Change in Social Participation Over Time Among Persons Aged 45-64 Aging With Long-Term Physical Disability

This study examined changes in satisfaction with and ability to participate in social roles and activities over 3 years for people who were aging with long-term physical disability. The goal was to understand the impact of physical health, function, depression, fatigue, and pain on participation.

A 3-wave longitudinal cohort survey study was completed from 2019 to 2022.

The general community.

The study included 323 respondents who participated all 3 years. Purposive sampling recruited individuals aged 45-64 with at least 5 years of disability history through community partners, advertisements, and social media.

Not applicable.

Patient-Reported Outcome Measurement Information System (PROMIS) Adult Ability to Participate in Social Roles and Activities and PROMIS Satisfaction with Participation in Social Roles.

Univariate repeated measures analysis of variance models indicated that satisfaction with participation did not change over time, and ability to participate slightly increased (means T0 44.4, T2 45.5, P=.045). Linear mixed models indicated that greater physical function was associated with greater satisfaction (β=0.21, 95% confidence interval [CI]: 0.14-0.28) and ability to participate (β=0.19, 95% CI: 0.13-0.26). Greater levels of depression, fatigue, and pain were associated with decreased satisfaction (depression β=-0.21, 95% CI: -0.28 to -0.14; fatigue β=-0.18, 95% CI: -0.26 to -0.11; pain β=-0.14, 95% CI: -0.21 to -0.07) and decreased ability to participate (depression β=-0.23, 95% CI: -0.29 to -0.17; fatigue β=-0.19, 95% CI: -0.25 to -0.12; pain β=-0.12, 95% CI: -0.18 to -0.06).

This longitudinal study demonstrated that satisfaction with and ability to participate in social roles fluctuated little over 3 years but were influenced by physical and mental health variables. Findings suggest that decreasing aging-with-disability symptoms and improving health and function may sustain social participation over time. Interventions to address social participation decline are available; however, further exploration into individual differences and external socioeconomic factors is warranted to understand the variance in social participation.