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

Serviced Housing for Older People and Prevention of Functional Decline: A One-year Follow-up Study in Japan

Serviced Housing for Older People (SHOP) is a community-based housing model in Japan that provides barrier-free apartments and support services for residents. Whether the SHOP model has positive effects on residents' health remains unclear. This follow-up study examines the association between living in SHOPs and functional decline. Using data from the Japan Gerontological Evaluation Study, we compared functional decline risks at one-year follow-up between older adults living in conventional housing (n = 2202) and SHOP residents (n = 160). Functional decline risk was assessed using the Kihon Checklist (KCL) and Care-Need Risk Assessment Scale (CNRAS). SHOPs residents had lower KCL and CNRAS scores than older adults living in conventional housing. In sensitivity analyses, these associations remained unchanged. The results, thus, showed that residing in SHOPs was associated with reduced functional decline; therefore, SHOPs designed to support residents' physical and social health could be important for supporting aging in place.

Disability-inclusive graduation programme intervention on social participation among ultra-poor people with disability in North Uganda: a cluster randomized trial

BACKGROUND

People with disabilities encounter significant barriers to social participation due to inaccessible environments and negative attitudes. This study evaluated the effectiveness of a comprehensive disability-inclusive graduation (DIG) programme in enhancing social participation among ultra-poor people with disabilities in rural Uganda.

METHODS

A two-arm, cluster-randomized controlled trial was conducted in four Northern Ugandan districts, involving 96 intervention and 89 control clusters. The DIG intervention encompassed four pillars: Livelihoods, Social Protection, Financial Inclusion, and Social Empowerment. The study identified households with disabilities using the Washington Group Short Set questions, verified by BRAC programme managers, comprising 370 working-age people with disabilities in the intervention group and 321 in the control group at baseline. Treatment clusters received an 18-month DIG intervention from December 2020 to June 2022. Social participation was measured using the SINTEF Participation Question Set at baseline, immediately post-intervention, and 16 months post-intervention, covering household and societal participation domains. Intervention effects were analyzed through linear mixed-effects regression models, reporting minimally adjusted and fully adjusted mean differences (MAMD and FAMD) with 95% confidence intervals.

RESULTS

Immediately after the intervention, the DIG programme showed a positive trend in overall social participation (3.04 point increase in intervention group vs. - 0.29 in control), though not statistically significant in fully adjusted analysis (FAMD = 3.14, 95% CI = (- 1.26, 7.54); p = 0.17), possibly due to sample size limitations and variability in individual responses. A larger improvement in societal participation was observed favouring the intervention group (5.92 point increase versus 0.21 in control), with the fully adjusted analysis approaching statistical significance (FAMD = 5.84, 95% CI = (- 0.01, 11.69); p = 0.05). No significant differences were found in the domain of household participation. At 16 months post-intervention, no significant differences were observed between the intervention and control groups in overall scores or any subdomain, suggesting challenges in maintaining initial improvements over time.

CONCLUSIONS

The DIG programme showed short-term positive effects on social participation among ultra-poor people with disabilities, especially in societal engagement. The absence of long-term sustained improvements underscores the complexity of disability inclusion in resource-constrained settings. Future interventions should develop strategies like extended support or booster sessions to maintain initial gains.

TRIAL REGISTRATION

Registry for International Development Impact Evaluations (RIDIE-STUDY-ID-626008898983a) and ISRCTN (ISRCTN-78592382).

Psychosocial work determinants of older adults' participation in the job market: protocol for a scoping review of quantitative longitudinal studies

BACKGROUND

More than one-third of the population in developed countries is aged 50 and older (hereafter older adults), and this proportion has been increasing every year. Aging is associated with labor shortages which places a large socioeconomic stress on individuals, organizations, and governments. Evidence on the influences of psychosocial factors in older workers mostly focuses on adverse health outcomes and early retirement, with little or no evidence of their influences on other aspects or assessments of older adults' participation in the job market. In this work, we aim to describe existing quantitative longitudinal studies on the relationship between psychosocial work factors and older adult's participation in the job market, and to explore how the outcome is operationalized in existing studies on this topic.

METHODS

The scoping review frameworks developed by the Joanna Briggs Institute (JBI) and Levac and colleagues will guide this study. We will perform a comprehensive search for eligible publications in the followingdatabases: MEDLINE, AgeLine, CINAHL, PsycInfo, SCOPUS, ProQuest One Business, SOCindex, Abstracts in Social Gerontology, and Social Works Abstract. This work will focus on the job-demand-control-support, the effort-reward imbalance, the organizational justice, three renowned theretical models, while paying attention to other work risk factors measured in selected studies. Studies involving older adults of 50 years old or more and published in English or French will be considered, regardless of publication date. Abstracts, full-text screening, and data extraction will be performed independently by two trained reviewers using standard methodology. While sorting studies, we will complete a narrative synthesis of findings considering, when possible, sex and gender.

DISCUSSION

While rigorous reviews are increasingly being recommended for decision-making in organizational and political guidelines, providing an overview of psychosocial work factors associated with older adult's participation in the job market is a crucial start point. This scoping review will contribute to the understanding of how to define and assess participation in the job market and its work-related determinants in older adults. Our findings may also help to prioritize if and what future systematic reviews on this topic should focus on.

SYSTEMATIC REVIEW REGISTRATION

Submitted in Open Science Framework on 07-10-2023.

High-Impact Participation? Social Activities, Activity Frequency, and Older Adult Cognition

ObjectivesThere is growing recognition that social participation may help attenuate cognitive decline in older ages. Unfortunately, previous research often relies on participation index measures, which may obfuscate associations among cognition, specific activities, and the frequency of partaking in those activities.MethodsData are from six waves of the Health and Retirement Study (N = 20,696). Regression models test how associations between social participation and cognition vary by social activity and by multiple specifications of activity frequency.ResultsUsing a participation index, any new activity or increase in activity frequency was positively associated with cognition. When segregating activities, only three activities had positive associations: meeting friends, volunteering, and being a part of community organizations. We find limited evidence that activity frequency is an important moderator.DiscussionSocial activities likely have heterogeneous associations with older adult cognition. The frequency threshold linking social participation to cognition may be "any" regular participation in select activities.

Personalized Citizen Assistance for Social Participation (APIC) adapted for older adults with visual impairment: results from a mixed study

PURPOSE

To explore the effects of the Personalized Citizen Assistance for Social Participation (APIC), an intervention adapted here for visual impairment, involving weekly stimulation sessions over six to twelve months, provided by trained and supervised attendants, on seven outcomes (social participation, leisure, independence, mobility, quality of life, health-related quality of life, and empowerment) in older adults with visual impairment, and to document its facilitators and barriers.

METHODS

A mixed-method design, which included a pre-experimental and an exploratory qualitative clinical research component, was used on 8 older adults (7 women) with visual impairment aged 70-86, and 8 attendants (5 women) aged 20-74. Before the intervention, directly after, and four months later, older adults completed questionnaires on the 7 outcomes. During the intervention, attendants completed diaries and participated in monthly meetings. Semi-structured interviews were administered to all participants after the intervention.

RESULTS

Social participation, leisure, mobility, quality of life and empowerment had increased immediately after the APIC. These improvements were still generally observed four months later. Participants reported that the APIC improved older adults' capabilities, social participation, and social environment.

CONCLUSIONS

The APIC is a promising intervention which helps older adults with visual impairment to deal with social restrictions.

Adults Aged 75+ Happy in Conventional Dwelling or Independent Living Facility but Associated With Thriving and Ageism

This study aimed to compare levels of happiness of older women and men living in conventional dwellings (CD) and independent living facilities (ILF), and examine happiness' associations with thriving, social participation, community integration and ageism (self-directed and discrimination). A cross-sectional survey was conducted with a random sample of 509 older adults in CD and 470 in ILF in Quebec, Canada. Participants' mean age was 82.22 ± 5.35, and two-thirds were women. Levels of happiness were similar in both sexes and settings. Greater happiness was associated with greater thriving for all (β = 0.28-1.48), social participation for women in CD (β = 0.67), community integration in CD (β = 0.42 for women and 1.18 for men), and reduced ageism, i.e., discrimination for women in CD (β = -1.02) and men in ILF (β = -0.28), and self-directed for men in CD (β = -0.21). The findings demonstrate that happiness was associated with factors related to the living environment and could be enhanced through targeted interventions.

