Article Text

Download PDFPDF
Does the association between leisure activities and survival in old age differ by living arrangement?
  1. Charlotta Nilsen1,
  2. Neda Agahi1,
  3. Benjamin A Shaw2
  1. 1 Aging Research Center, (Karolinska Institutet/Stockholm University), Stockholm, Sweden
  2. 2 Center for Social and Demographic Analysis, School of Public Health, University at Albany, State University of New York, Albany, New York, USA
  1. Correspondence to Charlotta Nilsen, Aging Research Center, Karolinska Institutet, Stockholm University, Gävlegatan 16, Stockholm 11330, Sweden; charlotta.nilsen{at}


Background Government policies to promote ageing in place have led to a growing frail population living at home in advanced old age, many of whom live alone. Living alone in old age is associated with adverse health outcomes, but we know little about whether it moderates the health impact of other risk and protective factors. Engagement in leisure activities is considered critical to successful ageing. We investigated whether the association between different types of leisure activities and survival in non-institutionalised older adults (aged 76 and above) differs by living arrangement and gender.

Methods We used the Swedish Panel Study of Living Conditions of the Oldest Old study from 2011 and the Swedish Cause of Death Register (until 30 June 2014) to conduct Cox regression analyses (n=669). Incident mortality was 30.2% during the follow-up period.

Results Overall level of leisure activity was not significantly associated with survival in either living arrangement, but some specific leisure activities, and associations, were different across gender and living arrangement. More specifically, certain social activities (participation in organisations and having relatives visit) were associated with longer survival, but only in men living alone. In women, most results were statistically non-significant, with the exception of solving crosswords being associated with longer survival in women living with someone.

Conclusion In order to facilitate engagement with life, interventions focusing on leisure activities in the oldest age groups should take gender and living arrangement into consideration when determining the type of activity most needed.

  • mortality
  • social activities
  • gender
  • elderly

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors CN processed the data, carried out the statistical analyses and drafted and finalised the manuscript. NA and BAS supervised the first author, participated in the conception and design of the study and the interpretation of the data and revised the manuscript. All authors have read and approved the final manuscript.

  • Funding This work was supported by the Marianne and Marcus Wallenberg Foundation (Grant MMW 2016.0081), by Forte, the Swedish Research Council for Health, Working Life and Welfare (Grant 2012-1704 and Grant 2015-01360).

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval The Regional Ethical Review Board in Stockholm approved the data collection (Dnr 2010/403-31/4).

  • Provenance and peer review Not commissioned; externally peer reviewed.