Latent Classification Analysis of Leisure Activities and Their Impact on ADL, IADL and Cognitive Ability of Older Adults Based on CLHLS (2008–2018)
Abstract
:1. Research Background
2. Methods
2.1. Data Sources
2.2. Variable Definitions
2.2.1. Dependent Variables
2.2.2. Independent Variables
2.2.3. Control Variables
2.3. Methods of Data Analysis
2.3.1. Latent Growth Curve Model
2.3.2. Latent Profile Analysis (LPA)
2.3.3. Panel Binary Regression
3. Results
3.1. Sample Descriptive Analysis
3.2. Trajectories of ADL, IADL, and COG Ability of Older Adults
3.3. Analysis of the Effect of Leisure Activities on the Health Status of the Older Population
3.4. Latent Classification Analysis of Leisure Activities
3.5. Effect of Latent Classifications of Leisure Activity on the Health Status of Older Adults
3.6. Moderating Effect of Age on Leisure Activities on ADL Disorder, IADL Disorder, and COG Impairment
3.7. Robustness Test
4. Discussion
4.1. Changing Trajectory of LA, ADL, IADL, and COG Ability of Older Adults
4.2. Effects of Leisure Activities on ADL and IADL Disorder, and COG Impairment
4.3. Effect of Latent Profile Analysis of Leisure Activities on the Health Status of Older Adults
4.4. Moderating Effect of Age on the Relationship between Leisure Activities and Health Status
5. Contributions and Limitations
6. Implications
7. Conclusions
- ①
- From 2008–2018, the leisure activities, ADL ability, IADL ability, and cognitive ability of the older population all show a significant nonlinear decline trend over time.
- ②
- Overall, leisure activities have a significant positive impact on the health level of the older population. Specifically, leisure activities are suggested to decrease the probability of ADL disorder, IADL disorder, and the cognitive impairment of older adults.
- ③
- The older population are classified according to engagement in the following three types of activity—relaxation, entertainment, and intellectual-learning—according to the latent profile analysis (LPA) conducted, and there are significant differences in the rates of ADL disorder, IADL disorder, and cognitive impairment among different types of older adults. In general, the rates of ADL disorder, IADL disorder, and cognitive impairment in older people with intellectual-learning leisure activities (Type III) are successively lower than in older people with entertainment (Type II) and relaxation leisure activities (Type I).
- ④
- The effects of leisure activities on the rate of ADL disorder, IADL disorder and cognitive impairment are significantly different in different age groups. Specifically, the inhibitory effects of leisure activities on ADL disorder, IADL disorder and cognitive impairment are greater in the middle-aged and high-aged older groups; however, there is no significant difference between the middle-aged and the high-aged groups.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Schaufeli, W.B.; Bakker, A.B. Job demands, job resources, and their relationship with burnout and engagement: A multi-sample study. J. Organ. Behav. Int. J. Ind. Occup. Organ. Psychol. Behav. 2004, 25, 293–315. [Google Scholar] [CrossRef] [Green Version]
- Mulhern, B.; Shah, K.; Janssen, M.F.; Longworth, L.; Ibbotson, R. Valuing health using time trade-off and discrete choice experiment methods: Does dimension order impact on health state values? Value Health 2016, 19, 210–217. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Roehrig, B.; Hoeffken, K.; Pientka, L.; Wedding, U. How many and which items of activities of daily living (ADL) and instrumental activities of daily living (IADL) are necessary for screening. Crit. Rev. Oncol. Hematol. 2007, 62, 164–171. [Google Scholar] [CrossRef] [PubMed]