The effect of recreational games on happiness, life satisfaction, loneliness, and somatisation in elderly individuals: a non-randomized controlled trial

BACKGROUND

Participation in recreational activities supports continuity of activity and psychological well-being in old age. Games are one of these recreational activities. This study aims to measure the influence of recreational games on somatisation, loneliness, happiness and life satisfaction among elderly individuals.

METHODS

This non-randomized quasi-experimental study involved 80 individuals from two nursing homes, allocated to intervention (n = 40) and control (n = 40) groups. Participants, aged 65 or older, met cognitive eligibility criteria based on the Standardized Mini-Mental State Examination. The intervention group selected 4 games (hot-and-cold, word challenge, bingo, matching pairs) from a set of 15 and played twice weekly for two months in smaller groups. The control group maintained their usual leisure activities. Data were collected using the Oxford Happiness Questionnaire Short Form, Satisfaction with Life Scale, De Jong Gierveld Loneliness Scale, and Symptom Checklist-90-Revised Somatization Subscale at baseline, 1 week, and 1 month post-intervention.

RESULTS

The intervention group (IG) showed significant improvements compared to the control group (CG). Happiness (η² = 0.93) and life satisfaction (η² = 0.92) increased significantly in the IG (p < 0.0001), with higher scores than the CG in both the post-test (r ≈ -0.246 to -0.212, p < 0.05) and follow-up (r ≈ -0.273 to -0.309, p < 0.01). Loneliness, including emotional and social loneliness, decreased significantly in the IG (η² = 0.94, p < 0.0001), with greater reductions than the CG in the post-test and follow-up (r ≈ -0.503 to -0.593, p < 0.0001). Somatization did not change significantly within the IG but showed a reduction compared to the CG in the post-test and follow-up (r ≈ -0.226 to -0.280, p < 0.05).

CONCLUSIONS

Recreational games may give psychological benefits to older adults. Yet, results of the study need to be interpreted with caution and need to be replicated.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT06505070 (retrospectively registered, Protocol ID: Duzce-U-merve0003, Last Update Posted: 2024-08-02). https://ctv.veeva.com/study/the-effect-of-recreational-games-on-happiness-life-satisfaction-loneliness-and-somatisation-in-el?comeFrom=study-search .

The Impact of Socioeconomic Factors on Cognitive Ability in Community-Dwelling Older Adults: Mediating Effect of Social Participation and Social Support

BACKGROUND AND PURPOSE

Previous studies have shown that socioeconomic status influences cognitive health in adults. Therefore, it is important for the development of healthy aging policies to further investigate the effect of specific socioeconomic factors on cognitive function in older people and the possible mechanism. In this study, three specific socioeconomic factors (i.e., income, occupation, and education) were used as independent variables, and social support and social participation were used as the parallel or serial mediating variables to investigate the effect on cognitive function in community-dwelling older adults and the specific pathway of influence.

METHODS

A cross-sectional study was conducted in the Pudong New District of Shanghai, China. A total of 970 community-dwelling older adults aged over 60 years old who had lived in their current location for more than 5 years were enrolled. Socioeconomic factors in older adults, including income, education level, and occupation before retirement, were investigated, and their cognitive function and social support and social participation levels were measured using the MoCA, MSPSS, and the quantity of participation in social activities, respectively. Covariates, including lifestyle, health status, sleep quality, and nutritional status, were assessed using a self-designed questionnaire, the PSQI, and the MNA-SF scale. Omnibus mediation effect analysis was adopted to examine the mediation effect, and the mediation analysis was performed using the SPSS PROCESS program.

RESULTS

Community-dwelling older adults with higher income, more complex occupation, or higher education level had a better cognitive function, with βmedium income = 1.949 and βhigh income = 3.799 compared to low-income level (all p < 0.001), βmedium occupational complexity = 1.262 and βhigh occupational complexity = 1.574 compared to low occupational complexity level (all p < 0.01), and βmedium education = 1.814 and βhigh education = 1.511 compared to low education level (all p < 0.001). Social participation significantly mediated the above relationship (all p < 0.001); the relative indirect effect of medium and high income through social participation was respectively βmedium income = 0.356 and βhigh income = 0.777 compared to low income, accounting for 18.36% and 20.45% of the total effect; the relative indirect effect (β) of medium and high occupational complexity compared to low level of occupational complexity was 0.358 and 0.561, accounting for 28.36% and 35.64% of the total effect; while the relative indirect effect (β) of medium and high education compared to low education level was 0.311 and 0.562, with 17.14% and 39.19% of the total effect. Social support significantly mediated the relationship of income and education with cognitive function (all p < 0.001), with the indirect effect (β) of medium and high levels of income or education compared to their low levels being 0.132 and 0.160, or 0.096 and 0.156, respectively, accounting for 4.21% and 6.77%, or 5.29% and 10.32%, of their total effects. Serial mediation analysis showed that income and education significantly affected social participation through social support and subsequently cognitive function (all p < 0.01), with the relative serial indirect effects (β) of medium and high levels of income or education compared to their low levels being 0.065 and 0.078, or 0.043 and 0.070, respectively, accounting for 3.3% and 2.0%, or and 2.4-4.6% of their total effects.

CONCLUSIONS

This study demonstrates that social support and social participation independently and cumulatively mediate the relationship between socioeconomic conditions and cognitive function in community-dwelling older adults. Therefore, improving the social support systems and encouraging older adults to actively participate in social activities may be beneficial in preventing or improving cognitive decline in community-dwelling older adults. The findings also provide new insights for the future improvement of cognitive function in community-dwelling older adults in the future.

Themes of togetherness. Examining space sharing sociality among older people

Extensive research demonstrates a positive relationship between social participation and health and well-being in older adults. Yet, knowledge is scarce regarding the diverse practices older individuals employ when engaging with others in everyday life settings. For the purpose, we elaborate on the concept of togetherness to encapsulate the full spectrum of co-located activities. Togetherness embodies a spatiotemporal understanding of sociality, involving "being with" others in shared spaces, times, and projects. We empirically investigate how various forms of togetherness manifest in everyday life and explore the motivation behind immediate and more overarching projects and goals. Drawing on time-space diaries that inform in-depth interviews with 22 older adults (aged 68-85) in Gothenburg, Sweden, our findings reveal that practising everyday togetherness seldom is a standalone project with the explicit purpose of socializing. More often, sociality is integrated into projects with other primary, sometimes overlapping, goals such as maintaining everyday routines, providing structure and rhythm to daily life, breaking away from routines, thriving and feeling safe in a place, and seeking inspiration and creativity in life.

The Mediating Effect of Social Participation Restriction on the Association Between Role Overload and Mental Health Among Caregivers of Older Adults with Dementia

Caregivers of older adults with dementia (dementia caregivers) often experience high role overload (i.e., feeling overwhelmed by caregiving demands that exceed available resources), which can take a toll on their mental health. Moreover, dementia caregiving can restrict caregivers' participation in valued social activities. This study aims to examine the mediating effect of social participation restriction on the relationship between role overload and mental health among dementia caregivers. A total of 894 dementia caregivers (mean age = 61.77) were selected from the National Study of Caregiving. The sample was predominantly women (64%) and White (78%). Path analysis shows that social participation restriction partially mediated the associations between (1) role overload and psychological distress (indirect effect β = .08, p < .001) and (2) role overload and psychological wellbeing (indirect effect β = -.05, p < .05). Interventions targeting coping strategies and healthcare-recreation programs are needed to improve social participation among dementia caregivers.

Development of lifestyle assessment: A Delphi survey of multi-faceted health experts

OBJECTIVE

In the field of health promotion, there's a growing focus on adopting an academic approach to assess and evaluate the intricate and ever-evolving nature of lifestyles. This approach is crucial for shaping and improving a healthy way of life. Systematic measurement of lifestyles is essential for enhancing overall health and well-being, encompassing physical, mental, and social dimensions. This study's goal is to create an assessment tool that measures the diversity and intensity of lifestyle behaviors linked to human health. Our efforts involved developing quantitative measurement items that encompass the holistic concepts of health and lifestyle and validating them.

METHODS

Between March and April 2023, we gathered insights from 14 experts in lifestyle and health. Building on previous research, we conducted a Delphi survey twice. In the initial survey, we collected expert opinions through open and closed-ended questions about lifestyle evaluation items. After the first survey, we corrected several items that didn't meet the Content Validity Ratio (CVR) standard before proceeding. We presented the first survey's findings to an expert panel, leading to a consensus.

