Patterns of social participation among older adults and their association with self-rated health: the mediating role of activities of daily living.

Background: The aging population poses challenges in various areas, particularly regarding the health of older adults, which is becoming a worldwide issue due to decreasing physical abilities. Social participation improves both mental and physical well-being, making it an important approach for promoting active aging. This research examined the patterns of social participation among the older adults and how these patterns relate to their Activity of Daily Living and their Self-rated Health.

Methods: Utilizing data from the 7th National Health Service Survey in Gansu, a potential category analysis was performed to examine the social participation patterns of older adults. To investigate how these patterns influence Self-rated Health and the Activity of Daily Living, mediation effect analysis was carried out, incorporating classical triple regression, structural equation modeling, and Bayesian structural equation modeling.

Results: In Gansu Province, the social participation patterns among older adults are categorized as Diverse Participation(9.85%), Agricultural-centered Participation (29.02%), and Low Participation (61.13%). Those engaged in diverse and agricultural participation exhibit better Activities of Daily Living and Self-rated Health compared to those with low participation. Using the Low Participation group as reference, both Diverse Participation (β = 0.038, 95% CI = 0.028-0.047) and Agricultural-centered Participation (β = 0.042, 95% CI = 0.030-0.055) showed that the association between social participation and Self-rated Health was achieved partly through Activities of Daily Living this mediators, accounting for 34.23% (Diverse Participation) and 40.00% (Agricultural-centered Participation) of the total effects respectively.

Conclusion: Activities of Daily Living mediates the relationship between social participation and Self-rated Health. Attention should be paid to the Activities of Daily Living of older adults, with particular attention to those living alone and those who are chronically ill, and to social resources to enhance the social participation of older persons.