- Pressman, S.D.; Matthews, K.A.; Cohen, S.; Martire, L.M.; Scheier, M.; Baum, A.; Schulz, R. Association of enjoyable leisure activities with psychological and physical well-being. Psychosom. Med. 2009, 71, 725–732. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kleiber, D.A.; Nimrod, G. ‘I can’t be very sad’: Constraint and adaptation in the leisure of a ‘learning in retirement’ group. Leis. Stud. 2009, 28, 67–83. [Google Scholar] [CrossRef]
- Kelly, C.M.; Strauss, K.; Arnold, J.; Stride, C. The relationship between leisure activities and psychological resources that support a sustainable career: The role of leisure seriousness and work-leisure similarity. J. Vocat. Behav. 2020, 117, 103340. [Google Scholar] [CrossRef]
- Kuykendall, L.; Tay, L.; Ng, V. Leisure engagement and subjective well-being: A meta-analysis. Psychol. Bull. 2015, 141, 364–403. [Google Scholar] [CrossRef]
- Brajša-Žganec, A.; Merkaš, M.; Šverko, I. Quality of Life and Leisure Activities: How do Leisure Activities Contribute to Subjective Well-Being? Soc. Indic. Res. 2011, 102, 81–91. [Google Scholar] [CrossRef]
- Fancourt, D.; Tymoszuk, U. Cultural engagement and incident depression in older adults: Evidence from the English Longitudinal Study of Ageing. Br. J. Psychiatry 2019, 214, 225–229. [Google Scholar] [CrossRef] [Green Version]
- Todd, C.; Camic, P.M.; Lockyer, B.; Thomson, L.J.; Chatterjee, H. Museum-based programs for socially isolated older adults: Understanding what works. Health Place 2017, 48, 47–55. [Google Scholar] [CrossRef]
- Gautam, R.; Saito, T.; Kai, I. Leisure and religious activity participation and mental health: Gender analysis of older adults in Nepal. BMC Public Health 2007, 7, 299. [Google Scholar] [CrossRef] [Green Version]
- Everard, K.M.; Lach, H.; Fisher, E.B.; Baum, M.C. Relationship of activity and social support to the functional health of older adults. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 2000, 55, S208–S212. [Google Scholar] [CrossRef]
- Nummela, O.; Sulander, T.; Rahkonen, O.; Uutela, A. Associations of self-rated health with different forms of leisure activities among ageing people. Int. J. Public Health 2008, 53, 227–235. [Google Scholar] [CrossRef]
- Wilkinson, A.V.; Waters, A.J.; Bygren, L.O.; Tarlov, A.R. Are variations in rates of attending cultural activities associated with population health in the United States? BMC Public Health 2007, 7, 226. [Google Scholar] [CrossRef] [Green Version]
- Balbag, M.A.; Pedersen, N.L.; Gatz, M. Playing a Musical Instrument as a Protective Factor against Dementia and Cognitive Impairment: A Population-Based Twin Study. Int. J. Alzheimers Dis. 2014, 2014, 836748. [Google Scholar] [CrossRef] [Green Version]
- Fancourt, D.; Steptoe, A.; Cadar, D. Community engagement and dementia risk: Time-to-event analyses from a national cohort study. J. Epidemiol. Community Health 2020, 74, 71–77. [Google Scholar] [CrossRef] [Green Version]
- Fancourt, D.; Steptoe, A.; Cadar, D. Cultural engagement and cognitive reserve: Museum attendance and dementia incidence over a 10-year period. Br. J. Psychiatry 2018, 213, 661–663. [Google Scholar] [CrossRef]
- Sundquist, K.; Lindström, M.; Malmström, M.; Johansson, S.-E.; Sundquist, J. Social participation and coronary heart disease: A follow-up study of 6900 women and men in Sweden. Soc. Sci. Med. 2004, 58, 615–622. [Google Scholar] [CrossRef]