RESULTS

The initial Delphi round produced 76 items, and the second round resulted in 72 items after adjusting those with CVR scores of 0.51 or less. The final Content Validity Ratio was 0.83, signifying a robust validation process, with a convergence of 0.50 and a consensus level of 0.75.

CONCLUSION

In summary, this study successfully developed a comprehensive lifestyle assessment tool using a modified Delphi technique. The 72 items are categorized into eight subcategories and four overarching themes. This tool provides a systematic approach to evaluate lifestyles, promoting health and well-being across physical, mental, and social dimensions. It also assists in identifying specific lifestyle elements that require more in-depth intervention strategies, all while preserving the academic integrity of the content.

Informal caregivers' perspectives on participation in a dementia rehabilitation programme

BACKGROUND

There is limited experience in combining interdisciplinary rehabilitation for persons with dementia and caregiver support.

AIM

To explore how informal caregivers perceive participation in a person-centred, multidimensional, interdisciplinary rehabilitation programme targeting community-dwelling older adults with dementia and their informal caregivers, and how the programme has influenced their everyday life.

MATERIAL AND METHODS

Fourteen informal caregivers, aged 45-84 years, participated in a qualitative interview following a randomised controlled pilot study. Transcribed interviews were analysed using qualitative content analysis.

RESULTS

The analysis resulted in seven categories and three themes: feeling challenged and boosted to face an uncertain future, perceiving supportive activities as sources of both joy and frustration in everyday life and finding relief in recognising their relative's former self.

CONCLUSIONS AND SIGNIFICANCE

Combining interdisciplinary rehabilitation for adults with dementia with education and support for caregivers was perceived as viable and valuable for the informal caregivers. They felt strengthened by the rehabilitation and better prepared for their uncertain future. However, participation also challenged everyday routines, but the benefits appeared to outweigh the strain.

Influence of personalised citizen assistance for social participation (APIC) on health, social participation, and life satisfaction: Perspectives from older adults and attendants

INTRODUCTION

The personalised citizen assistance for social participation (APIC) is promising to foster health and social participation of older adults with disabilities, especially when working in collaboration with occupational therapists. When implemented by community organisations, little is known about the influence of APIC on older adults, including perspectives of older adults and attendants. This study aimed to explore the short-term influence of APIC on physical and mental health, social participation, and life satisfaction of older adults with disabilities by considering the perspectives of older adults and their attendant.

METHODS

A mixed methods study was carried out by a team, including two occupational therapists. Twelve attendants were interviewed, and 12 older adults completed questionnaires about their health, social participation, and life satisfaction before and after the APIC.

RESULTS

Improvements in mental health, social participation, and life satisfaction were found. The influence of APIC was generally more subtle than expected and greatly affected by older adults' personal and environmental factors.

CONSUMER AND COMMUNITY INVOLVEMENT

This study was possible because of the collaboration between researchers, health-care professionals, community organisations, volunteers, and older adults.

CONCLUSION

The APIC might have a limited influence on the physical health of older adults with disabilities. Future studies examining the effects of this intervention on different levels of disabilities are recommended to target the best suited population.

PLAIN LANGUAGE SUMMARY

The personalised citizen assistance for social participation (APIC) is a 12-month intervention in which an older adult with disabilities (i.e., having difficulty to perform daily activities) meets weekly with a volunteer to experiment social activities. Although promising, little is known about the influence of APIC on older adults. This study explores the influence of APIC on the health, social participation (i.e., involvement in activities that provide interactions with others), and life satisfaction of older adults with disabilities. The perspective of 12 older adults and 12 volunteers were considered. Improvements in mental health, social participation, and life satisfaction of older adults were observed, but the influence of APIC was greatly affected by other factors such as their physical capabilities and their place of residence. APIC seems to have a limited influence on the physical health of older adults with disabilities.

Influence of Reading or Writing Activities Shared with Others on Older Adults: Results From a Scoping Study

This study aimed to provide integrated knowledge on the influence of shared reading or writing activities, that is, recreational occupations involving dynamic relationships based on personal development, on adults aged 55 and older. Using a scoping study framework, six databases were searched with 25 relevant keywords for papers, theses, and scientific reports published in 2001-2023. Based on the Human Development Model-Disability Creation Process, the content analysis of 20 documents showed that shared reading or writing activities mostly benefited aging adults' behavioral capabilities like positive affect, their intellectual capacities, such as developing new perspectives on life, their interpersonal relationships, and social support. Negative instances, such as frustration, were often mentioned at the beginning of the activities but decreased over time. These results suggest the importance of shared reading or writing activities for healthy aging and the necessity to better support these activities for more inclusive and caring aging societies.

Social participation classification and activities in association with health outcomes among older adults: Results from a scoping review

AIMS

The aim of this study is to summarize the characteristics of social participation classification and examine the association between activities and health outcomes among older adults.

DESIGN

Scoping review.

DATA SOURCES

Eight databases (Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Embase, ProQuest, Psychological Information Database, PubMed, Scopus and Web of Science) were searched. Reference lists of relevant social participation reviews were also considered.

METHODS

This study applied a five-stage methodological framework. A narrative synthesis summarized social participation classification and activities and their associations with health outcomes among older adults (≥65 years) living at home, in the community or in nursing residences.

RESULTS

Forty-two articles published between 1975 and 2022 were selected. Four classification criteria of social participation were extracted and summarized from these studies. Based on the depth and breadth of social interactions, this review proposed a four-level classification schema. A lower risk of mortality and less visual impairment were associated with participation in level-one, level-three or level-four activities, whereas less depression, less pain and better cognitive function were linked to participation in level-three or level-four activities.

CONCLUSION

Future studies should provide a clear definition, establish classification criteria for participation and properly select activity forms while considering both subjective and objective dimensions.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The results could provide data for designing targeted social participation interventions to improve specific health outcomes among older adults.

IMPACT

This review could help researchers examine the role of social participation activities in specific health outcomes. Moreover, a proposed classification of social participation activities would benefit researchers and community nurses in discerning the similarities and differences among activities.

REPORTING METHOD

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews guideline.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Typology of Social Participation and Network and Health in Older Adults: Results From the Canadian Longitudinal Study on Aging

This study aimed to document the typology of social participation and network among older Canadians and examine their associations with health. Using 2011-2015 cross-sectional data from the Canadian Longitudinal Study on Aging, a latent profile analysis was conducted to identify patterns of social participation and network, and multinomial logistic regressions examined associations with self-rated health. Four types of social participation and networks characterized older Canadians: diverse (74.0%), childless (12.1%), restricted (9.7%), and very socially active (4.3%). Compared to the diverse group and excellent/very good health, belonging to the restricted group was associated with higher probabilities of reporting fair or poor health, both general (1.95; p < .001) and mental (2.18; p < .001). Still comparing to the diverse group and excellent/very good health, the very socially active group presented lower likelihood of reporting good general health (0.82; p = .03). These results suggest that the social participation and network are associated with health inequalities in older Canadians. Future studies should look at the role of virtual interactions in the health of older adults.

Development and Psychometric Evaluation of the Social Participation Questionnaire: A Methodological and Cross-Sectional Study

PURPOSE

Social participation is vital for the health maintenance of general populations as well as the functional recovery and social ties of clinical patients. To develop a Social Participation Questionnaire (SPQ) to evaluate participation in social activities in an individual's life and to test the reliability and validity of the SPQ.

DESIGN

Cross-sectional study.

SETTING

Community and clinic in China.

SUBJECTS

A total of 1419 healthy adults and 486 breast cancer patients.

MEASURES

The initial items were developed from a theoretical framework, a literature review, and Delphi expert consultation. Item analysis, exploratory (EFA) and confirmatory factor analysis (CFA), criterion validity, construct reliability, and internal consistency reliability were performed to examine the psychometric properties of the SPQ.

RESULTS

The final SPQ was comprised of 11 different types of social activities, falling under the 3 dimensions of activities of daily life, sports and entertainment activities, and social service activities. EFA explained 50.674% of the total item variance contributing to the tool. CFA showed that the SPQ fit well. The total SPQ score was significantly associated with social network, quality of life, and cognitive function (r = |.180∼.466|, P < .001). The internal consistency coefficient was acceptable (range of Cronbach's alpha, .695 to .720).

CONCLUSIONS

The SPQ has robust properties, wide application, and provides a culturally relevant tool to evaluate the social participation of individuals, thus facilitating rigorous clinical and population-based research.

