Older Adults’ Social Participation During the COVID-19 Pandemic

This study aimed to assess changes in social contact with family, friends and healthcare providers, as well as social participation in working, volunteering, religious services and other organized activities, among older adults during the COVID-19 pandemic while examining the role of pre-COVID sociodemographic characteristics or cognitive and physical limitations in changes in social contact and participation. We conducted secondary data analyses in the National Health and Aging Trends Study (NHATS) COVID-19 questionnaire, collected in 2020 during a period of workplace closures and social distancing guidelines. We linked data to pre-COVID sociodemographic and medical information collected in 2019 before COVID interrupted social life. The frequency of participants' social contact and social participation prior to and during the COVID-19 pandemic, were compared using paired t-tests for summed scores. Multivariate linear regression was used to relate participants' socio-demographic, prior physical and cognitive performance with levels of social contact and participation and with changes reported during the COVID-19 pandemic. In total, results from 2,486 eligible participants revealed that COVID-19 was associated with decreased social contact among family and friends (change: -0.62; SE: 0.06; p<0.0001), and social participation among older adults (change: -0.58; SE: 0.02; p<0.0001). Pre-COVID characteristics including older age, lower educational attainment, poorer physical performance, and more chronic conditions were associated with lower social contact and social participation and with how older adults adapted their social lives during the COVID-19 pandemic. These results emphasize the importance of increasing digital inclusion for older adults in a major crisis.

Early in the COVID-19 pandemic, social services integral to the health and well-being of older adults were shuttered to curtail the spread of the virus. In this context, social participation and awareness of social services may be especially important factors in shaping older adults’ social service use. This study described older adults’ social participation, awareness of social services, and social service use. This study also examined awareness as a mediator in the relationship between social participation and service use among Korean older adults during the COVID-19 pandemic. This study used publicly available de-identified cross-sectional secondary data drawn from the 2020 Seoul Welfare Survey. Hayes PROCESS macro was utilized along with bivariate and multivariate analyses. This study found moderate awareness as well as low social participation and social service use. Social participation and service awareness contributed to variation in older adults’ service use. Awareness did not mediate the relationship between social participation and social service use. The findings offer a foundation for understanding the connection between the social participation of older adults and their social service use during a crisis. Based on the study findings, future research should examine the contribution of virtual social participation and its link to service use.

Developing and evaluating a continuum of innovative interventions promoting health and social participation in older adults

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

This quantitative study explored the relationship between social participation and happiness among older adults in a Chinese context by introducing the mediator of spirituality. The Howden Spirituality Assessment Scale (SAS), the Memorial University of Newfoundland Scale of Happiness (MUNSH), and the Frequency of Social Participation Scale, which was developed specifically for this study, were used to measure older participants’ spirituality, happiness, and social participation. Data were collected from a sample of 658 older participants located in sixteen cities across nine provinces in China and were subsequently analysed via structural equation modelling. Three main conclusions were obtained. First, Chinese older adults’ frequency of social participation was low, their level of spirituality was high, and their sense of happiness was fair. Second, older Chinese adults’ social participation, spirituality, and happiness were positively correlated with each other. Third, older Chinese adults’ spirituality fully mediated the relationship between social participation and happiness. Our data suggest that, first, it is fundamentally necessary to promote social participation among older adults with the aim of improving their happiness; second, older adults’ need for spiritual development and spiritual growth should be viewed as the core goal of the design of social activities; third, spiritual education should be included in the focus on older adult education.

Loneliness in the time of COVID-19: Impact on older adults.

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. 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. Cross-sectional exploratory study using structural equation modeling. Meetings organized by older adults at seven community gathering places in Osaka Prefecture, Japan. One hundred thirteen healthy older adult cohort members. Cognitive function assessed via Mini-Cog; loneliness assessed via the condensed UCLA Loneliness Scale. 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). 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.

