Effect of Age-Friendly Communities Action Plan on Trajectories of Older Canadians' Depressive Symptoms Between 2018 and 2020: Multilevel Results From the Canadian Longitudinal Study on Aging.

As the COVID-19 pandemic impacted mental health, this longitudinal study examined the effect of age-friendly communities (AFC) action plan on older adults' depressive symptoms. Using the CLSA, the CLSA COVID-19 Questionnaire study, survey of Canadian municipalities, and the census, the depressive symptoms trajectories were modeled with multilevel multinomial regressions. Most respondents (66.1%) had non-depressed trajectories, 28.1% experienced a moderate increase in depressive symptoms, and 5.8% had a depressed trajectory. AFC action plans did not have a protective effect on these trajectories. Being a female, greater loneliness, lower income, ≥2 chronic conditions, inferior social participation, weaker sense of belonging, COVID-19 infection, and pandemic stressors predicted a depressed trajectory. Neighborhood's deprivation had a weak protective effect on the declining trajectory. Although AFC action plans provided no benefits during the pandemic, volunteers facilitating resource access and social interactions could limit any increase in depressive symptoms.

[Indice du potentiel de participation sociale des Québécois âgés : cartographie des inégalités des zones métropolitaines, urbaines et rurales].

Afin de mieux comprendre la distribution géographique des facilitateurs et des obstacles à la participation sociale des Québécois âgés, cette étude visait à documenter l'Indice du potentiel de participation sociale (IPPS) selon les zones métropolitaines, urbaines et rurales. Des analyses de données secondaires, dont l'Enquête transversale sur la santé des collectivités canadiennes, ont permis de développer et de cartographier un indice composé de facteurs environnementaux associés à la participation sociale, pondérés par une analyse factorielle. En zones métropolitaines, l'IPPS était supérieur au centre qu'en périphérie, compte tenu d'une concentration accrue d'aînés et des transports. Bien qu'atténuée, la configuration était similaire en zones urbaines. En zone rurale, un IPPS élevé était associé à une concentration d'aînés et un accès aux ressources accru, sans configuration spatiale. Pour favoriser la participation sociale, l'IPPS soutient que les transports et l'accès aux ressources doivent respectivement être améliorés en périphérie des métropoles et en zone rurale.

Key Age-Friendly Components of Municipalities that Foster Social Participation of Aging Canadians: Results from the Canadian Longitudinal Study on Aging.

Municipalities can foster the social participation of aging adults. Although making municipalities age-friendly is recognized as a promising way to help aging adults stay involved in their communities, little is known about the key components (e.g., services and structures) that foster social participation. This study thus aimed to identify key age-friendly components (AFC) best associated with the social participation of older Canadians. Secondary analyses were carried out using baseline data from the Canadian Longitudinal Study on Aging (n = 25,411) in selected municipalities (m = 110 with ≥ 30 respondents), the Age-friendly Survey, and census data. Social participation was estimated based on the number of community activities outside the home per month. AFC included housing, transportation, outdoor spaces and buildings, safety, recreation, workforce participation, information, respect, health, and community services. Multilevel models were used to examine the association between individual social participation, key AFC, and environmental characteristics, while controlling for individual characteristics. Aged between 45 and 89, half of the participants were women who were engaged in 20.2±12.5 activities per month. About 2.5% of the variance in social participation was attributable to municipalities. Better outdoor spaces and buildings (p < 0.001), worse communication and information (p < 0.01), and lower material deprivation (p < 0.001) were associated with higher social participation. Age was the only individual-level variable to have a significant random effect, indicating that municipal contexts may mediate its impact with social participation. This study provides insights to help facilitate social participation and promote age-friendliness, by maintaining safe indoor and outdoor mobility, and informing older adults of available activities.

Scoping study of definitions of social participation: update and co-construction of an interdisciplinary consensual definition.

BACKGROUND: considering the importance of social participation for quality of life and active ageing in older adults, it is an important target of social and health professionals' interventions. A previous review of definitions of social participation in older adults included articles up to 2009; new publications and changes in the social context (e.g. social media and the COVID-19 pandemic) justify continuing this work. OBJECTIVE: this paper provides an updated inventory and synthesis of definitions of social participation in older adults. Based on a critical review by content experts and knowledge users, a consensual definition is proposed. METHODS: using a scoping study framework, four databases (MEDLINE, CINAHL, AgeLine, PsycInfo) were searched with relevant keywords. Fifty-four new definitions were identified. Using content analysis, definitions were deconstructed as a function of who, how, what, where, with whom, when, and why dimensions. RESULTS: social participation definitions mostly focused on people's involvement in activities providing interactions with others in society or the community. According to this new synthesis and input from content experts and knowledge users, social participation can be defined as a person's involvement in activities providing interactions with others in community life and in important shared spaces, evolving according to available time and resources, and based on the societal context and what individuals want and is meaningful to them. CONCLUSION: a single definition may facilitate the study of active ageing and the contribution of older adults to society, socioeconomic and personal development, benefits for older adults and society, self-actualisation and goal attainment.

