Mechanism of the impacts of older adults social participation on their health.

Purpose: Against the background of population aging challenges in China, focusing on health, security, and social participation as core elements of positive aging, this study aims to formulate strategies for promoting the health of the older adults and reveal the pathways and trends of social participation in promoting health. Method: The study analyzed 1,015 randomly selected older adults individuals living at home in Beijing using household survey questionnaires. Drawing on group dynamics theory and structural equation modeling, the study proposed hypotheses regarding the relationships between social participation, group cohesion, and health status. Results: First, the triangular path model of social participation, group cohesion, and health status among the older adults was established. The direct path coefficient of social participation on health status was 0.15, that of social participation on group cohesion was 0.56, and that of group cohesion on health status was 0.32. The indirect path coefficient of social participation on health status through group cohesion was calculated at 0.56 × 0.32 = 0.18. Second, of the older adults age groups-younger, middle, and older-social participation's direct path effects on health status were present only in the older age group. Social participation's indirect path effects on health status through group cohesion were relatively high in all three groups, with a slight increase in the older age group. Conclusion: First, just the older adults participation in social activities serves as a benign stimulus to physical and mental health. Additionally, group cohesion formed through interaction with others during social activities encourages self-improvement behaviors, indirectly promoting health. In fact, indirect pathways of health promotion through group cohesion are stronger than direct pathways, highlighting the importance of group cohesion during social participation. Second, participation in activities alone can provide only sufficient benign stimuli for the older adults aged 80 and above, with the direct path effect of social participation on health beginning to appear only with increasing age. With age, selectivity of interaction with others decreases, and dependence increases; social participation's indirect path effect on health through group cohesion continues to grow slightly.

Enjoying the golden years: social participation and life satisfaction among Chinese older adults.

Introduction: Older adults commonly face the risk of social isolation, which poses a significant threat to their quality of life. This study explores the association between social participation and life satisfaction among older Chinese adults. Methods: Data were sourced from the 2018 China Health and Retirement Longitudinal Study. Regression analysis and mediation analysis were employed to examine the relationship between social participation and life satisfaction, with a focus on the roles of loneliness and self-rated health. Results: The results indicate that social participation is significantly positively associated with older adults' life satisfaction. Furthermore, the positive association is more pronounced with increased diversity in social activities. Mediation analysis reveals that reductions in feelings of loneliness and improvements in health levels mediate the relationship between social participation and life satisfaction. Further analysis showed that social participation had a greater positive association among rural older adults and those lacking family companionship. Discussion: This study provides evidence for enhancing life satisfaction among older adults and highlights the importance of diversity in social participation.

Examining the content validity of the Comprehensive Assessment of Functioning for Mental Illness-Subjective Version (CAMI-S) with reference to the framework of the International Classification of Functioning, Disability, and Health (ICF).

Aim: To support the achievement of life goals and social participation of persons with mental illness, based on the World Health Organization's International Classification of Functioning, Disability, and Health (ICF), we generated items, identified domains, and examined the content validity of the Comprehensive Assessment of Functioning for Mental Illness-Subjective Version (CAMI-S). The purpose was to assess patients' strengths and weaknesses by incorporating the patient and public involvement perspective. Methods: Focus group interviews on the items to be included were conducted with Group A. A draft scale was constructed by extracting articles mentioning factors for social participation and recovery for each ICF component from PubMed. Group B participants rated themselves using the draft and highlighted items they considered inappropriate. Experts then rated the importance of the items through the Delphi method. Lastly, Group C participants evaluated whether the draft scale would help in understanding their strengths and weaknesses. Results: The interviews revealed subjective experience items. The draft scale had 81 items (physical and mental functions, 10; activities, 23; participation, 24; environment, 12; individuals, six; and subjective experience, six). Through the Delphi method, the number of items was reduced to 34 in six domains. Most participants (N = 50) indicated that it helped them ascertain patients' strengths and weaknesses (mean = 2.11 ± .714). Completion time for the scale was 56 min, including the 60-item face sheet (20-110 min). Conclusion: The CAMI-S helped participants ascertain patients' strengths and weaknesses. Its reliability and validity will be verified through a large-scale survey in the future.

Associations of type and intensity of social participation with depression, self-rated health, and life satisfaction among community-dwelling older adults in the Republic of Korea: a nationwide cross-sectional study.

