Participation Of Older Adults Research Articles

Exploring the Role of the Built Environment on the Functional Ability and Social Participation in Community-dwelling Older Adults

Background and Objectives. The built environment or physical environment consists of surroundings and conditions constructed by human activity. It includes urban design, neighborhoods, transportation, and smaller scale structures like the design and layout of rooms within buildings. The built environment can affect the physical, social, and functional wellbeing of older adults, both within their own homes and in the neighborhoods in which they live, and additionally plays a part in promoting healthy aging. This narrative review of the literature aims to present the ways in which the built environment can influence the functional ability of community-dwelling older adults, and affect their ability to live independently and age in place. Methods. Narrative literature review and inductive thematic analysis. Results. Forty-five full-text, English language publications from peer-reviewed sources were selected for this review, with the majority (35) presenting quantitative research findings and originating from North America (28). Older adults in rural and developing countries were underrepresented in the literature, despite acknowledgement that health of the aging population is a worldwide problem. Three major themes emerged. First, the built environment affects older adults in the most fundamental way at home through design considerations, modifications, and technological advances promoting aging in place and accessibility. Secondly, built environments outside the home can affect older adults’ physical activity and overall function with regard to mobility, transportation, and activities of daily living. The majority (22 of 45 publications) focused on this theme. Finally, the built environment in neighborhoods can affect older adults’ perception of social support, their social participation, and quality of life. Conclusion. As the built environment is created by humans and can be substantially modified, it possesses considerable potential for enhancing functional ability, social participation, and overall quality of life in community-dwelling older adults. It is possible to design a better person-environment fit, promoting safety, independence, optimal health, and quality of life. In order to support healthy aging, improvements in the built environment need to be accompanied by appropriate health and social policies, systems, and services. These changes require political will, as well as material resources that may not be readily available especially in the global South. A socioecological approach with adequate resources directed to older adults’ health and healthcare is necessary in order to achieve the ultimate goal of healthy aging in this population.

Non-Participation in a Digital Health Intervention Study Among Older Adults: Uneven Involvement, Biased Outcomes and the Effect of Weighting.

The involvement of older adults in research on digital health is uneven with respect to e.g. age, gender, health status, and digital skills. However, little is known regarding the impact of the uneven involvement of older adults in digital health research on researched outcomes. This study helps to fill this knowledge gap and identifies the effects of uneven involvement of older adults in digital health research on researched outcomes, and also develops a correction for this. Data are retrieved from a digital health intervention for postoperative monitoring of people who underwent day surgery in Sweden. Based on field information on the recruitment process and researched outcomes for the intervention, this study (1) tested intervention effects by using two standard unweighted procedures in a sample of 281 individuals aged 50 years or older, and then (2) used the information on participants, non-participants and their respective probabilities to be involved in the intervention study to perform a weighting of the intervention effects for each step of selection and for the study group membership. The intervention effects were found to be overestimated due to overrepresentation of groups which gained from receiving the intervention. No intervention effects were found after adjustment for participation bias. Selective participation of older adults in digital health research biases research outcomes and can lead to overestimation of intervention effects. Weighting allows researchers to correct and describe the impact of selective participation on researched outcomes.

Enhancing Labor Market Participation of Older Adults: Health and Workplace Adaptations

