation analysis demonstrated that mental health is associated with daily moving time and distance. In addition, men have higher self-rated health scores than women, and there are significant statistical differences between married and widowed seniors in daily outing time and distance. This exploratory study suggests that in future research on rural health and active aging in rural areas, understanding the daily outdoor mobility of the elderly can help to assess their health status and living demands and quickly find out whether there is a lack of rural living services or environmental planning.

Educational Intervention to Improve Citizen's Healthcare Participation Perception in Rural Japanese Communities: A Pilot Study

In this mixed-methods study, we hypothesized that social cognitive theory (SCT)-based educational interventions for healthcare participation can improve the self-efficacy of older rural citizens in participating in their health management without any difficulties. Quasi-experimental study before and after SCT-based educational interventions and semi-structured interviews were conducted. Participants were Japanese elderly (>65 years) from rural communities. Propensity score matching was performed to estimate the effectiveness of educational interventions on participants' perception (intervention: n = 156; control: n = 121). Interview contents were transcribed verbatim and analyzed based on thematic analysis. The intervention group scored significantly higher than the control group for participation in planning and managing self-care. Interviews revealed three themes: ability to manage health conditions, relationship with medical professionals, and relationship among citizens. Participants reported difficulties in judging symptoms and communicating with medical professionals. Hierarchy and low motivation to participate in healthcare hindered collaboration. The findings suggest that SCT-based educational interventions can positively impact rural citizens' self-efficacy in healthcare participation.

Membership, Neighborhood Social Identification, Well-Being, and Health for the Elderly in Chile

The world’s elderly population is growing, and in Chile they represent 16.2% of the total population. In Chile, old age is marked by retirement, with a dramatic decrease in income that brings precariousness. Older adults are economically, socially, and psychologically vulnerable populations. This condition increases their likelihood of disengaging from their usual social environment, facilitating their isolation, sadness, and discomfort. From the perspective of social identity, well-being (WB) can be explained by two principles: social groups’ importance for health and people’s psychological identification with those groups. This study analyzes the relationships between belonging to the neighborhood and extra-neighborhood groups and neighborhood social identification with WB. Urban or rural location and gender are measured, and the sample is 1,475 older Chilean adults of both sexes. The results show that the majority are not members of social groups (52%), and the remaining 48% are members of one or two groups or organizations (42.65%). Only 4.47% belong to three groups or organizations. Those who belong to groups obtain higher scores, emotional–mental WB, and positive emotions than older adults who do not belong to any organization. Urban and rural older adults have the same level of WB. Membership in close social organizations (neighborhood councils) or distant ones (clubs for the elderly and religious groups) causes different WB associations. Membership in neighborhood councils reduces gender differences in self-assessment of health. This result supports the idea that participation in heterogeneous groups with a shared sense of belonging to the neighborhood is associated with higher WB and lower perceived loneliness. Social identification with the neighborhood, rather than belonging to the group, had the most widespread impact on WB and health indicators. The variable social identification with the neighborhood was consistently associated with indicators of hedonic WB.

Perspectives on Aging-Related Preparation

When older adults face age-related life challenges, anticipating what to expect and how to access potential coping strategies can both prevent and provide the possibility of easier recovery from crises. Aging-Related Preparation (ARP) is defined as the continuum of thoughts and activities about how to age well, often beginning with the awareness of age-related changes, or the anticipation of retirement, and concluding with specifying end-of-life wishes. In the current paper, we introduce the concept of ARP and related formulations regarding plans for aging well, describe both predictors and outcomes of ARP for several the domains of ARP, and consider the elements of ARP within the context of existing social policy. We conclude that ARP is determined by a variety of influences both intrinsic to the older person (e.g., personality, cognitive ability, beliefs about planning, problem-solving skills), linked to social class and education, as well as dependent on family structures, access to and knowledge of options, services, and local community resources, and social policy. We further provide evidence that ARP has positive effects in the domain of pre-retirement planning (for retirement adjustment), of preparation for future care (for emotional well-being), and of ACP (for a good death). However, other domains of ARP, including planning for leisure, housing, and social planning are under-researched. Finally, we discuss policy implications of the existing research.

Acceptance and Influencing Factors of Social Virtual Reality in the Urban Elderly

In the stage of aging society and population aging, the social needs of the elderly are widely discussed by researchers. Especially driven by the demand of tele-medical treatment and tele-rehabilitation therapy, it is vital for the elderly to integrate into virtual communities by combining social virtual reality (VR) with different medical services and entertainment needs. In addition, affected by the COVID-19 epidemic, it is more difficult for people to have face-to-face contacts. With more remote consultation, entertainment and virtual social connectivity, the application of social VR is more urgent and valuable. However, there is little discussion on the acceptability and influencing factors of social VR among the elderly at present. Therefore, in order to get further data, we used (1) early stage semi-structured interviews and then (2) Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaires for investigation. One hundred fourteen elderly people aged 60–89 living in the metropolitan area of Taipei were taken as the subjects. To help them understand the situation and state of using social VR, these elderly people were asked to use a head-mounted display (HMD) to experience social VR games. The preliminary results showed that the elderly had obvious preference for entertainment (32.4%) and medical treatment (31.3%). The interview showed that this was related to the physiological condition or medical needs of the age range. In order to further understand how social VR would affect the social life of the elderly, we proposed the further demand structure of UTAUT Model based on the interview of both experts and the elderly. The model structures include (1) Performance Expectancy, (2) Perceived Enjoyment, (3) Social Influence, (4) User Attitude, (5) Behavioral Intention, and so on. These structures were applied to conduct interviews and questionnaires to find out the influence extent and relevance of the elderly on different structural needs, and suggestions were given accordingly. The results of the above interviews showed that (1) the elderly thought that the functions of entertaining and interacting of social VR could increase their social opportunities, and also meet medical needs (teleconference, cognitive decline, etc.), (2) the closeness of social relations (between family members, friends, doctors, and places), and also affect the relevance of Perceived Enjoyment (β = 0.77, p = 0.000 < 0.05). The results of these phenomena and interviews showed the interplay between the demand structures and their special relevance. They also indicated that as to social VR technologies, various demands and functional issues of the elderly need to be considered, and these demands would appear in the subtle usage, and different social VR interfaces and functions would emerge based on their special living ways and physical and psychological demands.