Objectives: Social activities are important and influential factors for healthy aging. However, limited information is available regarding the associations of the type and intensity of social participation with health and well-being. This study aimed to investigate how various types of social activities are associated with several dimensions of health outcomes. Methods: This cross-sectional study utilized data from the Seventh Korean Longitudinal Study of Aging, which included 5,526 adults aged 60 years and older. Multivariate linear regression analysis was employed to analyze the associations of social activities with depression, self-rated health, and life satisfaction. Additionally, subgroup analyses by sex and age were performed. Results: Among the participants, 73.5% reported involvement in at least 1 of the 4 types of social engagement. After adjustment for all covariates, individuals who participated in any social activity reported better self-rated health and higher life satisfaction compared to those who did not participate. However, the intensity of engagement in different social activities had varying impacts on subjective health outcomes. An increased level of participation was associated with a lower rate of depression and improved self-rated health. However, no significant differences were observed in the relationship between the intensity of participation in activities (with the exception of alumni societies or family councils) and life satisfaction. Conclusion: This study suggests that to improve their health, older adults in the Republic of Korea should not only engage in social activities but also do so actively and regularly.

Who can Benefit From Volunteer Participation? Analysis of Wellbeing Heterogeneity in Volunteer Participation of Older People.

The basic premise of this study is that the traditional method to treating all older people as coming from the same distribution misspecifies the true model and ignores potentially important information in wellbeing outcomes of social participation. Using data from the China Longitudinal Aging Social Survey (CLASS), this paper proposes a finite mixture model (FMM) to identify the heterogeneous relationship between volunteer participation and older people's subjective well-being (SWB) and then explore the determinants of wellbeing heterogeneity in volunteer participation. The results reveal that older people can be classified into two latent subgroups, that is the volunteering beneficiary group (accounting for about 42%) and the volunteering non-beneficiary group (accounting for about 58%). The FMM is therefore more appropriate in estimating the complex impact of volunteering. Rural older people with poorer health, weaker social networks, better economic status, and better community environments are more likely to benefit from volunteer participation. Our findings have suggested some practical implications to increase the probability of benefit from volunteer participation.

Childhood adversity and depression of older adults: the moderating effect of social participation.

Objective: Examine the effect of childhood adversity on depression in older adults and the regulatory impact that social participation has on depression. Methods: Based on 6,704 standard-compliant research subjects, single factor analysis, multiple linear regression model, and tendency score matching were used to analyze the impact of childhood adversity on depression in older adults and the regulatory effect of social participation. Results: The depression rate is higher among women, young age, low education, unmarried, in agricultural households, older adults with low annual income, pre-retirement work type in agriculture, non-drinking, and those with two or more chronic diseases (p < 0.05). Children who experienced adversity as children are more likely to suffer from depression as adults (ß = 0.513, 0.590, 0.954, 0.983, 1.221, 0.953, 0.718; p < 0.05). Through the tendency score, the result is matched with the endogenous test. As well, older adults are more likely to suffer psychological damage from a greater number of childhood adversities in their early years (ß = 1.440, 2.646, 4.122; p < 0.001). It has been shown that social participation will reduce the negative impact of low-income family economic circumstances on depression among older adults of all ages (ß = -0.459,-0.567; p < 0.01), aggravate depression resulting from "neighborhood void of mutual assistance" and "no more fun to play" for older adults of all ages (ß = 1.024, 0.894; p < 0.01), and exacerbate depression resulting from "loneliness because there are no friends" for the oldest old (ß = 0.476, 0.779; p < 0.05). Conclusion: Older adults who experience childhood adversity are more likely to suffer from depression. Social participation plays a regulatory role in the relationship between childhood adversity and depression in older adults. For older adults' mental health to improve, family and social adversity should be prevented, and moderate participation in society should be encouraged.

Social participation of women with breast cancer compared to the general population 5 years after primary surgery-what role do medical data and cancer-related complaints play?

