| ObjectivesThe association between social participation and health in Chinese elderly was studied using national longitudinal data from China Health and Retirement Longitudinal Survey(CHARLS).The aims of this study were to investigate the status of social participation and health in Chinese elderly,to investigate the association between social participation and elderly health,and to provide decision-making basis and recommendation so as to realize active ageing and healthy ageing.Detailed investigation aims included as follows:to study social participation and health status in Chinese elderly;to investigate the associations among joining in economic activity,physical activity,social organization,and volunteer activity of elderly with cognitive function,depression,activity of daily living,and self-rated health;and to study the associations between social participation of elderly in different genders,living in urban or rural area with their health;to address a suggestion about encouraging social participation of elderly so as to improve their health.Subjects and Methods(1)Research ParticipantsChina Health and Retirement Longitudinal Survey(CHARLS)2011,2013,2015 provided by National School of Development,Peking University were used in the study.These data covers 28 provinces(or Autonomous Regions,province-level municipalities),150 counties(or districts),and 450 villages(or communities)using multi-stage stratified probability proportionate to size(PPS)sampling.Research participants included elderly of 60 years old and above in a baseline survey in 2011 and all of them participated survey in 2013 and 2015.1ndividuals with many variables missing value and abnormal value were deleted.Finally,a total of 5686 individuals were included in this study.(2)Research MethodsDescriptive statistics were used to obtain general status,social participation information and healthy state of the survey population.The problem of the missing values in longitudinal data was dealt with multiple imputations.The associations between social participation and elderly cognitive function,activities of daily living(ADL),depression,and self-rated health were analyzed using generalized estimation equation(GEE).Excel 2017 and SPSS 20.0 software were mainly used to data analysis in this study.The statistical level is set to two sides a=0.05.Results(1)The social participation status in Chinese elderlyIn base period survey,the proportion of economic activity participation in elderly was much higher(56.2%).The second was interacted with friends,the proportion is 34.0%.The proportion of participation of hobbies activity was 16.4%.Participation rate of physical activity in elderly was 6.0%.The proportion of joining in volunteer activity in elderly was 5.3%.The rate of joining in community-related organization was 1.5%in this data.Participation of economic activity decreased in older individuals as they grew older.The participation rate of economic activity was 56.2%in 2011 and 46.8%in 2015,respectively.While the proportion rate of joining in volunteer activity increased with age,from 5.3%in 2011 to 12.6%in 2015.There were no significant differences among interaction with friends,joining in hobbies activity and physical activity,and community-related organization with age in this data.But the proportions of economic activity participation and joining in hobbies activities were significantly higher in male elderly than that in female elderly,and there were slightly higher in joining in volunteer activity and community-related organization in male elderly than that of female elderly.But the interaction with friends rate was higher in female elderly than that in male.The proportions of economic activity,hobbies activity,physical activity,community-related organization participation were significantly higher in urban elderly than that of elderly who are living in rural area.And the proportion of joining in volunteer activity was slightly higher in urban elderly than that in countryside.In rural area,there was higher rate of interaction with friends in females than in males.(2)Health state in Chinese elderlyIn base period survey,the average cognitive score in this elderly population was 12.2,the average depression score was 9.0±6.4.The self-rated health outcome was good in 19.5%of elderly.There was 58.6%of elderly whose ADL was normal.As their age grew,the cognitive function and ADL function declined significantly.The average cognitive function score was 12.1±3.2 in 2011 and 8.7±4.5 in 2015.ADL dysfunction rate was 41.4%in 2011 and 63.4%in 2015.The self-rated health score and depress score stayed stable,there was no significant difference with age in this data.The male elderly have better cognitive health,ADL,self-rated health and less depression scores than female elderly.The urban elderly have better cognitive health,ADL,self-rated health and less depression scores than rural elderly.(3)The relationship of social participation and cognitive healthFrom total sample analysis,the results showed that elderly who interacted with friends nearly every week had much better cognitive function(B=0.434,SE=0.216,p=0.044)when compared with those who did not interact with friends at all.Elderly who joined in hobbies activity every day had much better cognitive function(B=0.981,SE=0.274,p<0.001)in comparison of those who did not join in hobbies activity at all.When compared with elderly who did not participate physical activity,elderly participating physical activity owned much better cognitive function(B=1.251,SE=0.527,p =0.017).The results also showed that elderly who joined in community-related organization occasional had much better cognitive function than whose did not join in community-related organization at all(B=1.415,SE=0.450,p =0.002).Analysis by genderThe results showed that female elderly who interacted with friends nearly every week owned much better cognitive function than those who