Social participation, loneliness, and physical inactivity over time: evidence from SHARE.

OBJECTIVES: We aimed to explore the reciprocal effects of social participation, loneliness, and physical inactivity over a period of 6 years in a representative sample of European adults over 50 years old. DESIGN: A longitudinal study with a six-year follow-up period was conducted. SETTING: Four waves of the Survey of Health, Ageing and Retirement in Europe project were used. PARTICIPANTS: This study includes 64,887 participants from Europe and Israel, who were aged 50 or older at the first time. MEASUREMENTS: The relationship between participation in social activities, loneliness and physical inactivity was analyzed, controlling for age, gender, and disability. A series of cross-lagged panel models (CLPMs) were applied to analyze the relationships among these variables. RESULTS: A CLPM with equal autoregressive cross-lagged effects across waves was the best fit to the data (χ2 = 7137.8, CFI = .972, RMSEA = .049, SRMR = .036). The autoregressive effects for the three variables showed high stability across waves, and all the cross-lagged effects in the model were statistically significant. Social activity and physical inactivity maintained a strong negative cross-lagged effect, while their cross-lagged effects on loneliness were comparatively smaller. Social activity had a positive cross-lagged effect on loneliness, while physical inactivity had a negative cross-lagged effect on loneliness. CONCLUSIONS: These findings highlight the importance of promoting physical activity and social participation and addressing loneliness through targeted interventions in older adults.

Association between social participation and memory function among Chinese stroke survivors: The mediating role of depressive symptoms.

Although the association between social participation and memory function has been documented in other populations, whether it exists among stroke survivors is unclear. Additionally, the mechanisms underlying this association are largely unknown. We attempted to examine the association between social participation and memory function in stroke survivors and the possible mediating role of depressive symptoms. A total of 614 stroke survivors (mean age: 64.73 years) drawn from a nationally representative survey in China were investigated. Based on the descriptive statistics, a Pearson's correlation and bootstrapping-based mediation analysis were executed. The results indicated that an increase in social participation was associated with a decrease in depressive symptoms (r = -0.100, p < 0.05) and an increase in memory function (r = 0.162, p < 0.01). Moreover, memory function was significantly negatively related to depressive symptoms (r = -0.243, p < 0.01). In addition, after controlling for sociodemographic factors, depressive symptoms partially mediated the effects of social participation on memory function. Due to the cross-sectional research design, causal relationships cannot be verified between the study variables. However, interventions aimed at aiding stroke survivors in memory impairment recovery may consider strategies to enhance social participation and mitigate depressive symptoms.

[Points de vue d'adultes vieillissants ayant une déficience intellectuelle à l'égard de leur participation sociale].

Au cours du vieillissement, les adultes ayant une déficience intellectuelle (DI) vivent de nombreux changements susceptibles d'influencer leurs possibilités d'exercer leurs activités quotidiennes et leurs rôles sociaux. Une bonne connaissance de leurs points de vue sur le sujet apparaît cruciale pour mieux adapter l'offre de services à leurs besoins. Cette recherche a pour but de mieux comprendre les points de vue des personnes ayant une DI à l'égard de leurs possibilités de participation sociale à travers l'avancée en âge. Des entrevues individuelles et un atelier participatif ont été réalisés avec des adultes âgés de 40 à 75 ans dans la ville de Québec. L'analyse de leurs propos a permis d'identifier leurs points de vue relatifs à trois thèmes, soit leurs capacités, les possibilités d'exercer leur participation sociale et les soutiens reçus. Pour conclure, des recommandations sont proposées afin que les pratiques soutiennent réellement leur participation sociale à travers l'avancée en âge.

Factors Associated with Lower Social Activity in German Older Adults at Increased Risk of Dementia: A Cross-Sectional Analysis.