PURPOSE: This study analyzes levels of social participation in patients with breast cancer on average 5 years following primary surgery as compared to women in the general population. In addition, the role of breast cancer-related complaints and medical data as possible influencing factors on levels of patients' social participation is investigated. METHODS: A total of n = 454 patients after primary surgery (t0) were recruited for a third follow-up study, and n = 372 completed this survey (t3), corresponding to a response rate of 82.2%. For measuring breast cancer-related complaints, participants completed a written questionnaire. Social participation was measured by a questionnaire on different leisure activities that was taken from the Socio-Economic Panel Study. Medical information was extracted from medical reports at t0. A principal component analysis was carried out to identify different dimensions of social participation. Chi2-tests and logistic regression analyses were applied to analyze social participation as compared to the general population and the role of possible medical and diagnosis-related influencing factors thereby. RESULTS: Compared to the general population, patients show lower levels of social participation in the domains "socio-cultural participation" and "participation in institutions," while no significant differences for "social participation in the private sphere" and "social participation via social media" were found. Psychological symptoms, pain, and a history of mastectomy were most strongly associated with restrictions in social participation. CONCLUSIONS: Our study suggests that social withdrawal may happen due to disease-related symptoms, preventing some breast cancer patients from participating fully in society. Cancer-related follow-ups should address this issue and support patients' reintegration into society through appropriate therapeutic interventions.

Social participation in health: analysis of progress and challenges for the Region of the Americas.

This article analyzes the state of social participation in health in the Region of the Americas, framing it within the regional context and commitments assumed by the Member States of the Pan American Health Organization. It aims to provide regional input to the discussion of a resolution on social participation for universal health coverage, health, and well-being at the 77th World Health Assembly in 2024. In the Americas, social participation has evolved from a utilitarian approach to a fundamental aspect of health system governance, enshrined within legal frameworks and recognized as a citizen's right. Regional resolutions emphasize inclusive policies and intersectoral action to tackle health inequities, meanwhile the World Health Organization handbook on social participation underscores the need for inclusive governance mechanisms and addressing power imbalances. Informed by Member States' recommendations and scientific literature, the article emphasizes the importance of addressing power imbalances, strengthening legal frameworks, and enhancing capacities of governments and populations. It stresses adapting social participation mechanisms to diverse cultural contexts and ensuring meaningful community involvement in decision-making. Finally, the article advocates for a comprehensive approach to social participation grounded in principles of equity, democracy, and human rights; and fundamentally as an essential component of the primary health care approach. It calls for integrating social participation into health system governance, policy dialogues, capacity-building, and evaluation to ensure effective participatory processes.

En este artículo se analiza el estado de la participación social en materia de salud en la Región de las Américas dentro del marco del contexto regional y los compromisos asumidos por los Estados Miembros de la Organización Panamericana de la Salud. El objetivo es proporcionar aportes regionales para las deliberaciones en torno a una resolución sobre la participación social para la cobertura universal de salud, la salud y el bienestar en la 77.a Asamblea Mundial de la Salud en el 2024.En la Región de las Américas, la participación social ha evolucionado de un enfoque utilitarista a ser considerada un aspecto fundamental de la gobernanza de los sistemas de salud, consagrado en los marcos jurídicos y reconocido como un derecho ciudadano. Las resoluciones regionales hacen hincapié en las políticas inclusivas y las medidas intersectoriales para abordar las inequidades en materia de salud, mientras que el manual de la Organización Mundial de la Salud sobre participación social destaca la necesidad de mecanismos de gobernanza inclusivos y el abordaje de los desequilibrios de poder.Basándose en las recomendaciones de los Estados Miembros y la bibliografía científica, el artículo subraya la importancia de abordar los desequilibrios de poder, fortalecer los marcos jurídicos y mejorar las capacidades de los gobiernos y las poblaciones. Hace hincapié en adaptar los mecanismos de participación social a contextos culturales diversos y garantizar una participación trascendente de la comunidad en la toma de decisiones.Por último, el artículo aboga por un enfoque integral de la participación social basado en principios de equidad, democracia y derechos humanos; y, fundamentalmente, como un componente esencial del enfoque de atención primaria de salud. Insta a integrar la participación social en la gobernanza del sistema de salud, los diálogos sobre las políticas, la creación de capacidad y la evaluación para garantizar procesos participativos eficaces.