Social interaction of people living with dementia in residential long-term care: an ecological momentary assessment study

BACKGROUND

The importance of social health is increasingly recognized in dementia research. For most people living with dementia, their social environment changes as the disease progresses, especially when they move into a long-term care facility. However, maintaining social interactions in the new living environment contributes significantly to health and quality of life. Staff and other residents are the most readily available interaction partners to provide this. The aim of this study is to investigate the frequency, contexts, partners and influencing factors (personal and contextual) of social interactions of people living with dementia in residential long-term care.

METHODS

Participants were observed for two days in 20-min slots (from 7 am to 7 pm) in 12 long-term care facilities in Germany. The Maastricht Electronic Daily Live Observation Tool (MEDLO-tool) was used for ecological momentary assessment. Age, gender, functional status, cognitive status and length of stay at the facility were recorded. Generalized linear mixed-effect models were used for the data analysis.

RESULTS

In all, 106 people living with dementia (average age: 85.16 ± 7.42 years, 82.9% female) were observed at 6134 time points. No social interaction take place in 71.9% of the observations. The place where the participants spend their time influences the occurrence of social interaction (p < 0.001), with a significantly higher probability of social interaction in communal spaces. Most frequently, interaction takes place with staff (43.4%), closely followed by other residents (40.9%), with the context (location, p < 0.001; time of day, p < 0.001) and functional status (care level, p < 0.001) influencing which of the two groups people living with dementia interact with.

CONCLUSION

A better understanding of the context of social interactions and its influencing factors provide a basis for more targeted interventions. As the increasing staff shortage will further limit the opportunities for social interaction with staff, future concepts should focus on other residents. Meaningful activities that enable people living with dementia to co-operate and share responsibility can provide a stimulating framework for this. In addition, social assistance robots and the application of peer-mentoring/leading represent promising approaches for creating a socially interactive environment.

Development of ICF-based patient-reported outcome and experience measures to study social participation among people with chronic diseases: a mixed-methods protocol

INTRODUCTION

Living with a chronic disease impacts many aspects of life, including the ability to participate in activities that enable interactions with others in society, that is, social participation (SP). Despite efforts to monitor the quality of care and life of chronically ill people in Belgium, no disease-specific patient-reported measures (PRMs) have been used. These tools are essential to understand SP and to develop evidence-based recommendations to support its improvement. This protocol presents the phases for the disease-specific development of patient-reported outcome and experience measures to assess SP and its potential determinants among people living in Belgium with cancer, cystic fibrosis, diabetes, HIV or a neuromuscular disease.

METHODS AND ANALYSIS

This protocol applies the PROMIS Instrument Development and Validation Scientific Standards and COnsensus-based Standards for the selection of health Measurement INstruments to develop PRMs in a disease-specific manner to quantify the components of the International Classification of Functioning, Disability and Health (ICF). A mixed-method approach is used to create broad initial item pools based on patient (focus groups) and literature perspectives which are compared within ICF-standardised language by applying the refined ICF linking rules. An item set is first created based on this cross-matching exercise and then validated by multidisciplinary expert panels. Cognitive assessment and pilot testing are followed by the dissemination of the survey to a representative sample in Belgium. Advanced psychometric testing (classical test theory and item response theory) is applied to inform an item reduction strategy for the final measures and to develop scales for the ICF components.

ETHICS AND DISSEMINATION

Ethical approval was granted by the Ethics Committee of the Ghent University Hospital on 20 February 2023 to organise the patient focus groups (ONZ-2022-0470). Ethical approval for dissemination of the PRMs and psychometric testing will be sought at the Ghent University Hospital Ethics Committee at the start of Phase 6. Results will be disseminated through peer-reviewed journals and professional conferences.

The association between post-lunch napping duration and social participation among the Chinese older adults: a cross-sectional study

BACKGROUND

Social participation (SP) affects the physical and mental health of older adults. Post-lunch napping is a prevalent lifestyle practice observed among older adults, and it may have an impact on their SP. However, research that explores the association between these factors is limited, and we thus aimed to examine this association.

METHODS

We conducted a cross-sectional study using data from the China Health and Retirement Longitudinal Study (CHARLS), focusing on participants aged 60 and older. SP was measured by both the number and frequency of activities based on participant self-reports. The duration of post-lunch napping was also self-reported. We explored the association between post-lunch napping duration and SP using logistic regression, subgroup analysis, and Restrictive Cubic Spline (RCS) analysis.

RESULTS

We included 4259 participants in the study. Post-lunch napping demonstrated a significant association with decreased odds ratio of poor SP in fully adjusted logistic regression models (odds ratio = 0.77, 95% CI: 0.66 ~ 0.90, p = 0.011). Subgroup analysis indicated consistent proportional effects across all subgroups (p > 0.05). RCS analysis revealed a non-linear "J"-shaped relationship between post-lunch napping duration and SP, with the lowest odds ratio corresponding to a duration of 34.37 min.

CONCLUSION

Our study suggests that a moderate duration of post-lunch napping, ideally around 34 min, might have the potential to enhance SP, whereas exceeding this duration could could potentially have a limiting effect. This observation implies that incorporating moderate post-lunch napping into health management strategies for older adults might offer some advantages.

The influence of middle-aged and older adults' social capital and education on physical function: evidence from the China Health and Retirement Longitudinal Study

Background

Population aging is a major global trend with significant social, economic, and health implications. In China, the increasing aging population presents challenges, including increased chronic diseases and disabilities. Social capital has emerged as vital in determining health outcomes for middle-aged and older adults. This study seeks to examine the impact of social capital and educational attainment on physical functioning in middle-aged and older adults, with particular emphasis on the moderating effect of education within this relationship.

Methods

This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) from 2018 to 2020, involving 9,497 participants aged 45 and older. Physical function was assessed using the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales. Social capital was measured in four dimensions: social trust, social support, social participation, and reciprocity. Educational attainment was categorized into four levels: below primary school, primary school, middle school, and high school or above. Cox proportional hazards regression and moderating effect models were used for data analysis, adjusting for demographic and health-related variables.

Results

Our findings highlight the significant roles of social participation (aHR = 0.856, 95%CI: 0.675-0.809) and reciprocity (aHR = 0.700, 95%CI: 0.626-0.784) in improving physical function. Education enhanced the positive effects of social participation (aHR = 0.923, 95%CI: 0.840-0.980). Subgroup analyses showed that social support was a protective factor for females (aHR = 0.857, 95% CI: 0.737-0.998), while social trust negatively affected urban residents (aHR = 1.330, 95%CI: 1.135-1.560).

Conclusion

The findings underscore the importance of social participation, reciprocity, and education in enhancing physical function among middle-aged and older adults. Tailored interventions addressing gender and residential differences are essential to meet the unique needs of various subgroups. Understanding the relationship between social capital, education, and health can inform strategies to improve this population's well-being.

Fostering social participation among older adults: Perspectives of stakeholders

BACKGROUND

Fostering social participation for active and healthy ageing among older adults is an urgent issue in a changing society that requires new approaches from occupational therapists as well as from society at large.

AIM

To explore possibilities to foster social participation for older adults in society from the perspective of stakeholders.

MATERIAL AND METHODS

A qualitative design was applied. 18 key informants, engaged in supporting older adults in their organisational roles as either professionals or volunteers, participated in five different focus groups discussions.

RESULTS

The results involved two overarching themes that reflects different perspectives on key informants' possibilities to foster social participation for older adults. The first theme describes how they direct their attention towards their roles within the organisations to foster social participation in their own context. The second theme describes the broader societal perspectives that they address to establish a common ground for collaboration and knowledge-sharing among different stakeholders.

CONCLUSIONS

The findings emphasise how addressing common challenges and developing collaboration are essential to foster older adults' social participation. It is therefore necessary to involve policy-makers and decision-makers. Occupational therapists and researchers should consider the value of occupational justice to drive collective and social approaches.

A study on the mechanism of how sensory impairment affects depression in the elderly: the mediating roles of daily activity capability and social participation

Objectives

Through a longitudinal study, we explored the relationship between sensory impairments and depression in the elderly, and examined the mediating roles of daily activity capability and social participation within this relationship.

