Background Social engagement and participation in leisure activities are recognised as beneficial to the physical and mental health and wellbeing of older adults and have been shown to lower the risk of negative health outcomes and early mortality. Identifying factors that constrain or enable social participation in older age can help to facilitate continuing engagement and thus improve future health outcomes. This study aimed to investigate the longitudinal relationship between accrual of chronic health conditions and changes in depressive symptoms and continuing social participation in community dwelling older adults over a 4 year period.
Methods Data from waves 1 (2009–2011, n=6051), 2 (2012, n=5487) and 3 (2014–2015, n=4623) of the Irish Longitudinal Study of Ageing (TILDA), a stratified probability sample prospective cohort, was analysed. Frequency of participation in seven social activities (‘Go to films, plays, concerts’, ‘Attend classes or lectures’, ‘Travel for pleasure’, ‘Play cards, bingo or games’, ‘Go to pub’, ‘Eat out of house’ and ‘Participate in sport or exercise’) was collected. Depressive symptoms were assessed using the 8-item Centre for Epidemiological Studies Depression (CESD) scale, and chronic disease count included self-reported doctors’ diagnosis of cardiovascular (heart attack, angina, stroke, transient ischaemic attack, heart failure) and non-cardiovascular chronic conditions (high blood pressure, diabetes, arthritis, lung disease, osteoporosis). Multilevel mixed effects logistic regression modelling was employed to assess the effect of changes in 1) chronic disease count and 2) depressive symptoms on each item of social participation (defined as monthly participation or less) over three waves, adjusted for socio-demographic and health covariates.
Results Mean age at baseline was 63.2y and 46.9% of the sample were male. Rates of social participation remained stable across waves. Each additional chronic disease accrued was associated with decreased participation in ‘Attend classes or lectures’ (Odds Ratio (OR): 0.86, 95% CI: 0.74–0.99) and ‘Participate in sport or exercise’ (OR: 0.86, 95% CI: 0.77–0.97) and an increase in ‘Go to pub’ (OR: 1.28, 95% CI: 1.09–1.50). A one unit increase in depressive symptoms over time was associated with decreased participation in ‘Participate in sport or exercise’ (OR: 0.96, 95% CI: 0.93–0.99) only.
Conclusion This longitudinal analysis suggests that deterioration of physical and mental health may influence specific domains of social participation in community dwelling older adults. Holistic approaches to disease management and mental health interventions in older age should include programmes to facilitate and maintain social and leisure time activities.
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