Social Participation Among Older Adults Centered on Knowledge Sharing

Exploring the relationship between intrinsic capacity and social participation in healthy ageing: Evidence from Singapore

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.

SP0153 Social and Work Participation – Research into Practice

As populations age, the risk of cognitive decline presents significant public health challenges. While prior research highlights the role of lifestyle factors in cognitive health, less is known about the long-term protective effects of social engagement. Our previous cross-sectional study demonstrated that social participation moderates the relationship between aging and cognitive function in older adults. Building upon these findings, this study investigates how social participation influences cognitive trajectories in aging populations using data from the Health and Retirement Study (HRS) from 2008 to 2020. The sample included 6,109 adults aged 50 and older. Cognitive function scores were assessed across four waves (2008, 2012, 2016, 2020), and social activity participation was measured using a validated 10-point scale. A linear mixed-effects regression model, implemented in Stata, was used to estimate changes in cognition while accounting for key sociodemographic and health-related covariates. The mean participant age was 65.4 years (SD = 8.87); 57.8% were female, and 83.8% were White. Findings revealed that higher social activity participation predicted better cognitive function, with particularly beneficial effects observed in older age. Notably, the interaction effect indicated that increasing social engagement over time may slow cognitive decline. By examining these dynamics longitudinally, we provide deeper insight into the long-term protective effects of social participation. These findings can inform targeted interventions and policies aimed at supporting cognitive resilience in aging populations. Addressing barriers to social engagement remains critical for enhancing not only social well-being but also cognitive health among older adults.

Social isolation is a predictor of morbidity and mortality in older people. Speech pathologists often consider that communication disabilities associated with normal ageing (sensory loss, language and discourse changes) contribute to social isolation. The aims of this study were to describe the functioning of older people using the International Classification of Functioning, Disability and Health (WHO, ) as a conceptual framework for language and sensory functioning, communicative activity, and social participation, and to explore the relationship between communication (both at an impairment level and an activity level), social participation and personal factors (demographics and emotional health). In a prospective study, 47 women and 28 men aged 62 to 98 years (mean = 74 yrs) completed objective and subjective assessments of functioning and participation, and provided personal information. Assessments were individually conducted in a face-to-face interview situation with the primary researcher, who was a speech pathologist. Assessments revealed the sample had predominantly mild hearing and vision impairments, unimpaired naming ability, frequent involvement in a wide range of communication activities, and variable social network size and social activities participation. Social participation was shown to be associated with vision, communication activities, age, education and emotional health. Naming and hearing impairments were not reliable predictors of social participation. It was concluded that professionals interested in maintaining and improving social participation of older people could well consider these predictors in community-directed interventions. Speech pathologists should therefore promote older people's involvement in everyday communicative activities while also limiting the impact of communication-related impairments, so that social participation is maintained in our ageing population.

This study aimed to evaluate the association between family structure and healthy life expectancy among older Japanese adults, hypothesizing that social participation increases healthy life expectancy more in older men without a spouse than in older women. This study collected data on Healthy Life Expectancy from 541 older adults between 2003 and 2021 from the Healthy Life Expectancy Study, a cohort study of older adults in Yamanashi Prefecture, Japan. The Japanese long-term care insurance system serves as an indicator of a healthy life expectancy. The family structures of participants were categorized as living alone, with a spouse, and with non-spouse cohabitants, whereas social activity frequency was classified as low or high (Community participation was assessed using a 4-point scale: "often," "sometimes," "rarely," and "never."). Cox proportional-hazards regression was used to analyze the relationship between participant characteristics and the loss of healthy life expectancy. Each additional year of age for older men and women increases the risk of loss of healthy life expectancy by 13% and 16%, respectively. The risk of loss of healthy life expectancy was higher among older men who lived alone or lived with non-spouse cohabitants than older living with a spouse (hazard ratio [HR]: 1.95, 95% confidence interval [CI]: 1.01-3.75; hazard ratio: 1.66, 95% confidence interval: 1.05-2.64, respectively). However, older men living without a spouse and engaging in high social activity participation had a lower risk of loss of healthy life expectancy than did those with low social activity participation (hazard ratio: 0.35, 95% confidence interval: 0.17-0.71). In conclusion, older men living without a spouse with high social activity participation had longer healthy life expectancies than those living alone with low social activity participation did.

High indoor temperatures require behavioral adaptation, especially among vulnerable older adults. There are uncertainties as to the degree to which people adapt to these challenging conditions. The aim of this study was to describe the degree of adaptation of social participation and other heat-related behavior with respect to higher indoor temperatures. In this study 81 residents from 10sheltered living facilities (84% women, mean age 80.9 years) were visited every 4weeks from May to October 2015 and additionally during 2heat waves in July and August 2015. The indoor temperature, drinking and clothing and social participation were documented. Baseline documentation of gait speed and residential area were used to create subgroups of people with high or low gait speed and with facility location in a garden city/suburb or city/city center. Social participation and clothing decreased with -4.53 in the World Health Organization participation score units (95% confidence interval CI -5.32; -3.74) and -0.41 for clothing units (95% CI -0.46; -0.37) and volume of drinking increased (0.65 l/day; 95% CI 0.52; 0.77) per increase of indoor temperature by 10 °C. The negative association between indoor temperature and social life participation was stronger if functional capacity was low or if the facility was located in the city/city center. Not all older adults displayed temperature-related adaptive behavior. For older adults the negative association between indoor temperature and social life participation was stronger in the city/city center or if their functional capacity was low. Frequent personal contact and motivation of those who are frail might be helpful to support their adaptive behavior of drinking and clothing during heat stress.