Background: Studies demonstrate associations between low social activity in older adults and cognitive decline. Little has been investigated regarding which factors are associated with low social activity in older adults at increased risk of dementia. Objective: We investigate which sociodemographic, psychological, health-related, and environmental factors are associated with low social activity in older adults at increased risk of dementia. Additionally, we describe the stages of health behavior change, the types of social activities, and the duration of the current level of social activity. Methods: We used baseline data of 1,015 participants from the AgeWell.de trial. We conducted logistic and Poisson regression analyses to investigate factors associated with low social activity. We report descriptive statistics on the stages of change in the sample, the types of social activities most frequently pursued, and the duration of the current level of social activity. Results: Lower income, non-usage of public transport, depressive symptoms, cognitive, mobility, and hearing impairment were negatively associated with social activity. The majority of the sample was in the maintenance stage, followed by the precontemplation stage. The most common social activities were traveling and hobbies with others. Participants have maintained their current level of social activity for several years. Conclusions: We identified a lack of resources (income, transport), depressive symptoms and poorer health (cognitive, mobility and hearing impairment) as barriers to social activity. Interventions promoting social activity in older adults at risk of dementia may specifically target individuals with these risk factors. Low-threshold opportunities for social activity may be particularly beneficial.

Impacts of a Self-directed Social Resources Study Program on Negative Symptoms and Quality of Life in Schizophrenia Outpatients: A Randomized Controlled Trial.

To clarify whether a self-directed study program on social resources improves negative symptoms, quality of life (QOL), and social participation among outpatients with schizophrenia. Eighty-six participants were randomly divided into intervention and control groups. In addition to the usual day programs, the intervention group participated in a self-directed study program on social resources once a week for eight weeks. The control group participated only in the usual day programs. Negative symptoms and QOL were assessed at baseline and post-intervention using the Positive and Negative Syndrome Scale (PANSS) and the WHO Quality of Life-BREF (WHOQOL-BREF), respectively. Social participation was also assessed. After the intervention, there were no significant differences in the PANSS negative symptoms and WHOQOL-BREF total scores between the two groups. Within-group, PANSS negative symptom scores significantly improved in the intervention group (p < 0.05), but not in the control group. The WHOQOL-BREF physical health subscale scores improved significantly only in the intervention group (p < 0.05). Social participation remained unchanged between the intervention and control groups. The results suggest that a self-directed study program on social resources may be useful for improving negative symptoms and physical QOL in outpatients with schizophrenia. The findings highlight the potential of such interventions to bridge the existing gap in psychosocial rehabilitation strategies for this population.

Loneliness, Psychological Well-being, Depression, and Social Participation in the Older Persons: Rural and Urban Differences.

INTRODUCTION: The purpose of this study is to compare the loneliness, psychological well- being, depression, and social participation of elderly people living in Turkish society between rural and urban areas. The sample group of the study, in which a correlational survey model was used, consisted of 610 elderly adults. METHOD: The study population consists of two groups: the first group consists of individuals over 65 years of age living in the city (Istanbul) (n= 291), and the second group consists of individuals over 65 years of age living in rural areas (rural areas of Ordu) (n= 319). Socio-demographic Information Form, Loneliness in the Elderly Scale, Geriatric Depression Scale, Psychological Well-Being in the Elderly Scale, and Social Inclusion Scale were applied online. Statistical analyses of the study were conducted using SPSS 27.00, and the Independent Samples t-test and ANOVA test were used. RESULTS: According to the findings of this study, statistically significant results were found in psychological well-being, social inclusion, social relations, loneliness and depression, and place of residence. It was observed that the social isolation and social acceptance levels of those living in urban areas were higher than those living in rural areas. Social, loneliness, and depression scores of those living in the village/town were found to be higher than those living in the city centre. Furthermore, the social relationship scores of those living in the village/town were found to be higher than those living in the city centre. CONCLUSION: The increasing elderly population worldwide has become an issue that requires global measures. Place of residence is one of the factors thought to affect older people's health and well- being. It is thought that the study data will contribute to new policies that will ensure the protection and promotion of elderly health and those working in this field. In addition, the study, which provides information about Turkish culture, will also enable intercultural comparisons.