Purpose Loneliness affect older people’s health and well-being. This study explored the effects of changes in health and social relationships on loneliness in older adults. Methods Data were from the 2011 and 2015 surveys of the Taiwan Longitudinal Survey on Aging. Individuals who were aged ≥55 years at the baseline (2011) and who completed both waves of the survey were included in the analysis (n = 2,512). In the 2015 wave, loneliness was predicted on the basis of the factors identified in the 2011 wave and the changes in health and social relationship between the two waves. Multiple linear regression analysis was performed. Results Decreased social group participation, decreased receiving instrumental social support, increased negative support, decreased feeling of usefulness to others, decreased informational support, decreased financial life satisfaction, increased stress, and increased depressive symptoms were related to a higher level of loneliness, whereas increased social support and social participation as well as decreased stress and depressive symptoms were related to a lower level of loneliness. Changes in depressive symptoms, a reduction in financial satisfaction, and an increase in stress were related to both the social and emotional dimensions of loneliness. Decreased social connection, social support, and social participation were related to social loneliness, whereas an increase in physical disability was related to emotional loneliness. Conclusion Older people’s changes in social support, social participation, financial satisfaction, stress, and depressive symptoms may affect their loneliness afterward. Social networks and resources should be developed in the community for older adults.

Older adults commonly face the risk of social isolation, which poses a significant threat to their quality of life. This study explores the association between social participation and life satisfaction among older Chinese adults. Data were sourced from the 2018 China Health and Retirement Longitudinal Study. Regression analysis and mediation analysis were employed to examine the relationship between social participation and life satisfaction, with a focus on the roles of loneliness and self-rated health. The results indicate that social participation is significantly positively associated with older adults' life satisfaction. Furthermore, the positive association is more pronounced with increased diversity in social activities. Mediation analysis reveals that reductions in feelings of loneliness and improvements in health levels mediate the relationship between social participation and life satisfaction. Further analysis showed that social participation had a greater positive association among rural older adults and those lacking family companionship. This study provides evidence for enhancing life satisfaction among older adults and highlights the importance of diversity in social participation.

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

Social detachment due to Coronavirus disease (COVID-19) has caused a decline in physical activity, leading to sarcopenia and frailty in older adults. This study aimed to compare muscle mass, strength, and function values in older women before and after the first wave of the COVID-19 pandemic (April–May 2020). Furthermore, changes in muscle measures across women who experienced different levels of impact on their social participation due to the COVID-19 pandemic were examined. Muscle mass (total, trunk, and appendicular muscle), grip strength, oral motor skills, social interactions (social network and participation), and social support were assessed in 46 Japanese community-dwelling older women (mean, 77.5 y; range 66–93 y) before and after the first wave of the COVID-19 pandemic. Trunk muscle mass significantly decreased after the first wave of the pandemic. When comparing changed values between the enhanced/maintained and reduced group during the pandemic, significant group difference was observed in trunk muscular mass, grip strength, and oral motor skills. Intriguingly, those who enhanced social participation had a positive change of grip strength values, showing that social participation might influence muscle function during the COVID-19 pandemic.

Social participation provides health benefits for older adults. However, there is the need to identify whether higher social participation is associated with older adults being more physically active and less sedentary (sitting time). We examined the associations of social participation with physical activity, and sedentary time, in a population-based sample of older Japanese adults. A population-based, cross-sectional mail survey carried out in 2010 was used to collect data on social participation, physical activity, sedentary time and sociodemographic characteristics. Data were examined from 1146 community-dwelling, unemployed older adults (mean age 70.1 years, 43% men). Multivariate logistic regression analyses were used to calculate odds ratios (OR) for associations of social participation with physical activity and total sedentary time; and, for associations with passive and mentally-active sedentary (sitting) time. For both men and women, those with higher social participation were more physically active (OR 2.10, 95% CI 1.44-3.06 among men; OR 1.93, 95% CI 1.39-2.68 among women). Total sedentary time had significant associations among men (OR 0.62, 95% CI 0.42-0.90), but not among women (OR 0.80, 95% CI 0.58-1.11). Social participation was associated with less passive sedentary time (OR 0.55, 95% CI 0.38-0.81 for men; OR 0.72, 95% CI 0.51-0.99 for women). Promoting social participation among older adults could contribute to increasing physical activity and reducing sedentary time, with potential benefits for chronic disease. Further research is required to elucidate the deleterious and beneficial roles of passive and mentally-active sedentary time for older adults. Geriatr Gerontol Int 2017; 17: 1921-1927.

