Abstract
The Act-Belong-Commit campaign is the world's first comprehensive, population-wide, community-based program designed to promote mental health. The campaign targets individuals to engage in mentally healthy activities, while at the same time, encouraging community organizations that offer such activities, to increase participation in their activities. Using nationally-representative data from Ireland, the aim of this study was to prospectively assess the association between indicators of the Act-Belong-Commit behavioral domains and incident depression, anxiety, and cognitive impairment.Data from two consecutive waves of the Irish Longitudinal Study on Ageing (TILDA) were analyzed. The analytical sample consisted of 6098 adults aged ≥50years. Validated scales for depression, anxiety, and cognitive impairment were used. The number of social/recreational activities engaged in was used as an indicator of Act, social network integration as an indicator of Belong, and frequency of participation in these social/recreational activities as an indicator of Commit. Multivariable logistic regression analyses were conducted to assess associations between baseline indicators of Act-Belong-Commit and incident depression, anxiety, and cognitive impairment at two-year follow-up.The adjusted model showed that each increase in the number of social/recreational activities (Act) inversely predicted the onset of depression, anxiety, and cognitive impairment. The same was the case for social network integration (Belong); that is, being well integrated into social networks was a significant protective factor against all mental health outcomes. Finally, frequency of participation in social/recreational activities (Commit) significantly and inversely predicted the onset of depression and anxiety, while the protective effect against cognitive impairment was only marginally significant.Act-Belong-Commit indicators are shown to be protective against mental disorders and cognitive impairment among older Irish adults. This provides further evidence for the campaign's potential efficacy and has potentially wide-ranging implications for preventing the deterioration of mental health and cognitive decline in the aging community.
Highlights
While the burden of mental and neurological disorders continues to grow, investments in mental health are sparse (Chisholm et al, 2016)
In terms of the Act indicator, each increase in number of activities was associated with significantly lower likelihood of developing depression [odds ratios (ORs) (95%CI): 0.87 (0.81, 0.93)], anxiety [0.90 (0.83, 0.99)], and cognitive impairment [0.77 (0.65, 0.94)]
In terms of the Commit indicator, each increase in frequency of activity engagement was associated with significantly lower likelihood of developing depression [0.96 (0.95, 0.98)] and anxiety [0.98 (0.96, 0.99)], and the inverse relationship between the Commit indicator and cognitive impairment was of borderline significance [0.96 (0.93, 1.00), p = 0.061]
Summary
While the burden of mental and neurological disorders continues to grow, investments in mental health are sparse (Chisholm et al, 2016). Between 1990 and 2010, the global burden of mental and neurological disorders increased by 41%, and accounts for one in every 10 lost years of health worldwide (Patel et al, 2016). Population aging has a profound impact on the growing prevalence and. As health systems face various economic restrictions and continuing health care demands due to demographic aging (Rechel et al, 2009), it is uncertain whether the needed financial resources will be available to properly address these issues. There is a pressing need to identify possible and sustainable approaches to improve population mental health (Anwar McHenry and Donovan, 2013; EC, 2008; WHO, 2004; WHO, 2005)
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