Abstract
Background: This study aims to examine the impact of individual-level and community-based factors on popular social participation activities of Chinese middle-aged and older adults post-stroke. Methods: Sub-samples of survivors of stroke (2011: n = 413, 2013: n = 395, 2015: n = 441) recruited by the China Health and Retirement Longitudinal Study (CHARLS) were included in the analysis. Zero-inflated Poisson and multi-level logistic regression models were used to explore factors associated with social participation. Results: More than half of individuals (55.0%) had no social participation and 23.4% participated in multiple social activities. The most popular social activities that individuals participated in were interacting with friends (32.6%) and going to a community club to play table games (22.7%). Multiple individual-level factors were negatively related to social participation (e.g., depressive symptoms and multiple measures of functional limitations) while the allocation of an outdoor exercise facility in the community/village was positively associated with going to a community club to play table games. Conclusion: Stroke survivors are at high risk of limited social participation. Policymakers and other key stakeholders should consider community design among other potential solutions when identifying ways to link at-risk stroke survivors to both opportunities for rehabilitation (e.g., physical function) and social participation.
Highlights
Stroke is a leading cause of death and disability among middle-aged and older adults throughout the world
Females were more likely to interact with friends than males, and older individuals with lower education levels were more likely to go to a community club to play table games than younger individuals with higher education levels
Our study found that having depressive symptoms was negatively associated with the number of social activities one participated in and the probability of social participation
Summary
Stroke is a leading cause of death and disability among middle-aged and older adults throughout the world. A Chinese national survey recently reported the long-term disability rate in people five years after stroke was 45% [2]. These survivors of stroke likely have significant restrictions in social participation that may be associated with lower quality of life and a. This study aims to examine the impact of individual-level and communitybased factors on popular social participation activities of Chinese middle-aged and older adults post-stroke. Multiple individual-level factors were negatively related to social participation (e.g., depressive symptoms and multiple measures of functional limitations) while the allocation of an outdoor exercise facility in the community/village was positively associated with going to a community club to play table games. Policymakers and other key stakeholders should consider community design among other potential solutions when identifying ways to link at-risk stroke survivors to both opportunities for rehabilitation (e.g., physical function) and social participation
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