BACKGROUND AND OBJECTIVE

Humans need constant interaction for a better well-being. It is advisable to actively participate socially to acquire psychological support and elicit satisfaction. In fact, social participation is a key driver of life satisfaction among the elderly. This study aims to describe social participation and life satisfaction among employees of a premier university in Manila, Philippines and infer their relationship through activity theory.

Seventy-one participants ages fifty years and older as of June 30, 2020 representing various employee categories participated in the online survey: a) faculty; b) research extension and professional staff; and c) administrative staff. Ten key informant interviews (KIIs) were likewise conducted to determine their opinions and perceptions on social participation in campus.

Social media usage and “malling” ranked the highest, contributing to 76% and 48% of the activities for indoor and outdoor activities, respectively. In terms of membership, professional organizations comprised 69%. On the other hand, 68% of organization members were elected officers. The relationship between social participation and life satisfaction were observable as indicated by the high rate of social participation and low percentage of participants who reported life dissatisfaction (4%).

High levels of social participation in terms of indoor and outdoor activities; membership including activeness in organizations; as well as positions held in organizations may indicate high levels of life satisfaction. Further research on a large sample size may explore statistical analysis on the longitudinal effects of social participation and life satisfaction.

BACKGROUND AND OBJECTIVES

The built environment or physical environment consists of surroundings and conditions constructed by human activity. It includes urban design, neighborhoods, transportation, and smaller scale structures like the design and layout of rooms within buildings. The built environment can affect the physical, social, and functional wellbeing of older adults, both within their own homes and in the neighborhoods in which they live, and additionally plays a part in promoting healthy aging. This narrative review of the literature aims to present the ways in which the built environment can influence the functional ability of community-dwelling older adults, and affect their ability to live independently and age in place.

Narrative literature review and inductive thematic analysis.

Forty-five full-text, English language publications from peer-reviewed sources were selected for this review, with the majority (35) presenting quantitative research findings and originating from North America (28). Older adults in rural and developing countries were underrepresented in the literature, despite acknowledgement that health of the aging population is a worldwide problem. Three major themes emerged. First, the built environment affects older adults in the most fundamental way at home through design considerations, modifications, and technological advances promoting aging in place and accessibility. Secondly, built environments outside the home can affect older adults’ physical activity and overall function with regard to mobility, transportation, and activities of daily living. The majority (22 of 45 publications) focused on this theme. Finally, the built environment in neighborhoods can affect older adults’ perception of social support, their social participation, and quality of life.

As the built environment is created by humans and can be substantially modified, it possesses considerable potential for enhancing functional ability, social participation, and overall quality of life in community-dwelling older adults. It is possible to design a better person-environment fit, promoting safety, independence, optimal health, and quality of life. In order to support healthy aging, improvements in the built environment need to be accompanied by appropriate health and social policies, systems, and services. These changes require political will, as well as material resources that may not be readily available especially in the global South. A socioecological approach with adequate resources directed to older adults’ health and healthcare is necessary in order to achieve the ultimate goal of healthy aging in this population.

BACKGROUND: Individual-level social capital is an important determinant of older adults' long-term care needs; however, there is scant evidence regarding community-level social capital. Therefore, we investigated the association between community-level social capital and the prevalence of the need for long-term care among older adults. METHODS: Between January and February 2018, a cross-sectional survey was conducted among all older adults (n = 13,558) aged 65 to 74 years in a rural municipality in Japan (total population, n = 72,833). A self-reported questionnaire was used to identify community-level social capital, comprising civic participation, social cohesion, and reciprocity. A multilevel logistic regression analysis was performed to estimate the odds ratios of the need for long-term care and a decline in social activity competence as assessed by instrumental activities of daily living. For the analysis, the community levels were divided into 76 voting districts and adjusted for daily life, lifestyle, socioeconomic status, health conditions, and the three social capital subscale scores at the individual level. RESULTS: After adjusting for the covariates, we observed a tendency that a higher community level of reciprocity was associated with a lower prevalence of long-term care needs (OR: 0.86, 95% confidence interval: 0.75-1.00), whereas a high community level of social cohesion was associated with a significantly reduced decline in instrumental activities of daily living (OR per standard deviation increase: 0.87, 95% confidence interval: 0.79-0.96). No significant association was found with civic participation. Similarly, individual-level social capital was associated with the need for long-term care and decline in instrumental activities of daily living. CONCLUSIONS Our findings suggest that good community-level reciprocity or social cohesion as well as good individual social capital status may help prevent the need for long-term care among older adults.
Humans ; Aged ; Interpersonal Relations ; Activities of Daily Living ; Social Participation ; Social Capital ; Multilevel Analysis ; Cross-Sectional Studies ; Long-Term Care ; Japan/epidemiology* ; Social Support