The Association Between Community Participation and Loneliness Among Patients in Rural Community Hospitals: A Cross-Sectional Study.

Introduction Loneliness among adults is a critical public health issue, particularly in rural areas where social isolation can be more pronounced. Understanding the factors that influence loneliness can guide the development of effective interventions. This study explores the impact of demographic, health-related, and social participation factors on loneliness among rural Japanese adults, focusing on the role of community participation. Method This cross-sectional study was conducted with rural Japanese adults who regularly visited rural community hospitals. Data were collected on participants' demographic characteristics, health status, and social participation and analyzed using a multivariate logistic regression model to identify factors associated with higher levels of loneliness. The covariates included age, sex, body mass index (BMI), chronic health conditions, and community participation. Results The study found that community participation had a significant negative association with loneliness, with an odds ratio (OR) of 0.46 (p < 0.01), indicating that individuals engaged in community activities were substantially less likely to experience higher levels of loneliness. Higher BMI was associated with lower odds of loneliness (OR = 0.93, p < 0.02), suggesting a protective effect against loneliness. Conclusion The findings highlight the paramount importance of community engagement in mitigating loneliness among rural Japanese adults. The inverse relationship between BMI and loneliness suggests that BMI and social participation influence loneliness. These insights underscore the need for comprehensive interventions that promote community participation and address the multifaceted nature of loneliness. Future research should further explore the mechanisms through which community engagement and BMI impact loneliness to develop targeted strategies for improving the well-being of rural adults.

The Longitudinal Dyadic Associations between Social Participation and Cognitive Function in Older Chinese Couples.

OBJECTIVES: Based on the "linked lives" tenant of the life course perspective, this longitudinal study aims to examine the actor and partner effects of social participation on cognitive function in older Chinese couples. METHODS: A total of 1,706 couples aged over 60 were included in the final analyses. Social participation was measured using two questions regarding types of activities and frequency. Cognitive function was measured using a combination of memory, orientation, visuoconstruction, attention, and calculation. The lagged-dependent APIM was used to model the dyadic associations between social participation and cognitive function. RESULTS: The time-averaged actor effects of both husbands' and wives' social participation on their own cognitive function were significant (p < .001 for both). The time-averaged partner effect of husbands' social participation on wives' cognitive function was significant (p < .001) but the reverse-the effect of wives' social participation on husbands' cognitive function-was not (p = .381). The time-specific actor and partner effects were not significant (p > .05 for all). DISCUSSION: Our findings indicate an asymmetrical pattern of actor-partner interdependence, where husbands' social participation may affect their wives' cognitive function on average, but wives' social participation does not affect their husbands' cognitive function. Clinical practitioners should invite both partners, especially husbands, to participate in social participation interventions to facilitate crossover benefits for wives. Moreover, policymakers should build more facilities to encourage older couples to engage in social activities to prevent cognitive decline.

Social participation in Australian residential aged care: A human rights perspective.

The Royal Commission into Aged Care Quality and Safety emphasised the critical need for a human rights-based approach to protect the rights of older people in the Australian aged care context, including 'the right to social participation'. This topic is important because of the widespread social isolation and loneliness in Australian residential aged care. This article demonstrates how a human rights-based framework can provide guidance to governments in approaching issues involving the protection of older people's need for social connection in aged care. In doing so, the article considers examples of how the Australian government can ensure choice of living arrangement, individualised support and access to community services and facilities in the residential aged care context to better protect the right to social participation.

Associations between COVID-19 incidence, weight status, and social participation restrictions in the U.S.: evidence from the national population, cross-sectional study.

