Marital Status as a Moderator:Exploring the Relationship between Social Engagement and Depressive Symptoms in China’s Older Adult Population

Objective This study aims to explore the complex relationship between social engagement and depressive symptoms among older adults in China,focusing particularly on the moderating role of marital status.Methods This study used data from the latest Chinese Longitudinal Healthy Longevity Survey(CLHLS).The analysis used the latent class analysis to delineate personality clusters and hierarchical linear regression,supplemented by the PROCESS macro,to investigate the effects of social engagement and marital status on depressive symptoms.Results The analysis encompassed 7,789 respondents(mean age:82.53[s=11.20]years),with 54%female.The personality analysis categorized participants into four clusters,with the majority(77.60%)classified as Confident Idealists,who exhibited the lowest levels of depressive symptoms.Hierarchical linear regression analysis yielded several significant findings:Higher levels of social engagement were significantly associated with fewer depressive symptoms(t=-7.932,P<0.001,B=-0.463).Marital status was a significant factor;married individuals reported fewer depressive symptoms compared to their unmarried counterparts(t=-6.368,P<0.001,B=-0.750).There was a significant moderating effect of marital status on the relationship between social engagement and depressive symptoms(t=-2.092,P=0.037,B=-0.217).Conclusion This study demonstrates that,among Chinese older adults,both social engagement and marital status significantly influence depressive symptoms.Higher social engagement,particularly in other activities like doing household chores,gardening,reading newspapers or books,and playing cards or Mahjong,is associated with fewer depressive symptoms,especially among married individuals.

Aging gracefully: social engagement joins exercise and enrichment as a key lifestyle factor in resistance to age-related cognitive decline

Cognitive impairment is a consequence of the normal aging process that effects many species, including humans and rodent models. Decline in hippocampal memory function is especially prominent with age and often reduces quality of life. As the aging population expands, the need for interventional strategies to prevent cognitive decline has become more pressing. Fortunately, several major lifestyle factors have proven effective at combating hippocampal aging, the most well-known of which are environmental enrichment and exercise. While the evidence supporting the beneficial nature of these factors is substantial, a less well-understood factor may also contribute to healthy cognitive aging: social engagement. We review the evidence supporting the role of social engagement in preserving hippocampal function in old age. In elderly humans, high levels of social engagement correlate with better hippocampal function, yet there is a dearth of work to indicate a causative role. Existing rodent literature is also limited but has begun to provide causative evidence and establish candidate mechanisms. Summed together, while many unanswered questions remain, it is clear that social engagement is a viable lifestyle factor for preserving cognitive function in old age. Social integration across the lifespan warrants more investigation and more appreciation when designing living circumstances for the elderly.

What gets in the way of social engagement in schizophrenia?

BACKGROUND Social engagement-important for health and well-being-can be difficult for people with schizophrenia.Past research indicates that despite expressing interest in social interactions,people with schizophrenia report spending less time with others and feeling lonely.Social motivations and barriers may play an important role for understanding social engagement in schizophrenia.AIM To investigate how people with schizophrenia describe factors that impede and promote social engagement.METHODS We interviewed a community sample of people with(n=35)and without(n=27)schizophrenia or schizoaffective disorder about their social interactions with friends and family over the past week and planned social activities for the coming week.We reviewed the interview transcripts and developed a novel coding system to capture whether interactions occurred,who had initiated the contact,and frequency of reported social barriers(i.e.,internal,conflict-based,logistical)and social motivations(i.e.,instrumental,affiliative,obligation-based).We also assessed symptoms and functioning.RESULTS People with schizophrenia were less likely than people without schizophrenia to have spent time with friends[t(51.04)=2.09,P=0.042,d=0.51)],but not family.People with schizophrenia reported more social barriers than people without schizophrenia[F(1,60)=10.55,P=0.002,ηp2=0.15)]but did not differ in reported social motivations.Specifically,people with schizophrenia reported more internal[t(45.75)=3.40,P=0.001,d=0.83)]and conflict-based[t(40.11)=3.03,P=0.004,d=0.73)]barriers than people without schizophrenia.Social barriers and motivations were related to real-world social functioning for people with schizophrenia,such that more barriers were associated with more difficulty in close relationships(r=-0.37,P=0.027)and more motivations were associated with better community functioning(r=0.38,P=0.024).CONCLUSION These findings highlight the importance of assessing first person accounts of social barriers and motivations to better understand social engagement in schizophrenia.

Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans

Background:Large numbers of post-deployment U.S.veterans are diagnosed with post-traumatic stress disorder(PTSD)and/or traumatic brain injury(TBI),leading to an urgent need for effective interventions to reduce symptoms and increase veterans’coping.PTSD includes anxiety,flashbacks,and emotional numbing.The symptoms increase health care costs for stress-related illnesses and can make veterans’civilian life difficult.Methods:We used a randomized wait-list controlled design with repeated measures of U.S.military veterans to address our specific aim to test the efficacy of a 6-week therapeutic horseback riding(THR)program for decreasing PTSD symptoms and increasing coping self-efficacy,emotion regulation,social and emotional loneliness.Fiftyseven participants were recruited and 29 enrolled in the randomized trial.They were randomly assigned to either the horse riding group(n=15)or a wait-list control group(n=14).The wait-list control group experienced a 6-week waiting period,while the horse riding group began THR.The wait-list control group began riding after 6 weeks of participating in the control group.Demographic and health history information was obtained from all the participants.PTSD symptoms were measured using the standardized PTSD Checklist-Military Version(PCL-M).The PCL-M as well as other instruments including,The Coping Self Efficacy Scale(CSES),The Difficulties in Emotion Regulation Scale(DERS)and The Social and Emotional Loneliness Scale for Adults-short version(SELSA)were used to access different aspects of individual well-being and the PTSD symptoms.Results:Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR(P≤0.01)as well as a statistically and clinically significant decrease after 6 weeks of THR(P≤0.01).Logistic regression showed that participants had a 66.7%likelihood of having lower PTSD scores at 3 weeks and 87.5%likelihood at 6 weeks.Under the generalized linear model(GLM),our ANOVA findings for the coping self-efficacy,emotion regulation,and social and emotional loneliness did not reach statistical significance.The results for coping self-efficacy and emotion regulation trended in the predicted direction.Results for emotional loneliness were opposite the predicted direction.Logistic regression provided validation that outcome effects were caused by riding longer.Conclusion:The findings suggest that THR may be a clinically effective intervention for alleviating PTSD symptoms in military veterans.

Association between visual status and mental health status in Thai rural elderly:a community-based study

AIM：To evaluate the association between visual impairment（VI） and mental health or social engagement in older adults living in rural Thailand.METHODS：Data for this cross-sectional study were drawn from a community survey conducted in 2015 in Saraburi Province,Thailand.Participants were 327 adults aged ≥50 y.VI was assessed using presenting distance visual acuity.Mental health and social engagement were evaluated in face-to-face interviews using validated questionnaires.After determining the prevalence of VI and relevant sociodemographic characteristics,multivariate regression analysis was used to evaluate the impact of VI on mental health and social engagement.RESULTS：The prevalence of VI was 18.3%.Major causes were refractive error（58.3%） and cataract（35%）.Factors associated with VI in the crude analysis were：older age [odds ratio（OR） 8.08],unemployment（OR 2.72）,widowhood（OR 2.47）,being divorced/separated（OR 3.27）,smoking（OR 2.09） and disability in activities of daily living（OR 2.35）.Protective factors were undergoing eye screening at least once a year（P=0.029） and obesity（P=0.005）.VI was significantly associated with low social engagement（adjusted OR 4.13） but not with poor mental health（P〉0.05）.CONCLUSION：Although VI older adults reported less participation in social activities,there is no significant association between VI and poor mental health.Annual eye examinations may prevent VI in older adults.Information about employment and anti-smoking should be targeted to older adults with VI.

Reasons why older adults play sport:A systematic review

Background:Despite the known contribution of sport to health and well-being,sport participation declines in older age.However,for some people,sport continues to play an important role in older age and may contribute to improved health and well-being in older years.Although the health-related benefits of participating in sport are commonly reported,the reasons why some older adults continue to play sport are not well understood.This systematic review aimed to(1)identify studies from the literature that evaluated the reasons why older adults(aged 55 years and older)participate in sport and(2)synthesize and discuss the reasons for their participation reported in the literature.Methods:Searches of the electronic databases Embase,Medline,PsycInfo,PubMed,and SPORTDiscus were performed.Studies were included that evaluated reasons for sport participation in adults aged 55 years and older because this is the age at which sport participation has been reported to begin declining.The studies included in this review used qualitative,quantitative,or mixed methods designs,were peer reviewed,and were published in the English language before the search date(20 January 2019).Results:A total of 1732 studies were identified.After exclusions,30 studies were included in the review(16 qualitative,10 quantitative,and 4 mixed methods).The review presents several features and findings from the studies,including a description and systematization of the reasons for participating in sport and the main reasons that participants gave for participating in sport(maintaining health,feeling and being part of a community,and taking advantage of opportunities to develop relationships).Other reasons included competing and attaining a feeling of achievement,taking advantage of opportunities for travel,and being part of a team.Sport was identified as contributing to the overall experience of successful ageing.There were few comparative differences for participating in sport,and there were only small differences between genders for the reasons given for participation.Generally,the quality of the studies was good;however,mixed methods studies lacked appropriate data analysis procedures.Conclusion:Older adults play sport for a range of health-related and social reasons that can contribute to the experience of successful ageing.Strategies to increase sport participation by older adults should focus on promoting these aspects.