Relationship between functional disability, depression, and social and civic engagement among older European adults: A three wave longitudinal study using SHARE

BACKGROUND: Studies show that depression has a long-term effect on physical health and functional capabilities. Vice versa, onset of functional disability has a detrimental role in the decline in emotional and mental well-being of older adults. The current study was sought to explore the direction of the association between functional disability and depression, and further examined if social-civic engagement, as a means of coping, moderated the association. METHODS: Study employed a secondary analysis using data derived from waves 5 (2013), 6 (2015) and 7 (2017) of the Survey of Health, Aging and Retirement in Europe (SHARE). In total, 36 323 older adults aged 65+ at baseline (mean age 74.41 ± 7.09 years; 54.8% women; 83.2% retired) were followed up over a 4-year period. Analysis included GALI (The Global Activity Limitation Indicator), ADLs (Activities of Daily Living), IADLs (Instrumental Activities of Daily Living), EURO-D depression scale, and different types of social/civic activities (voluntary/charity work; educational or training course; sport, social or other kind of club; and political or community-related organization). Covariates included socio-demographic variables. RESULTS: Controlling for the effects of covariates, the association between functional disability and depression is reciprocal over time, but depression had a greater impact on functional disability than the reverse at both follow-up points. Different types of social-civic participation appeared to moderate the association between depression and functional disability, but in varied ways. CONCLUSIONS: Finding suggests that depression is associated with higher odds of functional disability, and impede recovery from the disability. Early behavioural and psychological interventions and social prescribing including social/civic activities can help develop positive resources, coping strategies, and resilience, and thereby, alleviating the vicious cycle linking functional disability and depression.