Este artigo analisa a situação da participação social em saúde na Região das Américas tendo em conta o contexto regional e os compromissos assumidos pelos Estados Membros da Organização Pan-Americana da Saúde. O objetivo é oferecer contribuições regionais para a discussão de uma resolução sobre participação social para cobertura universal de saúde, saúde e bem-estar na 77ª Assembleia Mundial da Saúde, em 2024.Na Região das Américas, a participação social evoluiu, deixando de ser uma abordagem utilitarista para se tornar um aspecto fundamental de governança do sistema de saúde, consagrada por marcos legais e reconhecida como um direito dos cidadãos. As resoluções regionais enfatizam políticas inclusivas e ações intersetoriais para combater iniquidades em saúde, e o manual da Organização Mundial da Saúde sobre participação social ressalta a necessidade de contar com mecanismos inclusivos de governança e abordar desequilíbrios de poder.Com base nas recomendações dos Estados Membros e na literatura científica, o artigo destaca a importância de abordar desequilíbrios de poder, reforçar marcos legais e fortalecer as capacidades dos governos e das populações. Além disso, enfatiza a necessidade de adaptar mecanismos de participação social a diversos contextos culturais e assegurar um envolvimento significativo da comunidade na tomada de decisões.Por fim, o artigo defende uma abordagem abrangente de participação social com base em princípios de equidade, democracia e direitos humanos e, fundamentalmente, como um componente essencial da abordagem de atenção primária em saúde. O artigo urge a integração da participação social na governança do sistema de saúde, em diálogos sobre políticas, no desenvolvimento de capacidades e na avaliação, a fim de assegurar processos participativos efetivos.

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 (ß=-0.034) and spouse health (ß=-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.

Factors influencing quality of life in extratemporal lobe epilepsy and mesial temporal lobe epilepsy: a cross-sectional study using medical records.

Objective: This study aimed to examine differences in factors influencing quality of life (QOL) in people with extratemporal lobe epilepsy (ETLE) and mesial temporal lobe epilepsy (MTLE). Methods: We obtained data from the medical records of 84 (47 ETLE and 37 MTLE) people with epilepsy. The data included age, sex, employment, seizure frequency, number of antiseizure medication (ASM), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) score, and Quality of Life in Epilepsy Inventory-31 (QOLIE-31) score. Multiple regression analyses were performed using QOLIE-31 as the dependent variable and age, sex, employment, seizure frequency, number of ASM, and NDDI-E score as the independent variables in ETLE or MTLE. Results: From the results of the multiple regression analyses, QOLIE-31 in ETLE was associated with NDDI-E (ß = -0.757, p < 0.001) and employment (ß = 0.388, p = 0.008). Meanwhile, QOLIE-31 in MTLE was associated with NDDI-E (ß = -0.625, p < 0.001), employment (ß = 0.396, p = 0.041), and number of ASMs (ß = -0.399, p = 0.018). Conclusion: Overall, our findings indicate that the number of ASMs is potentially an influence on QOL of MTLE but similar effect is not observed in ETLE.

20-Year trends in the social participation of the oldest old.

AIMS: To investigate 20-year trends in social participation among the oldest old (77+ years) in Sweden and assess the extent to which changes in educational attainment and functional abilities explain these trends. METHODS: Seven waves of the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) spanning 2002-2021 were used with a repeated cross-sectional design. To analyse the association between time and social participation we employed the Karlson-Holm-Breen method of decomposition. The study focused on informal social participation (contact with friends and family), leisure participation (public or semi-public gatherings), and formal participation (organisational engagement and study circle attendance). RESULTS: Both leisure and informal participation peaked in 2014 and declined in 2021, influenced by the COVID-19 pandemic, whereas formal participation showed a slight increase in 2021. Total participation increased at least until 2011. Overall, older adults have increased their levels of social participation in recent decades, disregarding the influence of the pandemic. Decomposition analysis revealed that population-level changes in educational attainment and functional abilities explained a substantial portion of the observed trends. CONCLUSIONS: As the proportion of older adults continues to rise, it becomes increasingly important to understand the developments and drivers of behavioural change in the older population. As more people are socially active, there may be increasing differences between those participating and those not - which could lead to increased inequalities. The observed trend in increasing participation, influenced by changes in education and health, emphasises the importance of fostering age-friendly environments and addressing potential social inequalities among older adults.

The impact of ageism experiences on social participation among community-dwelling older adults: Exploring the moderating role of digital literacy.

