Trajectories of Social Participation and Its Predictors in Older Adults: Based on the CLHLS Cohorts from 2002 to 2018

Abstract

Social participation is a key factor in achieving active aging. This study aimed to explore the trajectories and predictors of social participation changes among older adults in China. The data used in this study are from the ongoing national longitudinal study CLHLS. A total of 2492 older adults from the cohort study were included. Group-based trajectory models (GBTM) were used to identify potential heterogeneity in longitudinal changes over time and investigate associations between baseline predictors and trajectories for different cohort members using logistic regression. Four different trajectories of social participation were reported in older adults, namely, stable (8.9%), slow decline (15.7%), lower score with decline (42.2%), and higher score with decline (9.5%). On multivariate analyses, age, years of schooling, pension, mental health, cognitive function, instrumental activities of daily living, and initial social participation scores significantly impact the rate of change in social participation over time. Four trajectories of social participation were identified in the Chinese elderly population. Management of mental health, physical function, and cognitive function appear to be important in maintaining the long-term social participation of older people in the community. Early identification of factors influencing the rapid decline in social participation and timely interventions can maintain or improve social participation levels in older adults.

Effect of social participation on the trajectories of activities of daily living disability among community-dwelling older adults: a 7-year community-based cohort

“…Social participation fosters psychological resilience in older people, encourages healthier behaviors, and enhances cognitive and physical functioning [ 26 ]. These positive factors, in turn, may contribute to sustained engagement in social activities over the long term [ 41 ].…”

“…First, this study assessed older Chinese adults living in a major city, Shanghai, thus potentially limiting the generalizability of our results. Second, there may be a bidirectional relationship between social participation and ADL functioning, where a lack of active social engagement could be an early manifestation of ADL disability [ 40 , 41 ]. Although we used longitudinal data to consider the interplay between social participation and ADL abilities, we cannot completely eliminate the possibility of reverse causality.…”

Latent transition analysis of instrumental activities of daily living in Chinese elderly: based on the 2014–2018 wave of the Chinese Longitudinal Healthy Longevity Survey

“…Research suggests that elderly individuals with IADL impairment may experience social isolation [ 37 ], which may limit their social activities or counteract the protective effects of social activities. Meanwhile, the other study found that IADL was a predictor of social participation trajectories, with poorer IADL predicting poorer social participation [ 28 ]. Thus, there may be a bidirectional relationship between impaired IADL and reduced social participation.…”

“…Based on the relevant literature [ 11 – 19 ], several demographic characteristics at T1 were selected as covariates, including demographic information, disease information, and social participation [ 19 , 28 ]. Demographic information included age (measured in years), gender (male/female), place of residence (urban/rural), residential status (living with family/living alone, or in a nursing institution), smoking habits (yes/no), and drinking habits (yes/no).…”

“…Participants with one or more of these chronic diseases were deemed to have a chronic disease. Social participation was also included in the analysis, assessed across three dimensions: cognitive activity, physical activity, and social activity [ 28 ]. Cognitive activities include “reading newspapers/books,” “playing cards/mah-jong,” “watching TV and listening to the radio”.…”