- Ellaway, A.; Macintyre, S. Is social participation associated with cardiovascular disease risk factors? Soc. Sci. Med. 2007, 64, 1384–1391. [Google Scholar] [CrossRef]
- Fancourt, D.; Steptoe, A. Comparison of physical and social risk-reducing factors for the development of disability in older adults: A population-based cohort study. J. Epidemiol. Community Health 2019, 73, 906–912. [Google Scholar] [CrossRef]
- Fancourt, D.; Steptoe, A. Physical and psychosocial factors in the prevention of chronic pain in older age. J. Pain 2018, 19, 1385–1391. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rogers, N.; Fancourt, D. Cultural engagement is a risk-reducing factor for frailty incidence and progression. J. Gerontol. Ser. B 2020, 75, 571–576. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Paillard-Borg, S.; Wang, H.-X.; Winblad, B.; Fratiglioni, L. Pattern of participation in leisure activities among older people in relation to their health conditions and contextual factors: A survey in a Swedish urban area. Ageing Soc. 2009, 29, 803–821. [Google Scholar] [CrossRef]
- Adams, K.B.; Leibbrandt, S.; Moon, H. A critical review of the literature on social and leisure activity and wellbeing in later life. Ageing Soc. 2011, 31, 683–712. [Google Scholar] [CrossRef] [Green Version]
- Fancourt, D.; Steptoe, A. Cultural engagement predicts changes in cognitive function in older adults over a 10 year period: Findings from the English Longitudinal Study of Ageing. Sci. Rep. 2018, 8, 10226. [Google Scholar] [CrossRef] [Green Version]
- Han, L.; Allore, H.; Murphy, T.; Gill, T.; Peduzzi, P.; Lin, H. Dynamics of functional aging based on latent-class trajectories of activities of daily living. Ann. Epidemiol. 2013, 23, 87–92. [Google Scholar] [CrossRef] [Green Version]
- Avila-Funes, J.; Medina-Campos, R.; Tamez-Rivera, O.; Navarrete-Reyes, A.; Amieva, H.; Aguilar-Navarro, S. Frailty is associated with disability and recent hospitalization in community-dwelling elderly: The Coyoacan cohort. J. Frailty Aging 2014, 3, 206–210. [Google Scholar] [CrossRef]
- Sjölund, B.-M.; Wimo, A.; Qiu, C.; Engström, M.; von Strauss, E. Time trends in prevalence of activities of daily living (ADL) disability and survival: Comparing two populations (aged 78+ years) living in a rural area in Sweden. Arch. Gerontol. Geriatr. 2014, 58, 370–375. [Google Scholar] [CrossRef] [Green Version]
- Kim, J.; Heo, J.; Dvorak, R.; Ryu, J.; Han, A. Benefits of leisure activities for health and life satisfaction among Western migrants. Ann. Leis. Res. 2018, 21, 47–57. [Google Scholar] [CrossRef]
- Sala, G.; Jopp, D.; Gobet, F.; Ogawa, M.; Ishioka, Y.; Masui, Y.; Inagaki, H.; Nakagawa, T.; Yasumoto, S.; Ishizaki, T.; et al. The impact of leisure activities on older adults’ cognitive function, physical function, and mental health. PloS One 2019, 14, e0225006. [Google Scholar] [CrossRef]
- Center for Healthy Aging and Development Studies. The Chinese Longitudinal Healthy Longevity Survey (CLHLS)—Longitudinal Data (1998–2018), Peking University Open Research Data Platform, 2020; V2. [CrossRef]
- Katz, S.; Ford, A.B.; Moskowitz, R.W.; Jackson, B.A.; Jaffe, M.W. Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function. JAMA 1963, 185, 914–919. [Google Scholar] [CrossRef]
- Ai-mei, G.; Da-nan, G. The Association between Access to Healthcare and Health Outcomes among Older Adults in China from Health Disparity*—Based on CLHLS Data. Popul. Dev. 2020, 26, 60–69. [Google Scholar]