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.

Social participation has been consistently associated with lower risk of all-cause mortality, but studies have been ambivalent about how this association differs between men and women. The present study investigates if ethnicity accounts for gender differences in (a) the types of social activities older adults participate in and (b) the association between social participation and 4-year mortality. Data from 4,482 Singaporean older adults who participated in a nationally representative longitudinal survey were analyzed. Stepwise logistic regressions and Cox proportional hazard models with inverse probability of treatment weights were used. Men were more likely to engage in social activities compared with women, but this gender difference varied by ethnicity for three activities. Whereas going out to eat was associated with a lower risk of mortality for men only, playing sports was found to be protective for women only, but these associations did not vary by ethnicity. Findings suggest that although ethnicity may account for gender differences in the content of social activity participation, it does not explain gender differences in the association between social participation and mortality. More consideration should be given to whether each activity provides an appropriate milieu for the social interaction of each gender.

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

[This corrects the article DOI: 10.1371/journal.pone.0194703.].

Social participation is essential throughout life and is associated with decreased mortality and increased quality of life. It is unknown whether long-term care facility (LTCF) entry disrupts or facilitates it. To determine longitudinal trends in social participation before and after entry into nursing homes (NHs) and assisted living facilities (ALs) and to explore factors associated with participation. This nationally representative longitudinal cohort study using prospectively collected annual data from the US National Health and Aging Trends Study from 2011 to 2019 included community-dwelling Medicare beneficiaries entering LTCFs. Interviews conducted 4 years before and 2 years after NH or AL entry (index date) were included. Data analysis was performed from September 16, 2022, to May 25, 2025. Two categories of social participation comprising 5 activities were assessed: socialization (visiting with friends or family and going out for enjoyment) and community participation (attending religious services, participating in clubs or other organized activities, and volunteering). Participation over time was modeled using linear splines before, upon, and after LTCF entry. Modified Poisson regressions were used to explore associations with maintaining and starting activities, adjusted for age, sex, race and ethnicity, and proxy response were used. The total sample included 606 LTCF entrants (weighted mean [SD] age 85 [7.4] years, 404 female [66% weighted]), of whom 104 individuals were Black (7%), 23 Hispanic (4%), 464 White (86%); and 15 of any other race and ethnicity (3%). Before entry, social participation decreased in all activities (-4.7 to -2.0% annually). Of the total, 275 (44%) entered a NH and 331 (56%) entered an AL facility. Upon entry, going out for enjoyment decreased (-14.1%), but club participation and religious attendance increased (15.6% and 12.6%, respectively). Before LTCF entry, social participation decreased in all activities (-4.7 to -2.0% annually). After entry, going out for enjoyment decreased (-14.1%), but club participation and religious attendance (12.6%) increased (15.6% and 12.6%, respectively). In exploratory analyses, women were more likely to maintain visits (adjust risk ratio [aRR], 1.3; 95% CI, 1.1-1.5) and start attending religious services (aRR, 1.6; 95% CI, 1.0-2.8). NH residents were less likely to go out for enjoyment (aRR, 0.6; 95% CI, 0.5-0.8 for maintaining; aRR, 0.6; 95% CI, 0.4-1.0 for starting) and keep attending religious services (aRR, 0.7; 95% CI, 0.6-0.9). Black, Hispanic, and residents of other race or ethnicity were much less likely to start going out for enjoyment (aRR, 0.3; 95% CI, 0.1-0.8). This cohort study found that LTCF entry generally promoted community participation and reduced socialization. Benefits may be less likely among men, NH entrants, and residents of racial and ethnic minority groups.

This study aims to examine the impact of various patterns of social participation on social adaptation among retired Tibetan immigrant older adults, as well as the mediating role of institutional capital in this relationship. A cross-sectional survey was conducted in Sichuan Province, China, involving 700 older adults who immigrated to Sichuan after retiring from Tibet. After excluding invalid samples, 501 were retained for the final analysis. Distinct patterns of social participation were identified using latent class analysis (LCA), and multiple regression models were employed to analyze the mediating role of institutional capital in the relationship between social participation patterns and social adaptation. The study revealed four distinct patterns of social participation among the participants: full low-level participation, personal relationship-centric participation, social relevance-oriented participation, and balanced active participation. Institutional capital was found to play both a partial and a full mediating role in the relationship between social participation patterns and social adaptation. These findings suggest that the social participation of retired immigrant seniors is influenced by the combined effects of role change, spatial transition, and aging, highlighting the urgent need to identify alternatives prior to integration into the local community to facilitate a smoother adaptation to life in their new environment.

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.

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.