Abstract Background The labor market dynamics for older adults have significantly shifted due to extended life expectancy and evolving socioeconomic conditions. This study examines the prerequisites for older adults to remain longer in the labor market across various European countries, emphasizing the interplay between health status, workplace adaptations, and economic factors. Methods This cross-sectional study analyzed data from several European surveys focusing on older workers. The methodology included logistic regression to evaluate the impact of health status and workplace adaptations on continued employment among older adults. Data were further stratified by country to assess regional differences in employment patterns for this demographic. Results Preliminary results indicate that older adults with access to workplace adaptations-such as flexible working hours and ergonomic interventions-show a significantly higher likelihood of remaining in the labor market (OR = 2.3, 95% CI 1.8-2.9). Additionally, those reporting good to excellent health were 1.5 times more likely to continue working compared to their peers with poor health outcomes. The results also highlight substantial regional variability, with Scandinavian countries showing higher employment rates among older adults compared to Southern European regions. Conclusions The data strongly support the need for policy interventions that promote health maintenance among older workers and encourage employers to implement adaptive measures. Such strategies are likely to enhance the labor market participation of older adults, contributing to economic stability and reducing the potential strain on social security systems. Innovative public health policies aimed at supporting aging workers are crucial for sustaining workforce productivity in the face of demographic shifts. NordForsk supports the study Sustainable working-life for aging populations in the Nordic-Baltic region, Project No.: 139986. Key messages • Workplace adaptations and good health significantly extend working life among older adults. • Regional differences in employment for older workers highlight the need for tailored public health policies.

Social participation and loneliness in older adults: the moderating role of views of social change

ABSTRACT Our study investigates the relationship between social participation and loneliness among Chinese older adults, and explores how their views of social change moderate the strength of this relationship. We utilised cross-sectional nationwide data from the China Longitudinal Aging Social Survey (CLASS). Results show that increased online participation and community participation correlated with decreased loneliness, while greater workforce participation associated with increased loneliness. Moreover, older adults’ views of social change could moderate the association between their community participation and loneliness. Our findings indicate that promoting social participation and addressing older adults’ views of social change would help tackle later-life loneliness.

Does social capital enhance political participation in older adults? Multi-level evidence from the European Quality of Life Survey

This study explored the role of social capital for non-institutionalised and institutionalised political participation among older adults compared to younger age groups using European Quality of Life Survey data (EQLS) from 2016 and 33 countries (n = 36,908). Multilevel logistic regression analysis was employed to assess the association between individual- and country-level social capital and political participation. Findings revealed that, at the individual level, active associational engagement was positively related to both forms of political participation, while social trust and political trust were linked only to non-institutionalised participation—higher social trust and lower political trust were associated with a greater likelihood of participation. Country-level associational engagement was related to non-institutionalised political participation and country-level political trust with institutionalised participation. For older adults, active associational engagement had stronger individual and contextual effects on non-institutionalised political participation. These results enrich our understanding of political engagement in later life and highlight the unexplored potential for civic involvement among older adults.

Occupational Participation Among Older Adults During the COVID-19 Pandemic.

Background. The COVID-19 pandemic led to abrupt occupational disruption for all people. However, some populations, like older adults, were disproportionately impacted particularly in the earlier waves. Purpose. The purpose of this study was to explore and understand how the occupational participation of community-dwelling older adults was experienced during the COVID-19 pandemic, using the Canadian Model of Occupational Participation (CanMOP) to contextualize findings. Method. Sixty-seven older adults participated in semi-structured interviews from September 2020 to May 2021, 37 of which also participated in a follow-up interview one-year later. Findings. Using reflexive thematic analysis, four themes were generated: (1) experiences of loss are complex and layered for older adults, (2) technology as a medium for occupational participation, (3) risk perception influences return to occupation, and (4) age-related challenges for older adults resuming volunteer work. Conclusion. Increasing frequency and severity of influenza pandemics and other disasters are a global concern, and OTs can use their skillsets to foster participation and expand occupational possibilities for older adults. The CanMOP was a helpful tool to understand the nuances underlying the participation of older adults in this context.

Resistance Exercise Participation in Community-Dwelling Older Adults in Korea: Associated Factors and Sex Differences.