OBJECTIVES: This study examined how digital literacy moderates the relationship between ageism experiences and social participation among community-dwelling older adults. METHODS: Regression analysis of data from the 2020 National Survey of Older Koreans with 9,920 participants was conducted to identify the association of ageism experiences with social participation in model 1. The moderating effects of digital literacy were examined by adding an interaction term in model 2. RESULTS: In model 1, both ageism experiences and digital literacy were significant predictors of social participation. However, in model 2, the interaction term of digital literacy rendered the association between ageism experiences and social participation non-significant. Model 2 explained approximately 18.4 % of the total variance in social participation. CONCLUSIONS: By highlighting the importance of digital literacy in increasing social participation among older adults, this study offers valuable insights for interventions aimed at improving digital literacy to promote successful aging in a technology-dependent society.

Impact of dental caries and Self-perceived oral health on daily lives of children and mothers in rural Egypt: a household survey.

BACKGROUND: The present study assessed the impact of oral health on the daily lives of children and mothers living in a rural area in Northwestern Egypt. METHODS: A cross-sectional household survey including children between 6 and 12 years old and their mothers was conducted in rural Egypt, 2019-2020. Data were collected using clinical examination and interview-based questionnaires of children and mothers. Three binary logistic regression models were used to assess the relationship between the dependent variables (oral health impact (yes, no) on avoiding smiling, chewing problems, and missing school (children) and avoiding social events (mothers)), and the explanatory variables: oral health (clinically-assessed caries experience and self-reported oral health) controlling for sociodemographic profile (child age and sex, mother's education), daily toothbrushing and village of residence. RESULTS: A total of 211 households with 355 children and 211 mothers were included (91.5% response rate). About 54% of the children were girls, mean (SD) age = 8.7 (2.05) years and 82.3% did not brush their teeth daily. Mother's mean (SD) age was 31.70 (5.45) years. Because of dental problems, 31.3% of children reported chewing difficulties, 31% avoided smiling compared to 76.3% and 43.6% of mothers. Also, 30.4% of children missed school and 76.8% of mothers reported reduced participation in social activities. In children, the number of decayed anterior teeth was associated with significantly higher odds of avoiding smiling (AOR = 1.22, 95%CI: 1.03, 1.44). In mothers, a greater number of posterior missing teeth was associated with significantly higher odds of chewing difficulties (AOR = 1.21, 95%CI: 1.01, 1.45), and a greater number of all missing teeth was associated with significantly higher odds of reduced participation in social events (AOR = 1.30, 95%CI: 1.30, 1.57). Good/ very good reported oral health in children and mothers was associated with lower odds of avoiding smiling and chewing problems (p < 0.05). CONCLUSION: Decayed anterior teeth in children have a negative impact on smiling whereas missing teeth in mothers affect the ability to chew food and socialize. The psychological, functional, and social impacts of caries in this rural setting needs to be mitigated by improving oral health literacy and access to care.

Heterogeneity of social participation in patients three months after total knee arthroplasty: a latent profile analysis.

BACKGROUND: Social participation is an important index of rehabilitation and social reintegration in patients after total knee arthroplasty (TKA). However, most existing studies focus on improving patients' functioning and activities, with only a few examining the social participation among patients after TKA. Therefore, the study aims to investigate the heterogeneity of social participation in patients three months after TKA and analyze subgroup influencing factors, to promote functional exercise and postoperative follow-up in specific patients. METHODS: This cross-sectional study recruited 255 patients who underwent TKA in a Tertiary Hospital in Jinan City, China, from March to July 2022. Three months after having undergone TKA, participants' data were collected using the Numeric Pain Rating Scale, the Chinese version of the Tampa Scale of Kinesiophobia, the 10-item Kessler Psychological Distress Scale, Hospital for Special Surgery Knee-rating Scale, and Impact on Participation and Autonomy Questionnaire. Latent profile analysis was used to identify categories of patients' social participation. Multiple logistic regression analysis was used to analyze the influencing factors of the different subgroups. RESULTS: Three months after TKA, the patients were divided into three subgroups: low social participation group (17.9%), moderate social participation group (40.8%), and high social participation group (41.3%). The vast majority of patients who underwent TKA exhibited moderate-to-high level of social participation. The multiple logistic regression analysis results showed that age, degree of pain, knee function, and kinesiophobia were the influencing factors of the potential profiles of social participation in patients three months after TKA (p < 0.05). CONCLUSION: These results support a distinct categorical feature of social participation among patients three months after undergoing TKA. Medical staff need to provide targeted guidance according to the potential classification characteristics of social participation to improve the level of social participation and promote rehabilitation of patients.