BACKGROUND: To explore the associations between coronavirus infection incidence and weight status and social participation restrictions among community-dwelling adults in the United States. METHODS: We analyzed data from the 2021 National Health Interview Survey (NHIS), which included a representative sample of 29,394 individuals (Coronavirus disease 2019 (COVID-19): 3,205) and a weighted total of 252,461,316 individuals (COVID-19: 31,697,404), considering the complex sampling design used in the survey. RESULTS: Age, race/ethnicity, education level, family income index, body mass index (BMI), and smoking status were significantly associated with COVID-19 infection. Weight status was significantly correlated with social participation restrictions and strongly associated with COVID-19 infection, particularly among individuals who were overweight or obese. CONCLUSION: Weight status was shown to be associated not only with social participation restrictions but also with COVID-19 infection among U.S. adults. Understanding the complex interplay between weight status, social participation, and COVID-19 is crucial for developing effective preventive measures and promoting overall well-being in the community population.

Person and Environment Factors Supporting Self-Care Performance and Social Participation After Mild Stroke.

Mild stroke survivors seldom receive occupational therapy services as their deficits are assumed to be minor enough to not affect their daily occupations. Yet many mild stroke survivors report deficits in self-care performance and social participation. This study investigates person and environment factors influencing self-care performance and social participation among mild stroke survivors, using the Person-Environment-Occupation-Performance (PEOP) model. A retrospective cohort analysis of 736 mild stroke survivors was conducted using electronic health records. Person factors included demographic characteristics and clinical characteristics, and environment factors included the Social Vulnerability Index. The analysis included logistic regression. Approximately, 10% of patients reported deficits in self-care or social participation. Disability level was the only person factor associated with self-care performance. Person factors affecting social participation included mobility and unemployment. Socioeconomic status was associated with both occupation measures. Occupational therapy practitioners must address the person and environment factors affecting mild stroke survivors' self-care performance and social participation.

Person and Environment Factors Supporting Mild Stroke Survivors' Ability to Take Care of Themselves and Their Social LivesThis study looked at what happens to people after they have had a mild stroke. We wanted to find out what makes some people independent in taking care of themselves and able to socialize after a mild stroke, whereas others have more difficulty. To do this, we looked at many factors that were measured in the patients' hospital record, such as age, type of stroke, and where they live. We used their address to determine information about their neighborhood and how that may affect their independence and social lives. We found that patients who were less disabled had an easier time taking care of themselves. We found that patients who had difficulty moving or were unemployed had difficulty with their social lives. A patient's social life was also associated with whether they got therapy. Patients who lived in low-income neighborhoods had difficulties with taking care of themselves and with their social lives. Occupational therapists must understand the importance of addressing these factors when supporting patients with a mild stroke with their ability to take care of themselves and engage in their social lives.

The mediating roles of depressive symptoms and social participation in the relationship between the effects of pain and cognitive function among Chinese older adults: A longitudinal study.

Decline in cognitive function poses a substantial burden on individuals, families, and society. However, the longitudinal potential mechanism underlying the link of pain and cognitive function remains unclear. Using data of 4247 participants aged 60 years and over from the China Health and Retirement Longitudinal Study in 2011, 2013, 2018, and 2020, we discussed the longitudinal predictive effect of pain on cognitive function and the mediating effects of depressive symptoms and social participation. The longitudinal mediation model analysis revealed that pain could not directly influence cognitive function, but it could indirectly predict cognitive function through the independent mediation effects of depressive symptoms and social participation. Moreover, the association between pain and cognitive function was serially mediated by depressive symptoms and social participation. Diversified interventions aimed at relieving pain and depressive symptoms, and increasing social participation in older adults would be beneficial for their cognitive function.

Community-level group sports participation and all-cause, cardiovascular disease, and cancer mortality: a 7-year longitudinal study.