Background/Objectives: Despite the importance of resistance exercise in older adults, factors associated with participation remain unclear, especially regarding sex differences. This study investigated sociodemographic, behavioral, and comorbidity factors associated with insufficient resistance exercise participation among community-dwelling older adults in Korea, with analyses stratified by sex. Methods: Nationally representative cross-sectional data from 8671 participants aged ≥65 years (3758 men and 4913 women; mean age 72.8) were analyzed using the 6th-8th Korea National Health and Nutrition Examination Surveys (2014-2019). Complex-sample multivariable logistic regression identified factors associated with insufficient resistance exercise overall and by sex. Results: Women had a higher prevalence of insufficient resistance exercise than men (91.27% vs. 71.04%, p < 0.001). Older age groups, particularly those aged ≥80 years (OR: 2.39; 95% CI: 1.86-3.07), and those with lower education (OR: 1.56; 95% CI: 1.33-1.82), rural residence (OR: 1.89; 95% CI: 1.49-2.38), low household income, (OR: 1.45; 95% CI: 1.13-1.88), insufficient aerobic exercise (OR: 1.68; 95% CI: 1.46-1.94), current smoking (OR: 1.70; 95% CI: 1.26-2.29), and diabetes (OR: 1.28; 95% CI: 1.09-1.51) were independently associated with a higher likelihood of insufficient resistance exercise. The association of household income, current smoking, hypertension, and diabetes with resistance exercise adherence showed differences in sex-stratified analyses. Conclusions: Multiple sociodemographic, behavioral, and comorbid factors are linked to resistance exercise adherence among older Koreans. Tailored, sex-specific interventions are needed to promote resistance exercise in this population, informing public health strategies and further research on effective approaches for diverse older adults.

The Role of Age-friendly City Indicators in Predicting Social Belonging in Older Adults Residing in Mohammadiyeh County, Qazvin, Iran

Objectives A strong sense of belonging is crucial for the physical and mental health of older adults and their social interactions. The age-friendly city offers various opportunities for social participation of older adults. The present study aims to determine the role of age friendly-city indicators in predicting social belonging of older adults residing in Mohammadiyeh County, Qazvin Province, Iran. Methods &amp; Materials This descriptive-analytical study was conducted on 300 older adults in 2022, who were selected by a cluster sampling method from six municipal districts of Mohammadiyeh County. Data were collected using a demographic checklist, an age-friendly city scale, and a social belonging scale. Data analysis was conducted in SPSS software version 23 using multivariate linear regression analysis. The significance level was set at 0.05. Results The mean age of participants was 67.55±6 years, ranging from 60 to 84 years. The majority of them were male (n=157, 52.33%), married (n=216, 72%), and illiterate (n=157, 52.33%). Among the age-friendly city indicators, the highest score was related to the safety/ease of transportation (16.86±4.51) and open public spaces (45.61±11.47) indicators. The results of multivariate regression analysis showed that marital status (β=-0.150, P=0.006), lower than high school education (β=0.170, P=0.003) and high school diploma (β=0.192, P=0.001), and the age-friendly city indicator of safety/ease of transportation (β=0.328, P&lt;0.001) were predictors of social belonging in older adults. Conclusion The majority of older adults in Mohammadiyeh County are dissatisfied with age-friendly indicators. Those who feel safe and have easy access to public transportation are more likely to have a stronger sense of social belonging. The results of this study can effectively help policymakers and city managers in proper planning in order to develop an age-friendly city.

Effectiveness of Community-Based Multidisciplinary Integrated Care for Older Adults with General Practitioner Involvement: A Systematic Review and Meta-Analysis