Methods

Based on data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2015 and 2018, a total of 4,419 individuals aged 60 and above were selected as research participants. Sensory impairments (predictor variables) were assessed in 2015 through self-rated visual and hearing capabilities. Daily activity capability and social participation (mediator variables) were also assessed in 2015, with daily activities assessed using the Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL), and social participation assessed by the quantity of social activity participation. Depression status (outcome variable) was assessed in 2018 using the Center for Epidemiologic Studies Depression Scale (CESD-10). Statistical analysis was conducted using logistic regression and SPSS Macro PROCESS.

Results

First, there is a significant correlation between sensory impairments and an increased risk of depression among the elderly, including visual impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI), all of which increase the likelihood of depression. Second, DSI indirectly affect depression through the cascading mediating effects of daily activity capability and social participation. Finally, in contrast to DSI, when there is only a single sensory impairment, either VI or HI, the cascading mediating effects of daily activity capability and social participation on depression are not statistically significant.

Conclusion

The elderly population with dual sensory impairments requires continued attention to help these individuals adopt preventive measures to halt the onset and worsening of depression.

Role of Meaningful Social Participation and Technology Use in Mitigating Loneliness and Cognitive Decline Among Older Adults

IMPORTANCE

Community social participation aids dementia prevention and alleviates loneliness among older adults. Incorporating occupational therapy using information and communications technology (ICT) could potentially delay dementia onset and reduce loneliness.

OBJECTIVE

To quantify how meaningful social participation, participation frequency, ICT use, and expanded social networks influence cognitive function and loneliness among socially active older Japanese adults.

DESIGN

Cross-sectional exploratory study using structural equation modeling.

SETTING

Meetings organized by older adults at seven community gathering places in Osaka Prefecture, Japan.

PARTICIPANTS

One hundred thirteen healthy older adult cohort members.

MEASURES

Cognitive function assessed via Mini-Cog; loneliness assessed via the condensed UCLA Loneliness Scale.

RESULTS

The final model demonstrated excellent fit, χ2(23) = 28.291, p = .205 (root mean square error of approximation = .045, 90% confidence interval [.000, .094]; confirmatory factor index = .995; Tucker-Lewis Index = .993). ICT use directly affected social networks (β = 0.472), which directly influenced participation frequency (β = 0.324) and meaningful social participation (β = 0.381). The indirect effect of meaningful participation significantly improved cognitive function (β = 0.237). The only indirect effect of meaningful interpersonal participation was a reduction in loneliness (β = -0.235).

CONCLUSIONS AND RELEVANCE

ICT use contributes to the expansion of social networks among elderly people. Furthermore, the frequency of social participation and the meaningfulness of such participation are related to reduction in loneliness and maintenance of cognitive function. Although the frequency of social participation was not directly related to these outcomes, the results suggest that meaningful social participation may play an important role in reducing loneliness and maintaining cognitive function. Plain-Language Summary: The promotion of social participation among older people is a global phenomenon, driven by the recognition of its positive relationship with cognitive function and the alleviation of loneliness. Nevertheless, older people's social participation is constrained by a combination of physical and social factors. To address this issue, there has been a push to promote social participation based on information and communications technology (ICT). However, no specific study has been conducted on occupational therapists' perspective in capturing social participation and the use of ICT. The findings of this study show that using ICT has the potential to enhance opportunities for social interaction for older adults, thereby improving the quality and quantity of social participation. The quality of social participation was identified as the sole factor that had a positive impact on cognitive function and loneliness. This study suggests the need for occupational therapists to consider means of facilitating the use of ICTs among older adults as well as interventions that use occupational therapy theory to enhance the meaningfulness of existing social participation opportunities.

Developmental trajectories and heterogeneity of social engagement among Chinese older adults: a growth mixture model

BACKGROUND

Social engagement is closely related to well-being among older adults. However, studies on the changing trajectory and influencing factors (especially time-varying factors) of social engagement are limited. This study aimed to examine the social engagement trajectory of older Chinese adults and explore its time-fixed and time-varying factors, thus providing evidence for the development of strategies to promote a rational implementation for healthy aging.

METHODS

This study included 2,195 participants from a subset of four surveys from the Chinese Longitudinal Healthy Longevity Survey conducted from 2008 to 2018 (with the latest survey completed in 2018), with follow-ups conducted approximately every three years. Growth mixture modeling was used to explore the social engagement trajectory of older adults and the effects of time-varying variables. In addition, multinomial logistic regression was employed to analyze the association between time-fixed variables and latent classes.

RESULTS

Three distinct trajectories of social engagement among older adults in China were identified: slow declining (n = 204; 9.3%), which meant social engagement score decreased continuously, but social engagement level improved; slow rising (n = 1,039; 47.3%), marked by an increased score of social engagement, but with an depressed engagement level; and middle stabilizing (n = 952; 43.4%), which meant social engagement score and engagement level remained quite stable. A time-fixed analysis indicated that age, marital status, educational level, and annual family income had a significant impact on social engagement (P < 0.05). In contrast, the time-varying analysis showed that a decline in functional ability, insufficient exercise (means no exercise at present), deteriorating self-reported health and quality of life, negative mood, monotonous diet, and reduced community services were closely related to the reduction in social engagement levels (P < 0.05).

CONCLUSION

Three trends were observed at the social engagement level. Older adults with initially high levels of social engagement exhibited a continuous upward trend, whereas those with initially low levels experienced a decline in their social engagement, and those with initially intermediate levels remained quite stable. Considering the primary heterogeneous factors, it is imperative for governments to enhance basic services and prioritize the well-being of older adults. Additionally, families should diligently monitor the emotional well-being of older adults and make appropriate arrangements for meals.

Characteristics of Informal Caregivers and Social Participation of People With Dementia

BACKGROUND AND OBJECTIVES

Social participation is associated with increased quality of life and well-being but declines following the onset of dementia. Informal caregivers may facilitate social participation among people with dementia. This study aims to identify characteristics of informal caregivers associated with social participation of people with dementia in valued activities.

RESEARCH DESIGN AND METHODS

This cross-sectional study used data from the 2011, 2015, and 2017 National Health and Aging Trends Study (NHATS) and the National Study of Caregiving. NHATS respondents with possible or probable dementia and an informal caregiver were included (N = 1,060). Respondents were asked whether they participated in each of 5 social activities during the past month. Valued activities were considered somewhat or very important. Survey-weighted logistic regression models were computed to identify characteristics of primary informal caregivers associated with participation of people with dementia in social activities.

RESULTS

Social participation of people with dementia was not independently associated with sociodemographic variables or relationship to the primary caregiver (spouse/partner, adult child, or other relative/nonrelative). Social participation of primary caregivers was associated with increased participation of people with dementia in the same activity for visiting friends/family (odds ratio [OR] = 1.88, p = .016), attending religious services (OR = 4.82, p < .001), and volunteering (OR = 3.25, p = .015), whereas greater caregiver external support was associated with increased participation of people with dementia in organized activities (OR = 1.37, p = .022).

DISCUSSION AND IMPLICATIONS

Assets of informal primary caregivers found to promote social participation of people with dementia include traveling to the person with dementia's home, being socially active themselves, and utilizing support services.

Latent transition of social participation and its effects on depression among older adults in China: A National Longitudinal Study

OBJECTIVES

As populations age, the issue of social participation among older adults has gained prominence. Studies indicate variability in social participation trajectories among this demographic, yet the transition patterns and their effects on depression remain unclear. This longitudinal study aims to explore the latent classes and transition patterns in social participation among older adults and to evaluate their effects on depression.

METHODS

Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2014 (T1) and 2018 (T2) were analyzed, including 2293 older adults. Latent class analysis (LCA) and latent transition analysis (LTA) were employed to identify latent classes of social participation at T1 and T2, as well as the transition probabilities between these classes. Multinomial logistic regression was used to examine predictors of transitions, and depression levels at T2 were compared across transition patterns.

RESULTS

The LCA results supported a 3-class model labeled as low, moderate, and high social participation. The probabilities of remaining stable and transitioning to other classes were similar across the three classes (ranging from 0.50 to 0.54). Age, gender, and other baseline characteristics emerged as significant predictors of transition patterns. Older adults experiencing positive transitions exhibited reduced depression compared to those in their original class over time, while those with negative transitions showed increased depression.

CONCLUSIONS

This research prompts a deep understanding of social participation dynamics in older adults and their effects on depression. Identifying social participation classes and transition patterns could inform interventions to enhance social participation and reduce depression among older adults.

Effects of a Mobile App to Promote Social Participation on Older Adults: Randomized Controlled Trial

BACKGROUND

Social participation is crucial for healthy aging, improving physical and mental health, cognitive function, and quality of life among older adults. However, social participation tends to decline with age due to factors like loss of social networks and health issues. Mobile health apps show promise in promoting healthy behaviors among older adults, but their effectiveness in increasing social participation remains understudied.