BACKGROUND: Community-level group sports participation is a structural aspect of social capital that can potentially impact individual health in a contextual manner. This study aimed to investigate contextual relationship between the community-level prevalence of group sports participation and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in older adults. METHODS: In this 7-year longitudinal cohort study, data from the Japan Gerontological Evaluation Study, a nationwide survey encompassing 43,088 functionally independent older adults residing in 311 communities, were used. Cause of death data were derived from the Japanese governmental agency, The Ministry of Health, Labour and Welfare, for secondary use. "Participation" was defined as engaging in group sports for one or more days per month. To analyze the data, a two-level survival analysis was employed, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. RESULTS: Among the participants, 5,711 (13.3%) deaths were identified, with 1,311 related to CVD and 2,349 to cancer. The average group sports participation rate was 28.3% (range, 10.0-52.7%). After adjusting for individual-level group sports participation and potential confounders, a higher community-level group sports participation rate was found to be significantly associated with a lower risk of both all-cause mortality (HR: 0.89, 95% CI: 0.83-0.95) and cancer mortality (HR: 0.89, 95% CI: 0.81-0.98) for every 10% point increase in the participation rate. For CVD mortality, the association became less significant in the model adjusted for all covariates (HR: 0.94, 95% CI: 0.82-1.09). CONCLUSIONS: Our findings support the existence of a preventive relationship between community-level group sports participation and the occurrence of all-cause and cancer mortality among older individuals. Promoting group sports within communities holds promise as an effective population-based strategy for extending life expectancy, regardless of individual participation in these groups.

[Positive aging-How does it work? : Contribution of resilience to the prevention of depressive disorders in old age]. / Positives Altern ­ Wie geht das? : Beitrag von Resilienz zur Prävention depressiver Erkrankungen im Alter.

BACKGROUND: Although the prevalence of depressive disorders in old age is high, many older people succeed in staying healthy despite age-related stressors. The individual resilience or mental power of resistance can explain these differences. OBJECTIVE: It is shown how resilience factors or strategies of healthy aging can be used for the primary prevention of depressive disorders in old age. MATERIAL AND METHODS: The article summarizes the practically relevant age-specific aspects of resilience obtained through a narrative literature search and evaluates the relevant state of knowledge, also with respect to the consecutive development of primary preventive measures to avoid depressive disorders. RESULTS: Individual psychological strategies for promoting resilience include "stay active", and "mindfulness towards positive things", social strategies "remain socially connected" and "acceptance of support options". In addition to this individual level, which aims at every single person, the social dimension of resilience also includes strategies that start at the social level. Above all, this includes the esteem of older people in society as well as improved opportunities for participation. CONCLUSION: Age-specific aspects of resilience can be specifically used for the prevention of depressive disorders in old age. They enable a framework to establish resource-promoting and activating interventions, to counteract the deficit perspective on ageing. At the same time, there are clear limits to individual prevention and resilience. The responsibility cannot be seen solely for each individual but above all social structures and framework conditions must enable successful implementation in old age.

Social Activities and Risk of Dementia in Community-Dwelling Older People: Gender-Specific Findings From a Prospective Cohort Study.

OBJECTIVES: This study examines the gender-specific associations between a wide range of social activities and dementia risk. METHODS: A prospective cohort study was conducted involving community-dwelling older Australians (≥70 years) without significant cognitive impairment at enrolment. During the first year of enrolment, we assessed 25 self-reported social activities covering various aspects, including support from relatives and friends, community participation, social interactions with surroundings, and loneliness. Dementia diagnosis followed DSM-IV criteria, adjudicated by an international expert panel. To estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between social activities and dementia, we performed Cox proportional hazards models, adjusting for age, educational attainment, baseline global cognition, and depressive symptoms. RESULTS: Among 9,936 participants who completed all social activity questionnaires (median [IQR] age: 73.4 [71.6-77.1] years; 47.4% men), dementia was diagnosed in 3.8% of men (n = 181/4,705) and 2.6% of women (n = 138/5,231) over a median 6.4 years (IQR: 5.3-7.6, range: 0.2-10.1) follow-up. Gender-specific relationships emerged: caregiving for a person with illness/disability in women (HR: 0.65, 95% CI: 0.42-0.99), and having ≥9 relatives feeling close to call for help in men (HR: 0.56, 95% CI: 0.33-0.96; reference <9 relatives) were associated with reduced dementia risk. Unexpectedly, in women, having ≥5 friends with whom they felt comfortable discussing private matters were associated with a greater dementia risk (HR: 1.69, 95% CI: 1.10-2.59; reference ≤2 friends). Imputed models further identified that babysitting/childminding was associated with lower dementia risk in men (HR: 0.75, 95% CI: 0.56-0.99). No other social activities showed significant associations with dementia. DISCUSSION: This study provides evidence of social activities influencing dementia risk. Further investigations are required to uncover the mechanisms driving these observed relationships.