Objectives Social participation has generated a wealth of research in gerontology, but the concept suffers from a lack of conceptual clarity that renders it difficult to define and measure. This means that research on social participation is difficult to compare directly. The aim of the present study was to draw the literature on social participation in older adults together to inform health services researchers seeking to investigate social participation as an indicator of successful aging. Methods A narrative review of studies investigating the association between social participation and health in adults aged 65 years and older was conducted. Results Three concepts of social participation (i.e. social connections, informal social participation and volunteering) were defined, their measurement instruments described and evidence of their associations with health explored. All three concepts have demonstrated associations with an array of health indicators. Prospective studies reveal that social participation at baseline is positively associated with mental and physical health. Conclusion A model of social participation on health is presented, showing the evidence that all three concepts contribute to the association between social participation and health through their shared mechanisms of social support and social cohesion with the wider community. Using an instrument that can be separated into these three distinct concepts will assist health services researchers to determine the relative effect of each form of participation on the health of older adults. What is known about the topic? Social participation has generated a wealth of research in gerontology. The scope of the literature on social participation is broad and the concepts diverse. For this reason, most previous systematic reviews have been unable to comprehensively assess the effect of all concepts of social participation on health. This means the research on social participation is difficult to compare directly, and indicators of social participation in older adults are difficult for policy makers to select. What does this paper add? This paper overviews the three concepts of social participation, their methods of measurement and their associations with health in older adults. We present a model of social participation that incorporates all three concepts of social participation and their effects on health. We argue that the use of a measure that can be segmented into each of the three forms of social participation will predict more of the variance in health outcomes than any measure on its own. What are the implications for practitioners? Enhancing the social participation of older adults is a key factor in successful aging that many older adults value. However, many service provision organisations tend to focus on meeting the specific physical needs of clients, rather than targeting services that connect older adults with their community. Targeting social participation may present one of the greatest opportunities to improve older adults' general health, and will also generate societal benefits by increasing community contributions from this group. Selecting an indicator of social participation that measures each of the three concepts overviewed in this paper will enable policy makers to identify the areas in which social interventions for older adults will have the most effect.

This study developed system dynamic modeling (SDM) based on the International Classification of Functioning, Disability and Health (ICF) framework to simulate and identify key leverage points for enhancing social participation among older adults with noncommunicable diseases (NCDs), aiming to offer a robust theoretical foundation for designing effective interventions. Utilizing a system dynamics modeling, we simulated intervention strategies to augment social participation among older NCDs patients. Initial insights from in-depth interviews with 31 older individuals informed the construction of a causal loop diagram, elucidating the multifactorial relationships and feedback mechanisms among pertinent variables. Data from 500 patients were analyzed using correlation analysis, an independent weighting approach, and multiple regression to identify key variables, determine their equation coefficients, and construct a stock flow diagram for the model. The model then simulated social participation trends over 16 months under varying intervention intensities. The results showed significant improvements in mobility function, functional ability, pain management, and social support, resulting in increases of 54.9%, 32.4%, 28.7%, and 25.0%, respectively, at a 10% intervention level. When intervention intensity was escalated to 20%, the impact became even more pronounced, with mobility function leading the way at a 127.5% increase, followed by pain management (63.6%) and functional ability (62.8%), and social support (48.7%). Self-care and emotional functions showed minimal improvement in social participation, with increases of less than 3% and 5%, respectively. Improving social participation in older NCDs adults requires understanding complex system dynamics. This study highlights mobility function, functional ability, pain management, and social support as key leverage points, stressing the need for targeted interventions based on individual assessments.

Social participation is positively associated with older adults’ health. Health‐care services, therefore, need to empower older adults to adapt to the social changes that accompany aging. This systematic review, with a metasynthesis of qualitative studies, aimed to describe and develop an understanding of home‐dwelling older adults’ (65 yrs+) experiences of using strategies to maintain and foster their social participation. The main search was performed in March 2022 using the PubMed, CINAHL, PsycINFO, and AMED databases and included peer‐reviewed articles published between 2012 and 2022. A total of 35 full‐text articles from 15 different countries were included and assessed for quality by the assessment tool for qualitative studies provided by the Critical Appraisal Skills Programme (CASP). The metasynthesis resulted in the main theme: strategically creating routines that foster social participation and two main categories: inward‐looking strategies for social participation and outward‐looking strategies for social participation. Each main category contained three subcategories. The findings suggest that for perceiving social participation, it is important for older adults to create routines with patterns of activities and to be able to engage in these activities. The findings further reflect that older adults use earlier experiences of social participation to facilitate the making of routines. This indicates that health‐care interventions supporting older adults’ social participation must be applied early and with a health‐promotive focus. Conclusively, researchers need to develop interventions that support older adults in healthy activity patterns by raising awareness of how to use inward‐looking and outward‐looking strategies to create routines for social participation. The findings further suggest that older adults’ possibilities for social participation could be supported by designing accessible venues that facilitate spontaneous meetings and encourage older adults’ own choices and initiatives for social participation.