OBJECTIVE

This randomized controlled trial aimed to evaluate the efficacy of a mobile app called Encouragement of Social Participation (ESP, "Shakai Sanka no Susume;" Hitachi) in promoting social participation and physical activity among community-dwelling older adults.

METHODS

The study recruited 181 community-dwelling adults aged 60 years or older from 2 municipalities in Japan and through a web-based research panel. Participants were randomly assigned to either the intervention group (n=87), which used the ESP app for 12 weeks, or the control group (n=94), which used only Google Fit. The ESP app incorporated features such as self-monitoring of social participation, personalized feedback, gamification elements, and educational content. Primary outcomes were changes in social participation frequency over the previous 2 months and changes in step counts, measured at baseline and week 12. Secondary outcomes included changes in specific types of social activities and subjective well-being. Data were analyzed using analysis of covariance and linear mixed-effects models.

RESULTS

The intervention group showed a significantly greater increase in social participation frequency compared with the control group (adjusted difference 3.03; 95% CI 0.17-5.90; P=.04). Specifically, the intervention group demonstrated higher frequencies of participation in hobbies (adjusted difference: 0.82; 95% CI 0.01-1.63) and cultural clubs (adjusted difference 0.65; 95% CI 0.07-1.23) compared with the control group. However, there were no significant differences in weekly step counts between the groups. Subgroup analyses suggested potentially larger effects among participants who were older than 70 years, female, had lower educational attainment, and were recruited from community settings, although only females and the lower educational attainment subgroups demonstrated 95% CIs that did not encompass zero.

CONCLUSIONS

The ESP mobile app effectively promoted social participation among community-dwelling older adults, particularly in hobbies and cultural club activities. However, it did not significantly impact physical activity levels as measured by step counts. These findings suggest that mobile apps can be valuable tools for encouraging social engagement in older populations, potentially contributing to healthy aging. Future research should focus on optimizing app features to maintain long-term engagement and exploring strategies to enhance physical activity alongside social participation.

TRIAL REGISTRATION

University Medical Information Network Clinical Trial Registry UMIN000049045; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000055781.

Association of information technology ability, workplace social engagement, and successful ageing: validation of a short measure with three African samples

This study examined the association of workplace social engagement (WSE) and information technology ability (ITA) with successful ageing and validated a brief scale measuring WSE. The interaction of WSE and ITA on successful ageing was also assessed. A cross-sectional design was adopted, and the participants were 1186 older adults living in Kenya (n = 350), Nigeria (n = 260), and Ghana (n = 576). Pearson's correlation and factor analyses of two datasets (i.e., waves 1 and 2) from the sample were utilised to validate the WSE scale. Hierarchical linear regression analysis with relevant sensitivity analyses were utilised to assess the associations with wave 2 data. The WSE scale produced satisfactory psychometric properties (i.e., reliability and validity) as a unidimensional measure. WSE and ITA were positively associated with successful ageing in Kenya and Ghana and in the consolidated data. The interaction between WSE and ITA was positively associated with successful ageing and its domains (i.e., illness avoidance, functioning, and engagement with life) in Kenya, Ghana, and consolidated data. At higher ITA or the use of information technologies, WSE is less strongly associated with successful ageing. WSE is more strongly associated with successful ageing only at moderate ITA.

Framing Facets of Social Participation: Older Adults' Experiences of "Social Online Meetings"

Changing demographics with an increased proportion of older adults indicate the need to develop new health-promoting interventions where the potential of digitization is considered. The aim was to explore and create an understanding of how social online meetings are experienced by older adults. Interviews with older adults generated data that were analyzed using a grounded theory approach. The participants were interviewed after participating in a digital health promotion group initiative provided in a municipality context. A core conceptual category and three subcategories reflected an intertwined process of discovering facets of social participation where internal reflections on personal values and needs were nurtured by an external driven process of becoming part of a group in an online context. Occupational therapists and other health and social care professionals need to consider the various facets of social participation when supporting older adults active and healthy aging.

Life-course social participation and physical activity in midlife: longitudinal associations in the 1970 British Cohort Study (BCS70)

A hypothesized benefit of social participation is that it encourages people to be more physically active. However, limited evidence exists on the association between social participation over the life-course and physical activity in midlife. We sought to apply a life-course framework to examine the association of social participation and device measured physical activity in midlife in the UK. We used the 1970 British Birth Cohort Study (BCS70), which includes all people born in Britain during a single week in 1970. Social participation was assessed at ages 16, 30, 34 and 42. Physical activity was measured by accelerometery at age 46, as mean daily step count and time spent in moderate to vigorous physical activity (MVPA). The associations of social participation and physical activity were tested using two different life-course models: the sensitive period model and the accumulation model. Individuals with medium and high participation compared to no social participation over their life-course had higher mean daily step count and MVPA in midlife, supporting the accumulation model. In the sensitive period model, only those that actively participated at age 42 had higher mean daily steps and MVPA compared to those who did not participate. Our study provides empirical evidence on the importance of sustaining social participation at all ages over the life-course rather than at a particular timepoint of someone's life. If our findings reflect causal effects, interventions to promote social participation throughout the life-course could be an avenue to promote physical activity in middle life.

Social activities in multidomain dementia prevention interventions: insights from practice and a blueprint for the future

Introduction

Social activities are important for health and act as a driver of cognitive reserve during aging. In this perspective paper, we describe challenges and outline future (research) endeavors to establish better operationalization of social activities in multidomain interventions to prevent dementia.

Body

We first address the lack of conceptual clarity, which makes it difficult to measure engagement in social activities. Second, drawing from our experience with the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we discuss social activities in multidomain dementia prevention interventions. Using qualitative data from the Multimodal Preventive Trial for Alzheimer's Disease (MIND-ADmini), we reflect on participant experiences with social activities. Third, we address the potential and challenges of digital solutions in promoting social activities in interventions for dementia prevention. Finally, we share insights from a workshop on digital technology, where we consulted with individuals with and without cognitive impairment who have been involved in three European projects (i.e., EU-FINGERS, Multi-MeMo, and LETHE).

Discussion

Based on these insights, we advocate for research that strengthens and accelerates the integration of social activities into multidomain interventions for dementia prevention. We propose several ways to achieve this: (a) by conducting mixed methods research to formulate a broadly accepted definition and instructions to measure social activities; (b) by focusing on promoting engagement in social activities beyond the intervention setting; and (c) by exploring the needs and preferences of older adults towards digitally-supported interventions and co-design of new technologies that enrich in-person social activities.

Playing online videogames-more than just entertainment? A qualitative study of virtual social participation in persons with spinal cord injury

Introduction

Spinal cord injury (SCI) affects many aspects of life, physically, emotionally and socially. Engaging in online videogames holds the potential to facilitate increased social interactions for individuals with SCI. The aim of this study is to increase our understanding of the experiences people with SCI have with using online videogames as an arena for social participation.

Methods

A focus group interview was conducted with seven participants with SCI, aged 15-35, all experienced in using online videogames as a method of socializing. The data was analyzed using thematic analysis.

Results

The participants highlighted that playing online videogames way of maintaining social connections and expanding their social network. However, they faced challenges due to limited knowledge and negative attitudes from others regarding use of videogames as a social arena. Three main themes were developed from the findings: "Disabling social barriers", "Attitudes towards gaming" and "Gaming-connecting people".

Conclusion

Healthcare professionals should consider videogames as a leisure activity and facilitate their use, recognizing their potential for social interaction and well-being. Prioritizing activities that promote social interaction is crucial for good health.

Sex and gender differences in social participation among community-dwelling older adults: a systematic review

Background

Frequent social participation among older adults is associated with greater health. Although understanding how sex and gender influence social participation is important, particularly in developing sex-inclusive health promotion and preventive interventions, little is known about factors influencing engagement of older women and men in social activities.

Aim

This study thus aimed to examine factors influencing social activities of older women and men.

Methods

A mixed-method systematic review was conducted in nine electronic databases from inception to March 2023. The studies had to define social participation as activities with others and examine its influencing factors among community-dwelling older women and men. Data were analyzed using convergent synthesis design from a socio-ecological perspective.