Promoting meaningful activities by occupational therapy in elderly care in Belgium: the ProMOTE intervention.

BACKGROUND: Older people want to age in place. Despite advancing functional limitations and their desire of aging in place, they are not always faithful to therapy that maintains independence and promotes safety. Occupational therapists can facilitate aging in place. Occupational therapy is defined as the therapeutic use of everyday life occupations with persons, groups, or populations for the purpose of enhancing or enabling participation. AIM: To describe the content a high-adherence-to-therapy and evidence-based occupational therapy intervention to optimize functional performance and social participation of home-based physically frail older adults and wellbeing of their informal caregiver, and the research activities undertaken to design this intervention. METHODS: A roadmap was created to develop the occupational therapy intervention. This roadmap is based on the Medical Research Council (MRC) framework and is supplemented with elements of the Intervention Mapping approach. The TIDieR checklist is applied to describe the intervention in detail. A systematic review and two qualitative studies substantiated the content of the intervention scientifically. RESULTS: The application of the first two phases of the MRC framework resulted in the ProMOTE intervention (Promoting Meaningful activities by Occupational Therapy in Elderly). The ProMOTE intervention is a high-adherence-to-therapy occupational therapy intervention that consists of six steps and describes in detail the evidence-based components that are required to obtain an operational intervention for occupational therapy practice. CONCLUSION: This study transparently reflects on the process of a high-quality occupational therapy intervention to optimize the functional performance and social participation of the home-based physically frail older adult and describes the ProMOTE intervention in detail. The ProMOTE intervention contributes to safely aging in place and to maintaining social participation. The designed intervention goes beyond a description of the 'what'. The added value lies in the interweaving of the 'why' and 'how'. By describing the 'how', our study makes the concept of 'therapeutic use-of-self' operational throughout the six steps of the occupational therapy intervention. A further rigorous study of the effect of the ProMOTE intervention on adherence, functional performance and social participation is recommended based to facilitate the implementation of this intervention on a national level in Belgium.

Development of the "Social Participation Barriers in Patients With Diabetes" Questionnaire for Older Patients With Diabetes and Evaluation of its Reliability and Validity.

Objectives: To develop a questionnaire for evaluating the factors hindering social participation in older patients with diabetes (the Social Participation Barriers in Patients with Diabetes [SPBD] questionnaire) and assess its reliability and validity. Materials and Methods: This is a cross-sectional study. This study included outpatients aged ≥60 years having diabetes and undergoing treatment at the Ise Redcross Hospital. A draft questionnaire consisting of 20 questions was developed with reference to previous studies. Logistic regression analysis was conducted, and Cronbach's alpha coefficient was calculated. Exploratory factor analysis was conducted to test construct validity. Pearson's correlation coefficients between SPBD scores and frailty scores, social frailty scores and frequency of outings were calculated. Results: Overall, 353 patients were included in the analysis. After questions without an association in the logistic regression analysis were excluded and results of the exploratory factor analyses were obtained, 10 questions were excluded. As a result, we created a 10-item SPBD questionnaire. Cronbach's alpha coefficient was .87. The SPBD score was significantly associated with frequency of going out, and frailty. Conclusions: We created an SPBD questionnaire to assess barriers to social participation in older adult patients with diabetes. This study indicated the validity and reliability of the questionnaire.

Evaluating the efficacy of a school-based Finnish Gutsy Go programme in enhancing adolescents' positive mental health, experience of social inclusion, and social competence.