Topic Clusters of Successful Aging Studies: Results of a Topic Modeling Approach.

BACKGROUND AND OBJECTIVES: Literature regarding successful aging reflects a wide variety of fields and perspectives. Given the range of definitions and approaches found in published literature, it is important to investigate clusters of topics studied over time. This study aimed to show the change of topic clusters within successful aging studies. RESEARCH DESIGN AND METHODS: The study used topic modeling methodology to analyze vast amounts of abstract data. Among publications collected from Scopus (4,458) and Web of Science (5,187), 5,610 publications were analyzed. Topic clusters were analyzed in two ways: by a) division of time (1960s - 1990s, 2000s, 2010s, 2020s) and b) all years combined. RESULTS: In the 1960s - 1990s, 11 topic clusters ranging from health to emotional well-being emerged without any dominant domain. In the 2000s, two clusters related to social support and health appeared as major clusters. In the 2010s, one topic cluster that included words related to health and social participation was the biggest. In the 2020s, emotional health and social participation appeared again as one of the major clusters and health-related topics started to diverge into subgroups like physical health and mental health. In all years of publications combined, the major cluster involved words that are related to either health or social domains. DISCUSSION AND IMPLICATIONS: Results revealed that successful aging has been studied in many fields using multidimensional perspectives. The dominant categories were health and social domains. These findings suggest interprofessional practice, an interdisciplinary approach in research, and multi-sector involvement in policy.

Relationship between social participation, children's support, and social frailty with falls among older adults in Colombia.

Background: There is limited research on social factors related to falls among older adults. This study assessed the association between falls during the past year with social participation, children's support, relationship with children, and social frailty. Methods: Participants were 17,687 community-dwelling older adults from the SABE (Health, Well-being, and Aging, 2015) Colombia survey. Covariates included sociodemographic characteristics, environmental barriers, psychotropic intake, vision problems, memory loss, multimorbidity, and fear of falling. Results: In multivariate logistic regression analyses, being socially frail (vs. no-frail) was associated with higher odds of falls (OR=1.20; 95% confidence interval [CI], 1.10-1.32). Participating in groups (OR=1.07; 95% CI, 1.03-1.11), helping others (OR=1.04; 95% CI, 1.02-1.06), or volunteering (OR=1.09; 95% CI, 1.01-1.17) were also associated with higher odds of falls. These findings were partly explained because most group participants reside in cities where they are more exposed to environmental barriers. In contrast, receiving help, affection, and company from children (OR=0.95; 95% CI, 0.93-0.97) was associated with lower fall odds than not receiving it. Moreover, having a good relationship with children was associated with lower odds of falls (OR=0.75; 95% CI, 0.66-0.85) compared to an unsatisfactory relationship. Conclusion: Support from children and having a good relationship with them were associated with fewer falls; however, social frailty and participation in social groups were associated with more falls.

Association between the level of social participation and depressive symptoms among older Japanese adults: a cross-sectional survey.

BACKGROUND: Social participation is recommended for older adults to remain actively involved in daily life. Social participation is a broad concept, ranging from 'interacting with others without doing a specific activity with them' to 'actively contributing to society.' However, previous studies have not taken into account the components of social participation. Depressive symptoms are significant outcomes in older adults. Social participation mitigates these risks owing to its association with reduced mortality and enhanced quality of life. This study aimed to examine the association between the level of social participation and depressive symptoms in community-dwelling older adults. METHODS: We included 17 040 individuals aged ≥65 years. Social participation was categorised into Level 3, interacting with others without doing a specific activity with them; Level 4, engaging in an activity with others; Level 5, helping others; and Level 6, contributing to society, based on a previous study by Levasseur et al. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. Logistic regression models were used to examine the association between the level of social participation and depressive symptoms. RESULTS: Overall, 15 069 older adults met the inclusion criteria. A higher level of social participation was associated with lower odds ratios (ORs) for depressive symptoms (Level 6 = OR: 0.43, 95% confidence interval (CI): 0.37-0.50; Level 5 = OR: 0.50, 95% CI: 0.41-0.60; and Level 4 = OR: 0.60, 95% CI: 0.52-0.69). Subgroup analyses based on age and sex yielded similar results across all participants. CONCLUSIONS: Among older adults in Japan, a higher level of social participation was associated with lower rates of depressive symptoms. The relationship between depressive symptoms and the levels of social participation may help develop measures to reduce or prevent depressive symptoms in older adults.

