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Member Research & Reports

Member Research & Reports

Taiwan Study: Older Adults’ Leisure Time Activities are Mediating Variables in Functional Disability Progression

Engagement with life and a decrease in functional disability have been major components of successful aging, and they have become key public health priorities in many aging societies, including Taiwan[1]. In recent decades, researchers have paid increasing attention to how leisure time activity (LTA), which is one of the major components of a healthy lifestyle with an emphasis on active engagement with life, prevents functional disabilities. Studies also have shown that engagement in LTA in later life, and increases in LTA engagement, is associated with a slower speed of progression toward functional disability.

Since both the LTA and functional disability of older adults change over time, parallel-process Latent Growth Curve Modeling has been recommended to evaluate the longitudinal relationships between two distinct processes — one mediational process and one outcome process. The aims of this study were to investigate (1) whether and (2) to what extent LTA trajectories mediated the potential associations between six common sociodemographic factors and functional disability trajectories among Taiwanese older adults. The six sociodemographic factors evaluated in the current study were age, gender, education level, self-rated health, number of comorbidities, and depression.

For all six sociodemographic factors, both baseline LTA and change in LTA demonstrated either partial or total mediation effects on functional disability trajectories. Education, through LTA participation as a mediator, can have strong effects on older adults, having a lower baseline and a slower rate of progression of disability. The effects of education were as much as 3 to 6 times the size of the effect of the other sociodemographic factors. The large proportion of effects mediated through baseline LTA further emphasizes the importance of LTA as mediators in this relationship.

LTA may serve as potential positive interventions in the relationship between older adults’ sociodemographic characteristics and development and their progression in functional disability. The relationships between functional disability and age, education, and number of comorbidities—three of the six sociodemographic factors considered here—may in particular be positively affected by strong LTA participation, given the high proportion of effects mediated. LTA are key to helping older adults maintain an active lifestyle, and they may be particularly important for successful aging in Asian countries, where intensive physical exercise is less common than in Western countries.

National Taiwan University College of Public Health researchers study findings provide practical suggestions for a better targeting of subpopulations of older adults to promote healthy behaviors.

Source: Chen Y-M, Tu Y-K, Yu H-W, et al. Leisure time activities as mediating variables in functional disability progression: An application of parallel latent growth curve modeling. PLOS ONE 2018;13:e0203757. doi: 10.1371/journal.pone.0203757.