Abstract Background Changing demographics has led to healthcare systems reorientating healthcare delivery towards the community setting and implementing integrated models of care worldwide. A knowledge gap exists with regards to what elements of integrated care facilitate effective age-attuned healthcare delivery. This systematic review examines the effectiveness of community-based multidisciplinary integrated care strategies with General Practitioner (GP) participation for community-dwelling older adults and describes the level of care integration in each study. Methods PUBMED, EMBASE, CINAHL, Central Register of Controlled Trials in the Cochrane Library and MEDLINE were systematically searched in April 2023. Randomised controlled trials (RCTs) or cluster RCTs that focused on interventions for community-dwelling older adults delivered by health and social care professionals with GPs were included. Two reviewers independently conducted the risk of bias assessment, applied the GRADE tool to quantify the certainty of evidence and used the Rainbow Model of Integrated Care taxonomy to describe the elements of integrated care used within studies. The primary outcome was functional status. Meta-analyses were performed using Review Manager 5.4. Results Twelve trials (14 reports) recruiting 8069 participants across 8 countries were included. Community-based multidisciplinary team (MDT) integrated care demonstrated significant improvements in functional status (standardised mean difference (SMD) 0.21, 95% confidence interval (CI) 0.05-0.37; low certainty evidence), hospitalisation (risk ratio (RR) 0.77, 95% CI 0.63-0.95; very low certainty evidence) and participant satisfaction with care (SMD 0.46, 95%c CI 0.15-0.76; low certainty evidence) from 12-36 months. No statistically significant effects favouring community-based MDT interventions for functional status at 6-month follow-up, Emergency Department presentation, mortality, health-related quality of life, or nursing home admission were established. Conclusion Community-based MDT integrated care with GP participation improves clinical and process outcomes for community-dwelling older adults. Future research should focus on models of integrated care that respond to the needs and preferences of older adults.

The relationship between cognitive function and physical activity, functional status and social participation in older adults: a cross-sectional study

Aims: Cognitive function in older adults has been a topic of growing interest in recent years. This study aimed to investigate the relationship between cognitive function and physical activity, functional status, and social participation in older adults. Methods: A cross-sectional study was conducted involving 123 older adults aged 65 years and older who met the study’s inclusion criteria. The inclusion criteria for the study were as follows: who were aged 65 years or older, literate, volunteering to participate in the study, had no hearing or vision defects that prevented the measurement of the scales used in the study, had no chronic disease that prevented the scales used in the study. The data in the study were collected with sociodemographic form, Montreal cognitive assessment, international physical activity questionnaire, timed-up-and-go test, 10-meter walk test, and Keele assessment of participation. Results: The average age of the participants was 69.5±4.6. The study included 46.3% women and, 57.7% primary school graduates. A positive and moderate relationship was found between cognitive functions and physical activity level, functional status, and social participation in older adults. Additionally, there was a moderate positive relationship found between the level of physical activity, functional status, and social participation. In the cognitive function risk model, it was found that age, education level, and social participation significantly impact cognitive functions in older adults. Conclusion: Increasing physical activity, functionality, and especially social participation in older adults can be considered an important intervention to protect and improve the cognitive functions of older adults.

The Relationship of Active Aging Perspectives and Social Participation of Elderly Individuals with Their Mental States and Functional Independence

Objective: The aim of this study is to examine the active aging perspectives and social participation of older adults and to determine their relationship with their mental states and functional independence. Method: A total of 298 participants over the age of 60, with a mean age of 70.94±8.1 were included in the study. The degree of cognitive function of the individuals included in the study was evaluated with the Mini Mental State Examination (MMSE), the level of functional independence was evaluated with the Barthel Index. The social participation statuses of the older adult participants included in the study were analyzed with the social participation evaluation form created by the researchers. Results: Individuals with high social participation evaluation form mean scores had higher Mini Mental State Examination mean scores and Barthel Index mean scores (r1: 0.329, p

Dual trajectories of social participation and frailty in Chinese older adults: a longitudinal study based on CLHLS from 2008 to 2018.

This study aimed to identify the dual trajectories of social participation (SP) and frailty index (FI) among Chinese older adults, and investigate common influential factors of both trajectories. Utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2018 surveys, 1,645 individuals were analyzed. A group-based dual trajectory model and logistic regression were used to examine trajectories, their interrelations and shared influencing factors. This study identified three SP, two FI trajectories and six distinct sub-groups of individuals. The study confirmed a long-term, interrelated relationship between two outcomes and identified some common factors. Compared to participants in the lower SP trajectory, those who followed the middle SP trajectory and higher SP trajectory had increased probabilities of belonging to the slow-growth FI trajectory (90.28 and 99.71%, respectively). And the participants in the slow-growth FI exhibited higher probabilities of belonging to the middle SP and the higher SP trajectory (37.64 and 25.34% higher, respectively) compared with those in the rapid-growth FI trajectory. Age, marital status, and drinking status were mutual factors associated with the dual trajectories. The results showed significant associations between higher levels of frailty and lower levels of social participation. Related intervention policies should consider the dual trajectories and the common factors that underlie these trajectories of SP and FI.