did not interact with friends at all(B=0.939,SE=0.279,p=0.001).There was better cognitive function in elderly who occasionally joined in community-related organization when compared with those who did not join in community-related organization at all(B=2.431,SE=0.658,p<0.001),but this link did not exist in male elderly.Analysis by urban and rural areaThe results showed that urban elderly who participated physical activity every week owned better cognitive function than those who did not join in physical activity at all(B=1.460,SE=0.602,p =0.015).Elderly who joined in community-related organization occasionally or nearly every day had better cognitive function than those who did not join in community-related organization(B=1.842,SE=0.565,P=0.001;B=1.425,SE=0.682,p=0.037,respectively),but there was no link between joining in community-related organization and cognitive function in elderly who live in rural area.(4)The relationship between social participation and ADLFrom total sample analysis,the results showed that elderly who interacted with friends nearly every day had healthier ADL in comparison with those who did not interact with friends at all(B=0.349,SE=0.132,p=0.008).Elderly who participated in physical activity every day had healthier ADL when compared with those who did not join in physical activities(B=0.839,SE=0.319,p=0.008).Elderly who participate volunteer activity occasionally had healthier ADL than those who did not participate volunteer activity(B=0.619,SE=0.287,p=0.031).Analysis by genderThe results showed that there was healthier ADL in female elderly who interacted with friends every day than those who did not interact with friends(B=0.425,SE=0.183,p=0.020).There was healthier ADL in female who occasionally joined in volunteer activity than those who did not join in volunteer activities(B=-0.533,SE=0.253,p =0.036).But there was no association among male elderly.Analysis by urban and rural areaThe results showed that elderly who interacted with friends had healthier ADL in comparison with those who did not interact with friends at all(B=0.048,SE=0.150,p=0.001).But this link did not exist in city’s aged individuals.(5)The relationship between social participation and depression From total sample analysis,the results showed that elderly who interacted with friends nearly every day had less likely to suffer from depression than those who did not interact with friends at all(B=-0.569,SE=0.276,p=0.039).When compared with those who had no hobbies activity,elderly who had hobbies activity had less likely to suffer from depression(every week:B=-1.190,SE=0.361,p=0.001;every day:B=-1.730,SE=0.422,p<0.001,respectively);Elderly who joined in physical activity occasionally had less likely to suffer from depression than those who did not join in physical activity(B=-1.794,SE=0.748,p=0.016).Analysis by the genderthe results showed that female elderly who interacted with friends nearly every day had less likely to suffer from depression than those who did not interact with friends at all(B=-0.841,SE=0.413,p =0.042).But this link did not exist in male elderly in this data.Analysis by urban and rural area the results showed that who live in urban and interacted with friends every week had less likely to suffer from depression than those who did not interact with friends at all(B=-1.358,SE=0.582,p=0.020).And also,in comparison with those who did not join in community-related organization,elderly joined in community-related organization had less likely to suffer from depression(B=-3.369,SE=1.574,p=0.032).But this link did not exist in elderly who live in rural area.(6)The relationship between social participation and self-rated healthFrom total sample analysis,the results showed that elderly who participate economic activity had much better self-rated health than those who did not participate economic activity(B=0.486,SE=0.117,p<0.001).In comparison with those who did not join in physical activity,elderly who joined in physical activity every week had better self-rated health(B=0.622,SE=0.306,p=0.042).And also,elderly who participated volunteer activity occasionally had better self-rated health than those who did not participate volunteer activity(B=0.499,SE=0.246,p=0.043).From analysis by gender,the results showed that male elderly who joined in physical activity every week had better self-rated health than those who did not do physical activity at all(B=1.310,SE=0.628,p=0.037).While female elderly who did physical activity occasionally had better self-rated health than those who did not do physical activity at all(B=0.976,SE=0.419,p =0.020).From analysis by urban and rural area,the results showed that urban aged individuals who joined in volunteer activity occasionally had better self-rated health than those who did not join in volunteer activity at all(B=1.250,SE=0.573,p=0.029).But this link did not exist in elderly who live in rural area.Conclusions(1)Total social participation rate was relatively lower in Chinese elderly.Social participation in male elderly was better than that of female elderly.And social participation in urban elderly was better than that of elderly living in rural area.(2)There were positive correlation between social participation and health in elderly,but different social activities participated had different association with health of elderly.(3)There were significant different association between social participation and health in male and female elderly.And there were also significant different association between elderly who are living in urban or in rural area.In total,social participation was more likely to affect health in female elderly,and elderly who are living in urban.(4)There were different association between different frequency of social participation with health in elderly.Excessive social participation might be no benefits on health in elderly. |
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