The Relationship Between Participation Restrictions on Valued Activities and Well-Being Among Older Adults

Background and Purpose: Limited literature has examined the relationship between restrictions on valued activities and well-being among older adults. Previous research has demonstrated that disability and restrictions on activities due to a health limitation (typically measured as limitations on self-care, physical, or social activities), are associated with well-being and related mental and emotional health outcomes. However, there has been little research that has taken into account how a person felt about not participating in activities because of health or functioning limitations. The inability to participate in valued activities may be more detrimental to well-being than the inability to participate in other activities. We hypothesized that (a) restrictions on valued activities are associated with well-being among older adults, and (b) interpersonal relationships (i.e., social network and social cohesion) moderate this relationship.

Methods: We used the first wave of National Health and Aging Trends Study (NHATS), a nationally-representative panel study. The NHATS's sample included 8,245 Medicare beneficiaries aged 65 and older, and the present analyses included the 6,680 community-dwelling older adults who did not have a proxy respondent. We measured well-being through 11 responses to questions related to positive and negative affect, self-realization, self-efficacy, and resilience. Restrictions on valued activities measured (a) whether health and functioning limited participation in any of four activities (i.e., family visits, religious services, club activities, and enjoyment) and (b) if the activity was important to the respondent. Social cohesion was determined by how much respondents agreed with their community (i.e., people know each other, are willing to help, and can be trusted in the community). We measured social network by whether respondents had someone to talk about important things. Hierarchical multiple regression models also took into account sociodemographic and health characteristics.

Results: Restrictions on valued activities (B = -1.89, SE = 0.63, p = .005) were negatively associated with well-being and social cohesion (B = 0.26, SE = 0.02, p < .001) had a positive relationship with well-being among older adults. In addition, there was a significant interaction effect between restriction on valued activities and well-being. Specifically, those with higher levels of social cohesion and reported restrictions on valued activities had higher levels of well-being, whereas those with lower levels of social cohesion and reported restrictions on valued activities experienced lower levels of well-being.  

Conclusions and Implications: Our research adds to the growing empirical literature demonstrating the beneficial effects of a strong and connected neighborhood social environment for older adults. We will discuss how policy makers and social work practitioners plan to improve well-being of those with restrictions on valued activities. Furthermore, our finding that high levels of social cohesion may serve as a protective factor for those experiencing late-life disability provides support for a number of innovative community-based initiatives, such as the Village model, that aim to address not only the physical needs of older adults, but also their social needs. Recommendation for future research to include those who are not covered by Medicare will be also provided.