Date Presented 03/27/20
The study used cross-sectional data of 1,202 community-dwelling adults age 65 and older from the Health and Retirement Study. The finding indicates that SMC have a small but significant effect on social participation among older adults. Therefore, OTs need to start considering SMC when facilitating social participation among older adults.
Primary Author and Speaker: Chang Dae Lee
Additional Authors and Speakers: Sangmi Park
BACKGROUND: Social participation is one of the important goals of occupational therapy intervention (Berger et al, 2013). Cognitive function is a consistently reported determinant factor for social participation, older adults with cognitive impairments are more likely to have difficulty engaging in social activities (Marioni et al., 2012). The decline in social participation in older adults with cognitive impairments is not only due to cognitive difficulties, including sustaining conversation and keeping up with the details of the conversation, but also due to psychological reasons, including having difficulty opening their cognitive difficulties to others and hoping to avoid the embarrassments derived from the cognitive impairments (Singleton, 2017). Since psychological factor regarding cognitive changes affects older adults’ participation in social activities, their perception of one’s cognitive decline may also influence the outcome.
PURPOSE: The aim of this study is to examine whether subjective memory complaints (SMC) contribute to social participation among older adults.
DESIGN: This study is a cross-sectional study. I analyzed the data of 1202 community-dwelling older adults aged 65 years and older from the 2010 wave of Health and Retirement Study (HRS).
METHOD: Hierarchical linear modeling analysis was used to examine the association of SMC with social participation after controlling for the factors influencing on social participation. The demographic factors (i.e. age, gender, and perceived social status) were entered in block 1. Health conditions (i.e. the number of chronic disease, perceived health, ability to perform instrumental activities of daily living, and words recall-immediate and delayed, depressive symptoms) were entered in the next block, followed by environmental factors (i.e. positive and negative social support from spouse, child, family, and friend) in the block 3. The SMC was entered in block 4.
RESULT: Correlational analyses indicated that the social participation has positive associations with the female, perceived social status, perceived health, words recalls-immediate and delayed, ability to perform instrumental activities of daily living, and positive social support from child and friend. And social participation has negative associations with younger age, the number of chronic diseases, depressive symptoms, and SMC. Hierarchical regression analyses showed that factors significantly contributing to social participation are gender (β = −9.29, p < 0.001), perceived social status (β = −4.19, p < 0.001), perceived health (β = 5.5, p < 0.001), words recalls-immediate (β = −2.28, p < 0.05), depressive symptoms (β = 2.81, p < 0.01), ability to perform instrumental activities of daily living (β = 5.74, p < 0.001), positive social support from child, family, and friend (β = 2.27, p < 0.05; β = −2.98, p < 0.01; β = 4.39, p < 0.001, respectively), negative social support from friend (β = 3.05, p < 0.01), and SMC (β = 2.11, p < 0.05). The demographic factors explained 14.9%, health conditions explained 9.8%, social support explained 2.5%, and SMC explained 0.3% of the variance in social participation.
CONCLUSION: This finding suggests that SMC is a contributing factor for social participation in older adults. Therefore, to maintain or facilitate engagement in social activities occupational therapists need to start considering SMC in older adults. Furthermore, although SMC is one of the most common issues in older adults and associated with future cognitive decline, it has not actively studied in the occupational therapy field. Thus, occupational therapists should carry out research to examine the influence of SMC on not only older adults’ social participation but also other factors related to healthy aging.
References
Berger, S., McAteer, J., Schreier, K., & Kaldenberg, J. (2013). Occupational therapy interventions to improve leisure and social participation for older adults with low vision: A systematic review. American Journal of Occupational Therapy, 67, 303–311. http://dx.doi.org/10.5014/ajot.2013.005447
Marioni, R. E., van den Hout, A., Valenzuela, M. J., Brayne, C., & Matthews, F. E. (2012). Active cognitive lifestyle associates with cognitive recovery and a reduced risk of cognitive decline. Journal of Alzheimer’s Disease, 28(1), 223-230. doi: 10.3233/JAD-2011-110377
Singleton, D., Mukadam, N., Livingston, G., & Sommerlad, A. (2017). How people with dementia and carers understand and react to social functioning changes in mild dementia: a UK-based qualitative study. BMJ open, 7(7), e016740. doi: 10.1136/bmjopen-2017-016740
