Self-identified Social Participation Restriction among Community-dwelling Older Adults in the United States

Thesis (Ph.D.)--University of Washington, 2019Background: Social participation (SP) is believed to positively contribute to health and well- being of older adults and has been identified as a central contributor for successful aging. Available research on SP provides evidence on the associations of SP with demographic and health characteristics, but we know the least about the extent of social participation restriction (SPR) in older adults and whether SPR changes over time. Objective: The primary aim of this research was to determine the prevalence of SPR, SPR incidence at one-year follow-up, and SPR recovery rate at one-year follow-up in U.S. community-dwelling older adults. A secondary aim of this research was to determine the correlates of SPR incidence and recovery at one-year follow-up. Methods: This study used data from the 2015 and 2016 rounds of the National Health and Aging Trends Study (NHATS). Inclusion criteria of community-dwelling older adults who had completed SP survey items in 2015 resulted in a sample of 7,492. Participants were considered to have SPR if they reported restriction in at least one social activity and it was reported as “somewhat important” or “important”. The measured social activities were visiting in person with friends or family; attending religious activities; going out for enjoyment; and participating in clubs, classes, or other organized activities. Results: In 2015, the overall prevalence of SPR was 17.0% (95% Confidence Interval [CI]: 16.0-18.0). SPR prevalence increased with advancing age and was more common in women than in men. SPR incidence was 10.5% (95% CI: 9.72-11.3). The one-year incidence of SPR was associated with having more medical conditions, worse physical functioning, fatigue, bothersome pain, and cognitive decline at baseline. SPR recovery was 39.9% (95% CI: 36.7-43.1), and it was associated with having reporting no pain and better physical functioning at baseline. Conclusions: SPR is common in community-dwelling older adults in the U.S. SPR prevalence is expected to increase as the number of older adults increases with the baby-boomers aging. The identified SPR incidence risk factors can help healthcare providers identify those who are vulnerable to developing SPR and provide them with the services and resources that can support continued SP. More research is needed to design programs that facilitate and promote SP in community-dwelling older adults