BACKGROUND: The relationship between leisure activities (LA) in old age and prevention of disability has not been fully investigated, and age and gender differences of these relationships are unknown. This study aimed to investigate whether physical and cognitive LA predicted incident disability among community-dwelling older adults by age and gender. METHODS: We prospectively observed 8,275 residents aged 65 or above without disability at baseline for 3 years. Incident disability was defined as a new certification of the public long-term care insurance system. LA were classified into two types: physical LA and cognitive LA. The frequency of LA was categorized into frequent (i.e., once a week or more), moderate (i.e., monthly or yearly), and non-engagement. Covariates included age, gender, family number, education, perceived economic situation, body mass index, chronic medical conditions, alcohol consumption, smoking status, regular dental visits, depression, cognitive functioning, and social participation. Multivariable Poisson regression models were used to estimate adjusted cumulative incidence ratio (CIR) and 95% confidence interval (CI) for incident disability. We performed stratified analyses by age groups (i.e., the young-old aged 65-74 and the old-old aged 75-97) and gender (i.e., men and women). RESULTS: The 3-year cumulative incidence of disability was 7.5%. After adjustment for covariates and mutual adjustment for both types of LA, a significant dose-response relationship between more frequent LA and lower risk of incident disability was found in young-old physical LA (P-trend < 0.001), in old-old cognitive LA (P-trend = 0.012), in male cognitive LA (P-trend = 0.006), and in female physical LA (P-trend = 0.030). Compared with people without LA, adjusted CIR (95% CI) of frequent LA was 0.47 (0.30-0.74) in young-old physical, 0.75 (0.58-0.96) in old-old cognitive, 0.65 (0.46-0.89) in male cognitive, and 0.70 (0.52-0.95) in female physical. Regarding the effect modification according to age and gender, only interaction between age and physical LA significantly prevented incident disability (P for interaction = 0.019). CONCLUSION We found age differences in the association of physical LA with incident disability among community-dwelling older adults. An effective measure to prevent long-term care in the community would be to recommend frequent physical LA for the young-old.
Aged ; Disabled Persons ; Exercise ; Female ; Humans ; Independent Living ; Leisure Activities ; Male ; Middle Aged ; Social Participation

BACKGROUND: How community-based group resistance exercises affect the transition from robustness to frailty remains unclear. Thus, we conducted a retrospective cohort study to determine whether the trajectory from robustness to frailty over age differed depending on the duration of participation in group exercises. METHODS: We analyzed the Kihon Checklist (KCL) score of community-dwelling elderly residents of Sumoto city, Hyogo prefecture, who participated in community-based group resistance exercises between April 2010 and December 2019. Finally, 2567 older individuals were analyzed using multilevel modeling. The explanatory variables of interest were the frailty score measured using the KCL for each individual, where 0-3, 4-7, and ≥8 points denoted robustness, pre-frailty, and frailty, respectively. We considered age, sex, systolic blood pressure, pulse, duration of participation, and change in KCL score from baseline as possible confounders. Participants were classified as follows based on the duration of participation in the exercises: <3 times, short-term participation group; 4-6 times; mid-term participation group; and 7-13 times, long-term participation group. The mean duration from the baseline physical test for the total sample was 2.35 years (SD=2.51). RESULTS: The participants' mean total KCL score at baseline was 4.9±3.7. Multilevel modeling analysis revealed that the KCL scores changed by 0.82 points for each additional year of age (p<0.001) and changed by - 0.93 points for long-term participate group (p<0.001). The Estimated Marginal Means (EMM) of the KCL score was 3.98 (95%CI: 3.69, 4.28) points in the short-term participation group and was significantly worse than that of the long-term participation group at 70 years of age (p=0.001). The EMM was 4.49 (95%CI: 4.24, 4.74) at 75 years of age in the mid-term participation group and was significantly worse than that of the long-term participation group. The EMM was 3.87 (95%CI: 3.57, 4.16) in the long-term participation group and significantly better than that of the short-term (p<0.001) and mid-term (p=0.002) participation groups. CONCLUSION Participation in community-based group resistance exercises prolongs the transition from robustness to frailty. The improved KCL scores at baseline in the long-term participation group remained in the robust range at 75 years of age, which suggests the importance of initiating participation before the onset of functional decline.
Aged ; Checklist ; Cohort Studies ; Exercise Test ; Female ; Frailty/prevention & control* ; Humans ; Independent Living ; Japan/epidemiology* ; Male ; Resistance Training ; Retrospective Studies ; Social Participation