Advocating for transportation equity: A critical examination of paratransit service reductions in St. Louis and its impact on health and community social participation.

Social participation is associated with better health, quality of life, physical activity, and engagement in community living and is thus an emerging health priority. Transportation plays an important role in facilitating social participation. Our team recently reported in the Journal of Disability and Health that Missouri-dwelling adults aging with long-term physical disabilities who use paratransit services as their primary transportation mode are more likely to participate in social roles and activities outside the home compared to those who do not use paratransit. In March of 2023, the paratransit company Metro Call-A-Ride that serves St. Louis announced major scale backs to their coverage zones due in part to staffing shortages. This decision has been met with a formal complaint filed to the U.S. Department of Justice as well as protest from the St. Louis disability community and advocates. Thousands of individuals who relied on Call-A-Ride for their routine community outings-to work, grocery stores, or medical appointments, for example-have been affected by the cuts. In this commentary, we will summarize the media coverage this decision has received, including the perspectives of disability rights advocates and individuals who have been directly affected. We will then present an overview of our original research findings in the context of these recent events and a brief synthesis of existing literature on paratransit services in the U.S. The commentary will end with proposed policy, research, and programming solutions for St. Louis's Metro Call-A-Ride and public transportation at large.

Social Participation and Loneliness in Older Adults in a Rural Australian Context: Individual and Organizational Perspectives.

A rise in aging populations globally calls attention to factors that influence the well-being and health of older adults, including social participation. In Australia, rural older adults face cultural, social, and physical challenges that place them at risk for isolation. Thus, research surrounding social participation and healthy aging is increasingly relevant, especially in rural areas. This qualitative study in a remote town in Western Australia explores barriers and facilitators to older adults' social participation. To investigate multiple perspectives, 23 adults aged 50+ and 19 organizations from a rural town were interviewed. A stakeholder reference group was engaged to refine the research design and validate the findings. Feedback from early interviews was used to refine the data collection process, thus enhancing the validity of the findings. Thematic analysis showed that health and mobility issues, inadequate infrastructure, poor sustainability, and cultural tensions commonly impacted social participation. Themes of rural town culture, cultural power dynamics, and rural stoicism were identified as cultural aspects that inhibited participation. Based on results of this study and the supporting literature, recommendations for inclusive activities include supporting community-designed programs, utilizing culturally sensitive language and personnel, expanding services using existing community resources, and diversifying older adults' roles in existing groups.

Development and Psychometric Evaluation of the Social Participation Questionnaire: A Methodological and Cross-Sectional Study.

PURPOSE: Social participation is vital for the health maintenance of general populations as well as the functional recovery and social ties of clinical patients. To develop a Social Participation Questionnaire (SPQ) to evaluate participation in social activities in an individual's life and to test the reliability and validity of the SPQ. DESIGN: Cross-sectional study. SETTING: Community and clinic in China. SUBJECTS: A total of 1419 healthy adults and 486 breast cancer patients. MEASURES: The initial items were developed from a theoretical framework, a literature review, and Delphi expert consultation. Item analysis, exploratory (EFA) and confirmatory factor analysis (CFA), criterion validity, construct reliability, and internal consistency reliability were performed to examine the psychometric properties of the SPQ. RESULTS: The final SPQ was comprised of 11 different types of social activities, falling under the 3 dimensions of activities of daily life, sports and entertainment activities, and social service activities. EFA explained 50.674% of the total item variance contributing to the tool. CFA showed that the SPQ fit well. The total SPQ score was significantly associated with social network, quality of life, and cognitive function (r = |.180∼.466|, P < .001). The internal consistency coefficient was acceptable (range of Cronbach's alpha, .695 to .720). CONCLUSIONS: The SPQ has robust properties, wide application, and provides a culturally relevant tool to evaluate the social participation of individuals, thus facilitating rigorous clinical and population-based research.