Results

Forty-nine studies, comprising 42 quantitative, five qualitative and two mixed method design were included. Themes identified concerned: (a) sociodemographic factors, (b) personal assets, (c) interpersonal relationships and commitments, (d) physical environment, and (e) societal norms and gender expectations. The findings identified the heterogeneous needs, preferences and inequalities faced by older women and men, considerations on sociocultural expectations and norms of each gender when engaging in social activities, and the importance of having adequate and accessible social spaces. Overall, this review identified more evidence on factors influencing social participation among women than in men.

Conclusion

Special attention is needed among community care providers and healthcare professionals to co-design, implement or prescribe a combination of sex and gender-specific and neutral activities that interest both older women and men. Intersectoral collaborative actions, including public health advocates, gerontologists, policymakers, and land use planners, are needed to unify efforts to foster social inclusion by creating an age-friendly and sustainable healthy environment. More longitudinal studies are required to better understand social participation trajectories from a sex and gender perspective and identify factors influencing it.

Systematic reviews registration

http://www.crd.york.ac.uk/PROSPERO, identifier [CRD42023392764].

Participation of adolescents with and without physical disabilities and chronic diseases: A comprehensive conceptualization

BACKGROUND

In 2001, the International Classification of Functioning and Disability (ICF) introduced participation as a main goal of rehabilitation processes. However, to date, a comprehensive concept of participation in the rehabilitative context is missing, particularly in German-speaking countries. We thus aimed to refine and extend the existing concepts of participation in this brief communication.

METHODS

In preceding studies, we conducted semi-structured interviews with adolescents who either had chronic diseases and/or physical disabilities or had no impairments and focus groups with parents and experts. Based on these diverse perspectives and findings, we refine the term participation.

RESULTS

Participation is a construct that is embedded in a social context and consists of objective (i.e., attendance) and subjective (i.e., satisfaction and involvement) dimensions. These dimensions are reflected in different domains and areas that are relevant to adolescents' lives. In addition, the subjective relevance of respective areas in life needs to be regarded as a weighing component when evaluating participation.

CONCLUSION

Our results reflect international models on participation, refine the existing concept, and underline the multidimensional character of participation. These findings are urgently needed to develop appropriate instruments, for example, for assessing whether rehabilitative processes are effective regarding the goal of participation.

[Indice du potentiel de participation sociale des Québécois âgés : cartographie des inégalités des zones métropolitaines, urbaines et rurales]

Afin de mieux comprendre la distribution géographique des facilitateurs et des obstacles à la participation sociale des Québécois âgés, cette étude visait à documenter l'Indice du potentiel de participation sociale (IPPS) selon les zones métropolitaines, urbaines et rurales. Des analyses de données secondaires, dont l'Enquête transversale sur la santé des collectivités canadiennes, ont permis de développer et de cartographier un indice composé de facteurs environnementaux associés à la participation sociale, pondérés par une analyse factorielle. En zones métropolitaines, l'IPPS était supérieur au centre qu'en périphérie, compte tenu d'une concentration accrue d'aînés et des transports. Bien qu'atténuée, la configuration était similaire en zones urbaines. En zone rurale, un IPPS élevé était associé à une concentration d'aînés et un accès aux ressources accru, sans configuration spatiale. Pour favoriser la participation sociale, l'IPPS soutient que les transports et l'accès aux ressources doivent respectivement être améliorés en périphérie des métropoles et en zone rurale.

The relationship between frailty and social vulnerability: a systematic review

Both frailty (reduced physiological reserve) and social vulnerability (scarcity of adequate social connections, support, or interaction) become more common as people age and are associated with adverse consequences. Analyses of the relationships between these constructs can be limited by the wide range of measures used to assess them. In this systematic review, we synthesised 130 observational studies assessing the association between frailty and social vulnerability, the bidirectional longitudinal relationships between constructs, and their joint associations with adverse health outcomes. Frailty, across assessment type, was associated with increased loneliness and social isolation, perceived inadequacy of social support, and reduced social participation. Each of these social vulnerability components was also associated with more rapid progression of frailty and lower odds of improvement compared with the absence of that social vulnerability component (eg, more rapid frailty progression in people with social isolation vs those who were not socially isolated). Combinations of frailty and social vulnerability were associated with increased mortality, decline in physical function, and cognitive impairment. Clinical and public health measures targeting frailty or social vulnerability should, therefore, account for both frailty and social vulnerability.

How environments can promote active aging: results from a case study of two municipalities in Quebec, Canada

OBJECTIVES

To address global aging, a paradigm shift is needed from disease prevention and treatment towards active aging, i.e., optimizing opportunities for health, participation, and security as people age. Little is known about how age-friendly environments promote active aging. This study thus aimed to explore how (through which mechanisms and in what contexts) environments can promote active aging and, specifically, positive health, social participation, and health equity.

METHODS

Using a realist approach and semi-structured focus groups, a case study was used in two Quebec municipalities known for best fostering active aging. Data also included participants' logbooks, sociodemographic questionnaires, municipalities' sociodemographic profiles, and policy documents. A conceptual framework and thematic content analysis were carried out.

RESULTS

A total of 24 participants (9 older adults, 4 health professionals, 3 community-based actors, 5 municipal employees, and 3 elected officials) took part in 5 focus groups. Regarding contexts, both cases were midsize municipalities having an income and education level higher to Quebec's averages with supportive active aging policies. Two main themes explained how the environments promoted active aging: (1) by ensuring proximity through built (urban planning), social (network structures), services (variety and availability of local and outreach resources), and organizational (active listening to older adults' needs for active aging) environments; and (2) by fostering transversality through built (universal accessibility, intergenerational spaces), social (intergenerational opportunities for social participation), and political/organizational (unified and complementary policies) environments.

CONCLUSION

To better promote active aging through age-friendly environments, practices should focus on fostering proximity and transversality, and act simultaneously on multiple environments.

Social participation experiences of older adults with an early-onset physical disability: a systematic review protocol

OBJECTIVE

The objective of this review is to assess and synthesize the available qualitative evidence on the experiences of social participation of older adults with an early-onset physical disability.

INTRODUCTION

Understanding the experiences of social participation among older adults with a physical disability acquired earlier in life can guide the development of interventions and policies. It will also help with fostering meaningful community participation and aid in improving the quality of their social participation.

INCLUSION CRITERIA

This review will consider primary studies that explore the experiences of social participation of older adults with an early-onset physical disability. The review will focus on qualitative data, including methods such as phenomenology, grounded theory, ethnography, action research, and feminist research. Studies in French or English will be considered for inclusion, and there will be no limitation on publication dates.

METHODS

A keyword search strategy will be carried out in MEDLINE (Ovid), PsycINFO (Ovid), CINAHL (EBSCOhost), Web of Science, and the Cochrane Library. ProQuest Dissertations and Theses (ProQuest) will be searched for unpublished articles. Two independent reviewers will perform the screening and inclusion process, assess the quality of the evidence, and complete data extraction. The JBI approach to critical appraisal, study selection, data extraction, and data synthesis (meta-aggregation) will be used. The ConQual approach will be used to establish confidence in the synthesized findings.

REVIEW REGISTRATION

PROSPERO CRD42022371027.

Cognitive and functional evolution in older adults with and without intellectual disability using a multicomponent intervention: A prospective longitudinal study

BACKGROUND

The global population is experiencing accelerated biopsychosocial aging. Cognitive impairment is frequently associated with functional impairment in basic and instrumental daily living activities. To maintain optimal cognitive and functional functioning, health professionals recommend that older adults participate in cognitive training.

AIMS

This study examines the cognitive and functional evolution of older adults with and without Intellectual Disability and the factors associated with favourable evolution following the intervention of a multicomponent programme based on the human occupational model and the person-centred care model.

METHODS AND PROCEDURES

247 people participated. Descriptive and univariate analyses were performed to examine baseline data. The Wilcoxon paired samples test was used to compare cognitive and functional evolution one year after the intervention. Linear regression was used to detect factors predicting favourable evolution.

OUTCOMES AND RESULTS

Both populations improved cognitively. There was no change in basic activities of daily living. There was an improvement in instrumental activities of daily living in the group with Intellectual Disability. None of the variables collected was a predictor of greater improvement.

CONCLUSIONS AND IMPLICATIONS

This study demonstrated that older people with Intellectual Disability who have supports to cope with this life stage can improve their cognitive and functional abilities.