OBJECTIVE: To investigate the association between educational attainment and the onset of disability in activities of daily living (ADL), and to explore the mediating effect of social participation on such association. METHODS: A longitudinal dataset was drawn from the China Health and Retirement Longitudinal Study (CHARLS, 2015 to 2018). The measurements of educational attainment, social participation and other covariates were identified from 2015, while the outcome measurement of ADL disability was constructed with data from survey 2018. Descriptive analyses were conducted, and basic characteristics and social engagement of the respondents were compared between illiterates and non-illite-rates using Chi-square test. Logistic regression was used to investigate the associations of educational attainment and social participation on the onset of ADL disability. Mediation analysis was employed to examine the mediator role of the social participation on the linkage from being illiterate to the ADL disability onset. RESULTS: A total of 11 359 adults aged 45 years and above were included in the sample, of whom 3 222 were illiterates. The incidence of the onset of ADL disability of illiterates and non-illiterates were 10.4% and 6.2%, respectively. Among these respondents, only half of them were involved in social activities. Of all the 8 social activities, the percentage of interacting with friends (34. 1%) was the highest, and the lowest percentage was observed in participating in an educational or training course (0.6%). Moreover, the percentages of participation in all these 8 social activities among illiterates were significantly lower than that of their educated counterparts (all P < 0.001). The illiterate middle-aged and older adults were less likely to develop ADL disability in the follow-up period [adjusted odds ratio (aOR)=1.22, 95%CI: 1.02-1.45], and social participation was significantly associated with ADL disability onset (aOR=0.73, 95%CI: 0.63-0.85). Findings from mediation analysis illustrated that social participation accounted for 12.22% of the adverse effect of being illiterate on ADL disability onset. CONCLUSION Social participation could buffer the negative effect of being illiterate on ADL disability onset in middle-aged and older adults, suggesting that engagement in social activities might have impact on prevention of impairments in physical function, especially for middle-aged and older illiterates.
Activities of Daily Living ; Aged ; China/epidemiology* ; Disabled Persons ; Humans ; Longitudinal Studies ; Middle Aged ; Social Participation

BACKGROUND AND OBJECTIVES: Voice disorder is recognized as a major problem because it negatively affects the elderly's social participation and quality of life. The purpose of this study was to examine the validity and reliability of Korean aging voice index (KAVI), which assesses the quality of life related to the voice of the elderly. MATERIALS AND METHOD: This study was conducted on 211 elderly people aged 65 years or older : 111 patients with voice disorder (mean age 69.8, range 65–80 years) and 100 nomorphonic participants (mean age 70.6, range 65–82 years). Aging voice index was translated into Korean and used and Korean voice-related quality of life (KVQOL) was conducted to verify KAVI. The validity (item validity, concurrent validity, and construct validity) and reliability (test-retest reliability and internal consistency reliability) of KAVI. RESULTS: The item validity (ICC=0.895) and construct validity (r=0.765) showed a high correlation, respectively. And concurrent validity (r=0.748), test-retest reliability (0.851), and internal consistency reliability (α=0.832) were statistically significant in voice disorder group. In addition, there was a significant difference between the voice disorder and the nomorphonic group in AVI total score. CONCLUSION: KAVI is a validated and reliable quality of life tool that will be useful for assessing the presence and effectiveness of interventions in clinical settings.
Aged ; Aging ; Humans ; Methods ; Quality of Life ; Reproducibility of Results ; Social Participation ; Voice Disorders ; Voice