Scoping study of definitions and instruments measuring vulnerability in older adults.

BACKGROUND: It is important to foster social participation and health equity, especially for older adults in situations of vulnerability. Despite growing interest in vulnerability, there is no consensus regarding how to define or measure this concept. This paper provides an inventory and synthesis of definitions of and instruments measuring vulnerability in older adults. METHODS: Using a scoping study framework, eight databases (Abstracts in Social Gerontology, Academic Search Complete, AgeLine, CINAHL, MEDLINE, SocINDEX, PsycInfo, Scopus) were searched with relevant keywords [Vulnerab* AND (Concept*, Defin*, Meaning, Terminology, Measurement, Assessment*, Indicator*, Instrument*, Scale*, Questionnaire* OR Test*) AND (Aging, Aging, Elder*, Gerontolog*, Older OR Senior*)]. RESULTS: Thirty-one original definitions and five measuring instruments were identified, content-analyzed, and compared. Vulnerability definitions mostly focused on people under conditions that increased their risk of harm because of individual physical factors, the environment, and their interaction. Considering these definitions, experts in the field of aging, including two representing older adults, participated in a workshop, and a consensus was reached to define a situation of vulnerability as "a set of circumstances in which one or more individuals experience, at a specific moment in time, one or multiple physiological, psychological, socioeconomic or social difficulties that may interact to increase their risk of being harmed or having coping challenges that have a negative impact on their life." Although none of the measures fully targeted this definition, the Perceived Vulnerability Scale (PVS) is one of the most complete measures, with 22 items considering feelings of vulnerability toward personal and environmental factors, and good psychometric properties. CONCLUSIONS: The proposed definition and the PVS help to provide a common language and measure in health and social sciences research, policy and practice identifying and reaching older adults in situations of vulnerability and intervening to foster social participation and health equity.

Social participation and barriers to community activities among middle-aged and older Canadians: Differences and similarities according to gender and age.

AIM: This study described and compared participation with community activities and perceived barriers among middle-aged and older Canadians by gender and age group (45-64, 65-74, 75-84, ≥85 years). METHOD: Using the cross-sectional 2008-2009 Canadian Community Health Survey - Healthy Aging, we considered the frequency of involvement in eight community activities and the presence of 10 perceived personal and environmental barriers. RESULTS: Although frequency was globally similar for women and men (15.2 vs. 14.5 activities per month; P < 0.01), adults aged 65-74 years had higher participation (16.0 activities per month) than adults aged 45-64, 75-84 and ≥85 years (P < 0.01). Barriers showed wider gender and age gaps than participation to community activities. Notably, health condition limitations were the most reported barrier aged ≥65 years, and environmental barriers were generally greater for women than men, particularly transportation problems (P < 0.01), except ≥85 years. CONCLUSION: The results highlight that further study of social participation and barriers among older adults must consider gender and age differences. The differences are important to consider for designing population interventions aiming at improving social participation among aging Canadians. Geriatr Gerontol Int 2021; 21: 77-84.

Environmental Characteristics Associated with Older Adults' Social Participation: The Contribution of Sociodemography and Transportation in Metropolitan, Urban, and Rural Areas.

Although social participation fosters older adults' health, little is known about which environmental characteristics are related to greater participation in social activities. The Canadian Community Health Survey (n = 2737), a transportation survey, and multiple secondary data sources were used to identify the environmental characteristics associated with older Quebecers' social participation according to living area. Greater social participation was associated with: (1) a higher concentration of older adults (IRR = 2.172 (95% CI 1.600, 2.948); p < 0.001), more kilometers traveled by paratransit (IRR = 1.714 (95% CI 1.286, 2.285); p < 0.01), a lack of medical clinics (IRR = 0.730 (95% CI 0.574, 0.930); p = 0.01), and more funded home adaptations (IRR = 1.170 (95% CI 1.036, 1.320); p = 0.01) in large metropolitan areas; (2) larger paratransit fleets (IRR = 1.368 (95% CI 1.044, 1.791); p = 0.02) and a lower density of road intersections (IRR = 0.862 (95% CI 0.756, 0.982); p = 0.03) in regular metropolitan areas; (3) less social deprivation (IRR = 1.162 (95% CI 1.025, 1.318); p = 0.02) in urban areas; and (4) a higher concentration of older populations (IRR = 2.386 (95% CI 1.817, 3.133); p < 0.001) in rural areas. According to these findings, social participation interventions should target the local environment-for example, by providing more social interaction opportunities for older adults living in younger neighborhoods and by improving access to public transportation, especially paratransit.

