Leisure time activities as mediating variables in functional disability progression: An application of parallel latent growth curve modeling

Ya-Mei Chen; Yu-Kang Tu; Hsiao-Wei Yu; Tzu-Ying Chiu; Tung-Liang Chiang; Duan-Rung Chen; Ray-E Chang

doi:10.1371/journal.pone.0203757

Leisure time activities as mediating variables in functional disability progression: An application of parallel latent growth curve modeling

PLoS One. 2018 Oct 3;13(10):e0203757. doi: 10.1371/journal.pone.0203757. eCollection 2018.

Authors

Ya-Mei Chen¹, Yu-Kang Tu², Hsiao-Wei Yu³, Tzu-Ying Chiu⁴, Tung-Liang Chiang¹, Duan-Rung Chen⁵, Ray-E Chang¹

Affiliations

¹ Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan, R.O.C.
² Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Xu-Zhou Road, Taipei, Taiwan, R.O.C.
³ Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Kwei-shan,Taoyuan,Taiwan, R.O.C.
⁴ Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City, Taiwan, R.O.C.
⁵ Institute of Health Behavior and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan, R.O.C.

Abstract

Objectives: The aims of this study were to investigate (1) whether and (2) the extent to which Taiwanese older adults' leisure time activity (LTA) trajectories mediated the potential association between their sociodemographic factors and their functional disability trajectories.

Methods: Longitudinal data from four waves of the Taiwan Longitudinal Study on Aging (TLSA), collected between 1996 and 2007, were used for analysis (N = 3,429). Parallel-process latent growth curve modeling was adopted to evaluate the process by which LTA mediated between sociodemographic factors (age, gender, education, self-rated health, comorbidities, and depression) and the outcome process of functional disabilities.

Results: When mediated by baseline level of LTA, five sociodemographic factors-age, gender, education level, self-rated health, and number of comorbidities-had significant and negative mediating effects on baseline or change in functional disability, thus improving disability outcomes. However, four of the sociodemographic factors (age, education level, and number of comorbidities), when mediated through the rate of change in LTA, were found to have significant and positive mediating effects, which increased disability levels. The proportion of effects mediated by the LTA trajectory ranged from 0% to 194%.

Discussion: The large proportion of effects mediated through the LTA process underlines the importance of LTA to public health policy and health programs for older adults. The study's findings shed light on how to better target populations of older adults to promote an active lifestyle and achieve more successful aging in late life in Asian countries.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged
Aged, 80 and over
Aging / physiology
Aging / psychology*
Asia
Depression / physiopathology
Depression / psychology
Disabled Persons / psychology*
Disease Progression*
Female
Humans
Leisure Activities / psychology*
Life Style
Longitudinal Studies
Male
Middle Aged
Taiwan

Grants and funding

This study received funding support from the Ministry of Science and Technology and the National Science Council of Taiwan (NSC 101-2410-H-002-212-MY2, MOST 103-2410-H-002-146, MOST 106-2811-H-002-018) to YMC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.