OBJECTIVES: This study examined the functional disabilities of patients with chronic schizophrenia using WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and its related factors. METHODS: The subjects consisted of 86 patients with schizophrenia with more than 10 years' duration of illness and 40 healthy volunteers. The functional disabilities and psychopathology were evaluated using the WHODAS 2.0 and 18-items Brief Psychiatric Rating Scale (BPRS-18), respectively. This study analyzed the six sub-domains ('cognition', 'mobility', 'self-care', 'getting along', 'life activities', and 'participation') of WHODAS 2.0 and the four sub-scales ('positive symptoms', 'negative symptoms', 'affect', and 'resistance') of BPRS-18. RESULTS: Patients with chronic schizophrenia experienced severe functional disabilities across all six sub-domains of WHODAS 2.0 compared to healthy people. Hierarchical regression showed that 'negative symptoms' explained the disabilities in the WHODAS 2.0 sub-domains of 'cognition' (p<0.05), 'self-care' (p<0.05), 'getting along' (p<0.01), and 'life activities' (p<0.05). 'Positive symptoms' and 'affect' explained the disabilities in 'cognition' (p<0.01 and p<0.05, respectively) and 'participation' (p<0.05 and p<0.01, respectively). 'Resistance' was found to be a predictor of 'getting along' disabilities (p<0.01). CONCLUSION: Negative symptoms mainly accounted for the multiple domains of functional disabilities in the WHODAS 2.0 but residual positive and affective symptoms could also deteriorate the cognition and social participation of patients with chronic schizophrenia.
Affective Symptoms ; Appointments and Schedules ; Brief Psychiatric Rating Scale ; Cognition ; Disability Evaluation ; Global Health ; Healthy Volunteers ; Humans ; Psychopathology ; Schizophrenia ; Social Participation ; World Health Organization

OBJECTIVES: This study examined the characteristics and nutritional risk of the elderly who receive home delivery services. We then analyzed the effects of the characteristics of the elderly who receive the home-delivery meal service on their nutritional risk. METHODS: A total of 220 respondents who receive home-delivery meal service in Seoul participated in the survey. The survey consisted of the characteristics of the elderly (health status, tooth condition, physical activity, social participation activity, depression and relationship with neighbors), nutritional risk assessment and other general matters. The data was analyzed by using the SPSS program. Cross-tabulation analysis, t-test, correlation analysis and regression analysis were all conducted. RESULTS: 47.0% of the subjects were under 80 years old and 53.0% were over 80 years old, The nutritional risk score, as evaluated by a Nutrition Screening Initiative (NSI) checklist was 10.7 points, and the high nutrition risk group was 91.5% of the subjects. The subjective self-health status score was 2.24 points (out of a total of 5 points) and the tooth status score was 3.30 points. The physical activity level was 2.17 points for the under 80 years old group and 1.76 points for the over 80 years old, and there was a significant difference according to age (p<0.01), The higher the health status, tooth condition, physical activity and social participation activity level, the lower was the nutritional risk. Further, the higher the degree of depression, the higher was the nutritional risk. CONCLUSIONS: For the healthy life of the elderly in the community, various welfare policies should be planned to increase social participation as well as to promote physical health and reduce depression.
Aged ; Checklist ; Depression ; Humans ; Mass Screening ; Meals ; Motor Activity ; Risk Assessment ; Seoul ; Social Participation ; Surveys and Questionnaires ; Tooth

BACKGROUND: The aim of this study was to investigate whether generalized trust and/or social participation at an individual level have negative associations with unmet healthcare needs. METHODS: Door-to-door interviews were conducted by trained interviewers to collect information. The 8,800 study participants included 220 adults sampled systematically using the resident registration database from 40 sub-municipal-level administrative units in Korea. Unmet healthcare needs were measured subjectively by the following question: “During the past 12 months, was there ever a time when you felt that you needed healthcare (excluding dental care) but did not receive it?” The responses were classified as either “yes” or “no.” RESULTS: The adjusted odds ratios (ORs) for unmet healthcare needs based on one positive response, two positive responses, and three positive responses to the three items of generalized trust compared to no positive responses were 0.92 (95% confidence interval [CI], 0.77–1.09), 0.90 (95% CI, 0.74–1.09), and 0.73 (95% CI, 0.61–0.87), respectively. The adjusted ORs for unmet healthcare needs based on social participation only in informal organizations, only in formal organizations, and in both informal and formal organizations compared to no social participation were 0.83 (95% CI, 0.71–0.98), 0.97 (95% CI, 0.77–1.21), and 0.97 (95% CI, 0.82–1.15), respectively. The covariates included in the multiple logistic regression were sociodemographic variables (gender, age, marital status, educational level, occupation, food security, and administrative unit), self-rated health, and perceived stress. CONCLUSION: Therefore, generalized trust and social participation in informal organizations can decrease the incidence of unmet healthcare needs.
Adult ; Delivery of Health Care* ; Food Supply ; Humans ; Incidence ; Korea ; Logistic Models ; Marital Status ; Mortality* ; Occupations ; Odds Ratio ; Power (Psychology) ; Social Capital ; Social Participation*