The effect of self-rated health on depressive symptoms in Chinese older adults: The mediating role of social participation and spouse health

This study investigates the relationship between self-rated health, social participation, spouse health, and depressive symptoms in older adults. It also analyzed the moderating effects of gender, drinking, visual function, diet, quality of life, and economic level on the model. We analyzed data from 5119 participants aged 60 and above, from the CLHLS. We used a partial least squares structural equation model to explore the correlation between self-rated health, spouse health, social participation, and depressive symptoms. Self-rated health was significantly correlated with spouse health, social participation, and depressive symptoms (P < 0.001). Social participation (β=-0.034) and spouse health (β=-0.029) were mediators of self-rated health to depressive symptoms. In addition, gender, drinking, visual function, diet, quality of life, and economic level were mediated factors. This study provides evidence that self-rated health has direct or indirect associations with depressive symptoms in older people, with social participation and spouse health playing a crucial mediating role.

The transformation of 20-year social participation policies of older people in China: Network analysis and text analysis.

Social participation of older adults is a crucial component of China's aged care services and an important strategy for actively addressing the aging population. Analyzing policy texts on older people's social participation can inform future policy formulation and the development of relevant programs. This study aims to quantitatively analyze the transformation of China's social participation policies for older people from 1999 to 2023, employing institutional network analysis and policy text analysis. A two-dimensional policy analysis framework was constructed based on the perspective of "policy tools and social participation stages." Using Rost Content Mining 6.0 and Nvivo 11.0 Plus software, 55 national-level policy texts were coded. Structural analysis of policy-issuing subjects and topic words was conducted to visualize the findings. The analysis revealed that the policy-issuing subjects demonstrated strong authority but weak coordination, with a lack of communication and cooperation across subjects. The use of policy tools was imbalanced, with an over-reliance on supply-type tools and insufficient use of demand-type tools. Additionally, the lack of effective policy tools to support various social participation stages has limited policy implementation. With technological advancement and changing needs of the elderly population, there is a need for a more systematic and forward-looking top-level design of elderly social participation policies: accelerating the systematization and precision of technological elements in policies for elderly social participation, integrating social organizations via technological platforms to mobilize diverse stakeholder engagement, and addressing the digital divide between the elderly and new technologies is imperative.

Modifiable Predictors of Social Participation in Older Adults With Chronic Disease: Identifying Targets for OT Intervention

Abstract Date Presented 03/23/24 The social isolation epidemic is particularly dire for older adults. We need to identify modifiable risk factors within the OT practice domain that are associated with the occupation of social participation for this group to develop targeted programs. Primary Author and Speaker: Mansha Mirza Additional Authors and Speakers: Heidi Christine Fischer, Dalmina Arias

Association Between Exercise Program Participation and Hospitalization of Older Adults

Government and insurance sponsored exercise programs have demonstrated decreased hospitalizations, but it is unclear if this is the case for self-referred programs. In this retrospective cohort study from 2013 to 2020, older adults who participated for at least three months at a community-based exercise center (participants) were compared with those who did not (non-participants). Each completed a baseline physical assessment and periodic reassessments thereafter. These data were paired with regional hospital data and a national mortality database. Statistical analysis and modeling were performed from 2020 to 2023. Survival to all-cause hospitalization was assessed with a priori subgroup comparison by gender and cox proportional hazard modeling by age, gender, and comorbidities. The cohort included 718 adults, mean age 69.5 years (SD 8.4), with 411 (57.2%) participants and 307 non-participants. Mean follow-up was 26.7 months. Participants had similar baseline measures of fitness (p>0.05) but were more likely to be retired and less likely to have diabetes or prior stroke than non-participants. Sustained participation was associated with a reduced rate of all-cause hospitalization (9.0% vs 12.7%, p = 0.02), even when adjusted (HR 0.54; 95% CI 0.34, 0.87, p = 0.01). This decrease was noted only in women (p = 0.03) but not in men (p = 0.49), gender was non-significant after adjustment for comorbidities (p = 0.15). Exercise program participation was independently associated with decreased risk of all-cause hospitalization, with possible differential effects by gender. Further randomized trials of the benefits of personalized exercise programs are warranted to assess sex- and gender- specific effects.