Measurement Development for Japanese Clients' Experiences during Adult Day Care Service Use (The J-AdaCa Tool)

Adult day care (ADC) is among the most common services in the Japanese long-term care context, but information on how such care is offered remains scarce. This study aimed to develop a measurement tool to assess the richness of clients’ experiences regarding their ADC service use. Through a collaboration with ADC administrators and staff, semi-structured interviews were conducted with three ADC clients (in one ADC agency), and a questionnaire survey (17 items about clients’ and their families’ experiences within ADC) was applied to 360 ADC clients (in 11 ADC agencies). Principle component analysis showed four factors regarding experience of ADC use: “Social participation”, “Hygiene and health”, “Exercise and eating habits”, and “Family support”. These positive experiences might be effectively provided if stakeholders refer to clients’ needs during ADC experiences, and their effective provision may relate to better care outcomes.

Natural History of Social Participation in the Very Old: Findings from the Newcastle 85+ Study

Objective: To describe the natural history of social participation in people aged 85 years and over. Methods: Prospective cohort study; Newcastle 85+ study. Data were collected at baseline (n = 850) and at 18-, 36- and 60-month follow-ups (n = 344). Participation in 19 social activities (e.g. playing bingo, doing volunteer work and watching television) was measured at each time point. Results: The mean number of activities reported at baseline was 8.7 (SD 2.6). The number of activities was higher in those with higher educational attainment and intact walking ability (both p < .001). Social participation decreased significantly over time (p < .001) and at a similar rate in both sexes and for those with/without limited walking ability but at a higher rate in those with higher than lower educational attainment (p = .019). Discussion: Social participation seems to decrease significantly between ages 85 and 90 years; ways of encouraging social participation in this age group are needed.

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.

Multidimensional and Physical Frailty in Elderly People: Participation in Senior Organizations Does Not Prevent Social Frailty and Most Prevalent Psychological Deficits

Purpose: The study explores how the involvement in community-based senior organizations affects the prevalence of multidimensional and physical frailty among community dwelling elderly people.

Materials and Methods: The group of 1,024 elderly people (270 males) over the age of 65 years (mean age 72.6 ± 6.3 years; range 65–93 years) took part in this study. The subjects completed a questionnaire regarding multidimensional (i.e., the Tilburg Frailty Indicator, TFI) and physical frailty (i.e., the FRAIL scale), as well as factors associated with frailty and participation in senior organizations.

Results: The prevalence of multidimensional frailty (if at least 5 points in the TFI) was 54.6%, and the prevalence of physical frailty (if at least 3 points in the FRAIL scale) and a non-robust status (if any point in the FRAIL scale was positive) was 6.3 and 52.9%, respectively. The most prevalent frailty deficits were missing other people (66.6%), feeling nervous or anxious (65.9%), and feeling down (65.5%). Members of senior organizations presented a lower prevalence of multidimensional and physical frailty comparing with non-members. This was mainly caused by a lower prevalence of physical deficits and problems with memory; however, the prevalence of social deficits was similar in both groups. Senior organizations had no influence on the most widespread frailty deficits, i.e., missing other people, feeling nervous or anxious, and feeling down.

Conclusions: Multidimensional frailty and physical non-robust status are common among people over the age of 65 years. Participation in senior organizations is associated with lower risk of physical frailty; however, it has no effect on social frailty and the most prevalent psychological deficits. This information has important implications for practical management with senior problems and may influence community strategies concerning elderly people.

Social Capital and Preferences for Aging in Place Among Older Adults Living in Rural Northeast China

The present study examines the association between cognitive social capital and structural social capital and aging-in-place among older adults living in rural Northeastern Chinese communities. Data were derived from a survey conducted in Dongliao County, Jilin Province, China, in late 2019. A quota sampling approach was used to recruit 458 respondents aged 60 years and older. Structural equation modeling was applied to test the proposed model. The results show that the measurement models of cognitive social capital and structural social capital were established in rural Chinese communities. Structural social capital was found to have a higher effect on aging in place than cognitive social capital (structural social capital: β = 0.241, p < 0.001; cognitive social capital: β = 0.118, p < 0.05). The findings highlight the crucial role both cognitive and structural social capital play in affecting the preference for aging in place among older rural Chinese adults. Policy and intervention implications are discussed.

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

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

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.