Does engagement with life enhance survival of elderly people in Sweden? The role of social and leisure activities

Objectives. This research examined whether engagement with life, defined as involvement in social, leisure, and productive activities. produced a surv ival advantage among oldest old persons in Sweden. Survival was investigate d with respect to activities that involved (a) social integration, (b) phys ical mobility, and (c) neither social nor physical aspects. The authors als o investigated the degree to which any observed survival benefits were rela ted to prior health differences that select older adults into active roles. Methods. Baseline data derived from the Swedish Panel Study of Living Condi tions of the Oldest Old, a nationally representative sample of persons aged 77 years and older living in Sweden in 1992. The authors used factor analy sis to apply a simplifying measurement structure to frequency of participat ion in 10 leisure activities. They used Cox proportional hazard regression to estimate the relative effects of activity factors and other independent variables on the logged hazard rate of mortality up to 1996. Results. Analyses revealed 4 domains of activities that lie along 2 basic d imensions: solitary-social and sedentary-active. Among men, only participat ion in activities that were both solitary and active was significantly asso ciated with reduced mortality risk when health variables were controlled. A mong women, none of the activity domains was significant when health variab les were controlled. For the entire sample, greater participation in solita ry-active activities significantly reduced risk of mortality when all other activity domains and health factors were controlled. Discussion. Although most of the observed associations between activity inv olvement and survival are a byproduct of the confound between poor initial health and low activity levels, solitary activities have a positive influen ce on the survival of very old individuals, especially men, suggesting that nonsocial aspects of activities may promote health and longevity in late o ld age.