Caractéristiques environnementales favorisant la participation sociale: une enquête auprès d'aînés québécois.

We document and compare the environmental characteristics potentially associated with social participation of older Quebecers, according to the level of rurality. A survey was carried out among older Quebecers aged 65 and over recruited by different senior groups and through social media. The Questionnaire their potential for social participation, developed from a systematic literature review, was completed by respondents. According to the 515 older participants, 71.5 years old on average, environmental characteristics linked to social participation, as well as user-friendliness of the city and neighborhood, are more favorably perceived in metropolitan and urban areas than rural areas. However, access to public transportation and the welcoming and openness of local residents are more appreciated by rural respondents. These results support the presence of inequalities in social participation according to level of rurality and offer some leads for action.

Nous avons documenté et comparé les caractéristiques environnementales potentiellement associées à la participation sociale de Québécois âgés, selon le niveau de ruralité. Une enquête a été réalisée auprès de Québécois âgés de 65 ans et plus recrutés par différents regroupements d'aînés et les réseaux sociaux. Les répondants ont rempli le Questionnaire du potentiel de participation sociale, développé à partir d'une recension systématique des écrits. Selon les 515 aînés, âgés en moyenne de 71,5 ans, les caractéristiques environnementales liées à la participation sociale, ainsi que la convivialité des villes et des quartiers, sont perçues plus favorablement dans les milieux métropolitains et urbains que dans les milieux ruraux. Toutefois, l'accès à l'autobus ainsi que l'accueil et l'ouverture des gens du quartier sont davantage appréciés par les aînés ruraux. Ces résultats témoignent de la présence d'inégalités de participation sociale selon le niveau de ruralité et permettent d'envisager de nouvelles pistes d'action.

Social participation in older women and men: differences in community activities and barriers according to region and population size in Canada.

BACKGROUND: Social participation is a modifiable health determinant influenced by physical and social aspects of the environment. Little is known about aging women's and men's community activities and barriers according to region and population size. This study compared social participation, desire to participate more, and perceived barriers of aging women and men by Canadian region and population size. METHODS: A secondary analysis of the 2008-2009 cross-sectional Canadian Community Health Survey - Healthy Aging was done with 16,274 respondents aged 65+. Respondents were grouped into five regions [Atlantic, Quebec, Ontario, Prairies and British Columbia] and five population size groups [rural (< 1000 inhabitants); small urban (1000-29,999); medium urban (30,000-99,999); large urban (100,000-499,999); and metropolitan (≥500,000) areas]. Social participation was estimated by monthly frequencies of engagement in community activities. If they desired to participate more, respondents were asked to identify barriers to their participation from a list of 13 reasons. RESULTS: There were no differences in total social participation between regions but Prairies and Quebec respondents had the highest and lowest frequency, respectively, of activities with family and friends (5.4 and 4.3 activities/month; p = 0.01). Medium urban centers had the highest participation and metropolises, the lowest (17.4 vs 14.3 activities/month; p < 0.01). About one fourth of all respondents wanted to participate more, regardless of region or population size. Overall, women wanted to participate more than men (26.6 vs 20.7%; p < 0.001), especially in Ontario (28.3 vs 21.1%; p < 0.001) and British Columbia (30.1 vs 22.9%; p < 0.001). Men in Quebec were less likely than men in other regions to report "personal responsibilities" as a barrier to participation (p < 0.001). Men were more likely than women to report being "too busy", especially in rural areas (27.1 vs 6.5%; p < 0.001). Rural women were more likely than rural men to be constrained by transportation problems (15.1 vs 1.2%, p < 0.001). Unavailability of activities was more of a constraint in rural areas than metropolises (13.6 vs 6.0%, p < 0.001). CONCLUSIONS: Overall, there were no practical differences between women's and men's social participation. However, unavailability of activities and transportation problems suggest that local initiatives and further research on environmental characteristics are required to foster aging Canadians' participation.