Influence of Hearing Loss on Social Participation in Older Adults: Results From a Scoping Review

This study aimed to provide a comprehensive understanding of the influence of hearing loss on social participation in older adults and including its facilitators and barriers. Following the rigorous methodological framework of scoping studies, nine multidisciplinary databases were searched with 44 keywords. Published mainly in the last decade, 41 studies using primarily a quantitative cross-sectional design were selected. Older adults with hearing loss have been found to have difficulty maintaining relationships and social activities. While social support and engaged-coping strategies were major facilitators of social participation, barriers included greater hearing loss, communication difficulties, comorbidities and reduced mental health. To better promote the social participation of older adults, early detection of hearing loss, holistic assessment, and interprofessional collaboration must be considered. Future research is necessary to better address the stigma related to hearing loss in older adults and challenges of early detection, and to propose innovative solutions to develop interprofessional collaboration.

Types and frequency of social participation and comprehensive frailty among community-dwelling older people in Japan

Although research has established social participation as important for preventing frailty in older people, the association between the type and frequency of social participation and comprehensive frailty remains unclear. This study aimed to reveal the associations between types and frequency of social participation and comprehensive frailty among community-dwelling older people. This was a cross-sectional study conducted in four cities and towns (Inabe City, Nabari City, Odai Town, and Kiho Town) of Mie Prefecture, Japan, among adults who were: (i) aged ≥65 years and (ii) not certified as needing long-term care. We measured comprehensive frailty using the participants' total scores on the Kihon Checklist, developed by Ministry of Health, Labour and Welfare of Japan, which divides frailty status into three categories: robust (0-3 points), prefrail (4-7), and frail (8-25). Types and frequency of social participation were explanatory variables, and ordered logistic regression analysis adjusted for potential confounding factors identified the associations. The frailty status of the 296 participants (age 65-74 years: 44.3 %; female: 74.0 %) was as follows: frail, 21.3 %; prefrail, 40.2 %; and robust, 38.5 %. Lower level of frailty was associated with interaction using smartphones 2-3 times per month, participating in sports ≥4 times per week, participating in local improvement activities several times per year, and engaging in activities for children 2-4 times per month. Social participation among older adults at appropriate frequencies were associated with the lower level of comprehensive frailty. However, future longitudinal studies are needed using populations from more diverse countries or regions and from different cultures.

[Implantation de l'Accompagnement-citoyen personnalisé d'intégration communautaire (APIC) : vers l'optimisation de la mise en œuvre de cette approche novatrice visant la participation sociale des aînés]

La présente étude visait à documenter l'implantation de l'Accompagnement-citoyen personnalisé d'intégration communautaire (APIC), lors duquel des bénévoles soutiennent la participation sociale d'aînés, dans des organismes communautaires en identifiant les facteurs favorables et défavorables ainsi que ses conditions essentielles. Soutenu par un devis qualitatif descriptif de type recherche clinique, une rencontre et six entretiens semi-dirigés ont été réalisés afin de documenter cette implantation dans six organismes communautaires œuvrant en milieu urbain au Québec (Canada). Selon les six coordonnatrices de l'APIC, les cinq directeurs généraux et l'agente de recherche, le principal facteur favorable est la conviction des responsables de l'implantation en la valeur ajoutée de l'intervention, incluant sa concordance avec la mission et les valeurs des organismes et les besoins de la population qu'ils desservent. Les facteurs défavorables sont principalement la répartition aléatoire et le temps accordé pour l'implantation. Ces résultats permettront de mieux guider l'implantation de l'APIC à plus grande échelle.

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.

Social participation and tooth loss, vision, and hearing impairments among older Brazilian adults

BACKGROUND

Vision and hearing impairments can reduce participation in social activities. Given the prominent role of the mouth in face-to-face interactions, this study evaluated the associations of tooth loss, vision, and hearing impairments with social participation among older adults.

METHODS

This analysis included 1947 participants, aged 60+ years, who participated in three waves (2006, 2010, and 2015) of the Health, Wellbeing and Aging Study (SABE) in Brazil. Social participation was measured by the number of formal and informal social activities (requiring face-to-face interaction) participants were regularly involved in. Teeth were counted during clinical examinations and categorized as 0, 1-19, and 20+ teeth. Reports on vision and hearing impairments were classified into three categories (good, regular, and poor). The associations of each impairment with the 9-year change in the social participation score were tested in negative binomial mixed-effects models adjusting for time-variant and time-invariant covariates.

RESULTS

Each impairment was associated with the baseline social participation score and the annual rate of change in the social participation score. Participants with 1-19 (incidence rate ratio: 0.96, 95% CI: 0.91-1.01) and no teeth (0.92, 95% CI: 0.87-0.97), those with regular (0.98, 95% CI: 0.95-1.01) and poor vision (0.86, 95% CI: 0.81-0.90), and those with regular (0.94, 95% CI: 0.91-0.98) and poor hearing (0.91, 95% CI: 0.87-0.95) had lower baseline social participation scores than those with 20+ teeth, good vision, and good hearing, respectively. Furthermore, participants with 1-19 (0.996, 95% CI: 0.990-1.002) and no teeth (0.994, 95% CI: 0.987-0.999), those with regular (0.996, 95% CI: 0.992-0.999) and poor vision (0.997, 95% CI: 0.991-1.003), and those with regular (0.997, 95% CI: 0.992-1.001) and poor hearing (0.995, 95% CI: 0.990-0.999) had greater annual declines in the social participation score than those with 20+ teeth, good vision and good hearing, respectively.

CONCLUSION

This 9-year longitudinal study shows that tooth loss, vision, and hearing impairments are associated with reduced social participation among older adults.

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.

Frequency of social participation by types and functional decline: A six-year longitudinal study

Social participation is effective for preventing functional decline in older people. However, researchers have not fully explored how different frequencies of social participation by type. We aimed to clarify the relationship between the frequency of social participation by type and functional decline. We used data from the Japan Gerontological Evaluation Study, which consists of individuals aged 65 years and older who were not eligible to receive public long-term-care insurance benefits. From 13 municipalities, 51,968 respondents who met the criteria were included in the analysis. We used a sex-stratified Cox proportional hazards model. The outcome was the new incidence of functional decline during a six-year follow-up, and the exposure was the frequency of social participation of one of the following six types: sports, hobbies, volunteering, neighborhood, senior clubs, and industry groups. The frequency was categorized as "never," "a few times a year," "once or twice a month," and "once a week or more." We set non-participation in each activity as the reference, and we adjusted for 12 potential confounders (i.e., sociodemographic and health-related factors). After we adjusted for confounders, participation in sports and hobbies once or twice a month, once a week or more was protectively associated with functional decline. We found a similar association for participation in neighborhood a few times a year. Our findings demonstrate the importance of considering the effects of different types and frequencies of activities when promoting social participation among older people as part of public health policies.

Social participation during the COVID-19 pandemic in persons with a high risk for a severe course of COVID-19 - results of a longitudinal, multi-center observational study in Germany

Objective

The COVID-19 pandemic has affected how people go about their daily lives, often in various and substantial ways. This study aims to prospectively evaluate the changes in social participation during the COVID-19 pandemic in persons with a high risk for a severe COVID-19 course in Germany.

Methods

A paper-pencil-based survey was conducted starting at March 2021. Participants filled out questionnaires at four time points based on their COVID-19 vaccination status: before COVID-19 vaccination, one month, six months and twelve months after COVID-19 vaccination. Social participation measures included the Pandemic Social Participation Questionnaire (PSP-Q) and the Index for measuring participation restrictions (IMET). Repeated measures ANOVA and paired t-test were used to test for changes between time-points. Repeated measures correlation was used to assess the relationship between social participation and local COVID-19 incidences.

Results

Data from 245 participants was analyzed before and one month after COVID-19 vaccination. In addition, data from 156 participants was analyzed at time points one, six and twelve months after COVID-19. PSP-Q and IMET scores changed significantly after participants received a COVID-19 vaccination. Between one month and twelve months after vaccination, social participation improved significantly measured by PSP-Q. Social participation was negatively correlated with regional COVID-19 incidences before and after COVID-19 vaccination. Social participation was positively correlated with COVID-19 incidences between one month and twelve months after COVID-19 vaccination.

Conclusions

Social participation improved in persons with a high risk for a severe COVID-19 course during the pandemic. The local COVID-19 incidence showed a negative association with social participation only until the fall of 2021 when it was used as the sole metric to regulate COVID-19 protective measures. Although our data describes the trends in social participation, further studies are needed to identify the influencing factors for the observed increase in social participation.

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.