Abstract
ObjectivesThe aims of this study were to investigate (1) whether and (2) the extent to which Taiwanese older adults’ leisure time activity (LTA) trajectories mediated the potential association between their sociodemographic factors and their functional disability trajectories.MethodsLongitudinal data from four waves of the Taiwan Longitudinal Study on Aging (TLSA), collected between 1996 and 2007, were used for analysis (N = 3,429). Parallel-process latent growth curve modeling was adopted to evaluate the process by which LTA mediated between sociodemographic factors (age, gender, education, self-rated health, comorbidities, and depression) and the outcome process of functional disabilities.ResultsWhen mediated by baseline level of LTA, five sociodemographic factors—age, gender, education level, self-rated health, and number of comorbidities—had significant and negative mediating effects on baseline or change in functional disability, thus improving disability outcomes. However, four of the sociodemographic factors (age, education level, and number of comorbidities), when mediated through the rate of change in LTA, were found to have significant and positive mediating effects, which increased disability levels. The proportion of effects mediated by the LTA trajectory ranged from 0% to 194%.DiscussionThe large proportion of effects mediated through the LTA process underlines the importance of LTA to public health policy and health programs for older adults. The study’s findings shed light on how to better target populations of older adults to promote an active lifestyle and achieve more successful aging in late life in Asian countries.
Highlights
Engagement with life and decrease in functional disability have been major components of successful aging and have become key public health priorities in many aging societies, including Taiwan[1]
Evidence has shown that sociodemographic factors such as older age, female gender, lower educational attainment, lower self-rated health, and a greater number of comorbidities and depressive symptoms are commonly found as predictors of higher functional disabilities [7,8,9,10,11] and of leisure time activity (LTA) participation [12]
Our findings suggest that older women are less likely than their male counterparts to build a high level of baseline LTA and continue to increase their participation in LTA, which indirectly results in a higher baseline general functional disability (GFD) and a faster increase in GFD
Summary
Engagement with life and decrease in functional disability have been major components of successful aging and have become key public health priorities in many aging societies, including Taiwan[1]. Researchers have paid increasing attention to how leisure time activity (LTA), which is one of the major components of a healthy lifestyle with an emphasis on active engagement with life, prevents functional disabilities [2,3,4]. Evidence has shown that sociodemographic factors such as older age, female gender, lower educational attainment, lower self-rated health, and a greater number of comorbidities and depressive symptoms are commonly found as predictors of higher functional disabilities [7,8,9,10,11] and of LTA participation [12]. Liang (2010) has emphasized the importance of examining the role of health behaviors (such as participation in LTA) as mediating factors between older adults’ sociodemographic factors and their physical function. The goal of this study was to gain insight into both the mechanisms through which sociodemographic factors are associated with older adults’ development of functional disability and the role played by LTA participation in mediating the relationship between sociodemographic factors and functional disability
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