Background: The Finnish Gutsy Go programme is a positive youth development intervention designed to enhance adolescents' psychosocial well-being by enabling eighth-grade students to develop and execute good deeds within the community.Objective: This study aimed to explore the effect of the Gutsy Go programme on adolescents' positive mental health, experience of social inclusion, and social competence using a quasi-experimental study design.Methods: Data were collected with electronic questionnaires at baseline (n = 236 programme participants and n = 303 controls) and follow-up two weeks after the programme (n = 126, 54.2% programme participants and n = 103, 34.1% controls). Analyses included paired samples t-tests and mixed ANOVA analyses.Results: A statistically significant intragroup change across time was detected in the level of cooperation skills among programme participants (t(127) = -2.460, p = 0.015) but not among controls (t(102) = 1.088, p = 0.279). Statistically significant main effects were found for the intervention group on the experience of social inclusion (F(1, 1) = 9.34, p = 0.003, ηp2 = 0.040), cooperation skills (F(1,1) = 5.28, p = 0.020, ηp2 = 0.020), and empathy (F(1,1) = 6.44, p = 0.010, ηp2 = 0.030) across time.Conclusion: The Gutsy Go programme could be beneficial in improving adolescents' experience of social inclusion, cooperation skills, and empathy. More studies are needed to address the effects of the programme more firmly.

Life-course social participation and physical activity in midlife: longitudinal associations in the 1970 British Cohort Study (BCS70).

A hypothesized benefit of social participation is that it encourages people to be more physically active. However, limited evidence exists on the association between social participation over the life-course and physical activity in midlife. We sought to apply a life-course framework to examine the association of social participation and device measured physical activity in midlife in the UK. We used the 1970 British Birth Cohort Study (BCS70), which includes all people born in Britain during a single week in 1970. Social participation was assessed at ages 16, 30, 34 and 42. Physical activity was measured by accelerometery at age 46, as mean daily step count and time spent in moderate to vigorous physical activity (MVPA). The associations of social participation and physical activity were tested using two different life-course models: the sensitive period model and the accumulation model. Individuals with medium and high participation compared to no social participation over their life-course had higher mean daily step count and MVPA in midlife, supporting the accumulation model. In the sensitive period model, only those that actively participated at age 42 had higher mean daily steps and MVPA compared to those who did not participate. Our study provides empirical evidence on the importance of sustaining social participation at all ages over the life-course rather than at a particular timepoint of someone's life. If our findings reflect causal effects, interventions to promote social participation throughout the life-course could be an avenue to promote physical activity in middle life.

Factors associated with social participation among community-dwelling frail older adults in Japan: a cross-sectional study.

BACKGROUND: In recent years, it has become clear that participation in social activities by the older adult suppresses their need for long-term care. Likewise, social participation can promote long-term care prevention among frail older adults who are at a higher risk of needing long-term care. However, their social participation rate is low, and the factors causing these low rates of participation are unclear. Therefore, this study identifies the factors affecting social participation of frail older adults. METHODS: After excluding those certified as requiring long-term care, 28,636 older adults within the target region were selected to receive questionnaires. The questionnaires were distributed and collected via mail. A total of 22,048 respondents (77.0%), including 9,325 men and 10,150 women, were included; 2,655 frail older adults were identified for analysis. Questionnaire items inquired about social participation, basic attributes, need for long-term care, mobility, subjective health, direct and indirect contact with relatives living separately and direct and indirect contact with friends and neighbors. For the statistical analysis, this study employed a binomial logistic regression analysis with social participation as the objective variable. RESULTS: The rate of social participation among frail older adults was 13.7%. Items related to social participation included sex, economic status, mobility, subjective health, direct contact with friends, and indirect contact with friends. CONCLUSIONS: Interactions with friends and neighbors and physical functionality are correlated with levels of social participation among frail older adults, suggesting that social participation can be promoted by maintaining friendships, forming new ones, and maintaining and improving physical functionality.