Enhancing Social Participation of Older Adults to Promote Active Ageing in High-Density Urban Communities: A Case Study of Tseung Kwan O, Hong Kong

Enhancing Social Participation of Older Adults to Promote Active Ageing in High-Density Urban Communities: A Case Study of Tseung Kwan O, Hong Kong

Routines and Attitudes of Smart Phone and Tablet Use for Social Participation Among Older Adults

Abstract Date Presented 03/22/24 Information and communication technology (ICT) use among older adults is associated with decreased loneliness and social isolation. This project investigated routines and attitudes of ICT use for social participation of older adults. Primary Author and Speaker: Chelsea Ann Conrad Additional Authors and Speakers: Maya Dupree, Deja Myers, Monica Le Contributing Authors: Amanda Davis

Motivational Barriers and Facilitators for Older Adults' Engagement in Exercise during Depressive Episodes: A Network Meta-Analysis of Randomized Controlled Trials.

This study aims to assess the motivational factors influencing the participation of older adults in various exercise interventions during depressive episodes and to identify which types of exercise are most effective in alleviating depressive symptoms in this population. Therefore, randomized controlled trials (RCTs) focusing on exercise interventions and their impact on depression in older adult patients, identified by the terms "exercise" AND "depression" AND "elderly" OR "geriatric", were selected from primary electronic databases to conduct this network meta-analysis (NMA). The primary outcome was the effect on depressive symptoms, while the secondary outcome was the comparison of dropout rates between the intervention groups and the usual care control groups, as a measure of sustained motivation and engagement. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed for effect evaluation. This study protocol has been registered in IPLASY (INPLASY 202460035). The results of 31 RCTs with 3238 participants indicated that qigong (SMD -1.17, -2.28 to -0.06), Otago Exercise (SMD -1.15, -2.29 to -0.01), and yoga (SMD -0.88, -1.55 to -0.21) significantly alleviate depressive symptoms in older adults. Walking (SMD -0.82, -1.34 to -0.31) and strength training (SMD -0.67, -1.05 to -0.30) also showed significant effects. Aerobic, physical training, and tai chi had moderate effects, while multisport showed a weaker impact with no significant improvement. In summary, our research findings demonstrate that exercise can effectively alleviate depressive symptoms in older adults, with low dropout rates likely due to interconnected physiological, psychological, and social mechanisms. This is crucial for enhancing treatment strategies for older adults' depression.

Fostering social participation among older adults: Perspectives of stakeholders

Background Fostering social participation for active and healthy ageing among older adults is an urgent issue in a changing society that requires new approaches from occupational therapists as well as from society at large. Aim To explore possibilities to foster social participation for older adults in society from the perspective of stakeholders. Material and methods A qualitative design was applied. 18 key informants, engaged in supporting older adults in their organisational roles as either professionals or volunteers, participated in five different focus groups discussions. Results The results involved two overarching themes that reflects different perspectives on key informants’ possibilities to foster social participation for older adults. The first theme describes how they direct their attention towards their roles within the organisations to foster social participation in their own context. The second theme describes the broader societal perspectives that they address to establish a common ground for collaboration and knowledge-sharing among different stakeholders. Conclusions The findings emphasise how addressing common challenges and developing collaboration are essential to foster older adults’ social participation. It is therefore necessary to involve policy-makers and decision-makers. Occupational therapists and researchers should consider the value of occupational justice to drive collective and social approaches.