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

Abstract 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.