Participation in leisure activities has been shown to benefit the mental health of older adults, but it has not always been clear what mental health symptom changes are affected by which leisure activity. Recently a study in Taiwan looked at which types of symptoms associated with depression were impacted by changes in social, physical, and intellectual activity.
The impact of certain types of activities on depression is of great interest, since depression is one of the most common chronic mental health issues affecting older adults globally. In Taiwan, where this study was conducted, the prevalence of depressive symptoms (which is not necessarily a medical diagnosis of depression) has been estimated to be between 26 and 35 percent of all community-dwelling older adults. Moreover, symptoms of depression have been associated with greater risk of physical impairment, cognitive impairment, and suicide.
This study looked at data from 2,660 adults age 60 or better, with an average age of 81 years at the start of the study. The study followed these participants for 12 years. At regular four-year intervals, these individuals reported on the frequency of their participation in eight leisure activities, with responses ranging from “never” to “almost every day.” Since a number of different sorts of symptoms are associated with depression, these researchers wanted to explore which symptoms of depression might be impacted by changes in each type of activity. The four types of symptoms they examined were depressive emotions (“I feel sad”), physical symptoms (“I did not feel like eating”), low levels of positive emotions (“I felt very happy”), and interpersonal difficulties (“People were unfriendly”).
Overall, the study found that over time the study’s participants were reporting significantly fewer positive emotions, and increased physical symptoms of depression. The study also found that overall physical activity and intellectual activity decreased over time, while the level of social activity remained consistent. Yet there were also significant proportions of participants who increased each type of activity. While intellectual activity decreased for 20 percent of all participants from 2003 to 2007, for 15 percent of the participants, it increased over this period. For physical activity, while 31 percent reported decreased physical activity over that time, 21 percent reported increased physical activity. Twenty-six percent of participants reported decreased social activity, while 25 percent reported increased social activity. This suggests that while overall trends show a decline in certain types of activities, these declines are by no means an inevitable part of the aging process.
Turning to the main questions of this study, this study found that different types of activities do impact certain types of symptoms of depression differently. When taking into account changes of social and physical activities, the study found that declines in intellectual activities led to higher levels of depressive emotions, physical symptoms, and interpersonal difficulties, as well as a higher score overall on the combined scale of depression symptoms used. However, in this analysis, increased intellectual activity did not show any impact on depressive symptoms. When taking changes of intellectual and physical activity into account, the study found that decreased social activity was associated with a lower overall score on the depression scale. On the other hand, increased social activity was associated with higher positive emotions, lower interpersonal difficulties, and a lower overall score. Taking social and intellectual activities into account, the study found that decreased physical activity was associated with lower positive emotions and a higher overall depression score. Increases in physical activity were associated with higher positive emotion and a lower overall score.
Importantly, the analysis of this study’s data also showed that the beneficial impact of these types of activities appears to be cumulative, with each type of activity making its own contributions to different types of symptoms. Furthermore, this analysis also suggested that gains in certain types of activities made up for losses in other activities. So for individuals faced with decreased ability to maintain the same level of physical activity, increased social activity could offset the negative impact that decreased physical activity was shown to have on positive emotional experiences.
As the author notes, this study “provides important insights into the development of leisure activity programs that can help improve mental health outcomes in later life.” These results support the “successful aging model” that has suggested that active engagement in life promotes positive mental health and that such engagement should be considered integral to successful aging.
Shiau-Fang C. Changes in leisure activities and dimensions of depressive symptoms in later life: a 12-year follow-up. The Gerontologist. (2014). gnu052 DOI:10.1093/geront/gnu052