- Lv, Y.-B.; Gao, X.; Yin, Z.-X.; Chen, H.-S.; Luo, J.-S.; Brasher, M.S.; Kraus, V.B.; Li, T.-T.; Zeng, Y.; Shi, X.-M. Revisiting the association of blood pressure with mortality in oldest old people in China: Community based, longitudinal prospective study. BMJ 2018, 361, k2158. [Google Scholar] [CrossRef] [Green Version]
- Zeng, Y.; Feng, Q.; Hesketh, T.; Christensen, K.; Vaupel, J.W. Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: A cohort study. Lancet 2017, 389, 1619–1629. [Google Scholar] [CrossRef]
- Folstein, M.F.; Folstein, S.E.; McHugh, P.R. “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 1975, 12, 189–198. [Google Scholar] [CrossRef]
- Feng, L.; Ng, X.-T.; Yap, P.; Li, J.; Lee, T.-S.; Håkansson, K.; Kua, E.-H.; Ng, T.-P. Marital status and cognitive impairment among community-dwelling Chinese older adults: The role of gender and social engagement. Dement. Geriatr. Cogn. Disord. Extra 2014, 4, 375–384. [Google Scholar] [CrossRef]
- Galea, M.; Woodward, M. Mini-mental state examination (MMSE). Aust. J. Physiother. 2005, 51, 198. [Google Scholar] [CrossRef] [Green Version]
- McArdle, J.J. Latent growth curve analysis using structural equation modeling techniques. In Handbook of Research Methods in Developmental Science; Blackwell Publisher: Hoboken, NJ, USA, 2005. [Google Scholar] [CrossRef]
- Weller, B.E.; Bowen, N.K.; Faubert, S.J. Latent class analysis: A guide to best practice. J. Black Psychol. 2020, 46, 287–311. [Google Scholar] [CrossRef]
- Rost, J. Latent-class-analyse. Handb. Psychol. Diagn. 2006, 4, 275–287. [Google Scholar]
- Lubke, G.; Muthén, B.O. Performance of factor mixture models as a function of model size, covariate effects, and class-specific parameters. Struct. Equ. Model. A Multidiscip. J. 2007, 14, 26–47. [Google Scholar] [CrossRef]
- Dyussenbayev, A. Age Periods of Human Life. Adv. Soc. Sci. Res. J. 2017, 4, 258–263. [Google Scholar] [CrossRef] [Green Version]
- Yang, L.; Martikainen, P.; Silventoinen, K.; Konttinen, H. Association of socioeconomic status and cognitive functioning change among elderly Chinese people. Age Ageing 2016, 45, 674–680. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lee, Y.; Chi, I.; Palinkas, L.A. Retirement, leisure activity engagement, and cognition among older adults in the United States. J. Aging Health 2019, 31, 1212–1234. [Google Scholar] [CrossRef] [PubMed]
- Feng, Q.; Fong, J.H.; Zhang, W.; Liu, C.; Chen, H. Leisure activity engagement among the oldest old in China, 1998–2018. Am. J. Public Health 2020, 110, 1535–1537. [Google Scholar] [CrossRef] [PubMed]
- Zimmer, Z.; Hickey, T.; Searle, M.S. The pattern of change in leisure activity behavior among older adults with arthritis. Gerontol. 1997, 37, 384–393. [Google Scholar] [CrossRef]
- Burton, L.A.; Sumukadas, D. Optimal management of sarcopenia. Clin. Interv. Aging 2010, 5, 217–228. [Google Scholar]
- Best, J.R.; Nagamatsu, L.S.; Liu-Ambrose, T. Improvements to executive function during exercise training predict maintenance of physical activity over the following year. Front. Hum. Neurosci. 2014, 8, 353. [Google Scholar] [CrossRef] [Green Version]
- Daly, M.; McMinn, D.; Allan, J.L. A bidirectional relationship between physical activity and executive function in older adults. Front. Hum. Neurosci. 2015, 8, 1044. [Google Scholar] [CrossRef] [Green Version]
- Chen, Y.; Feeley, T.H. Social support, social strain, loneliness, and well-being among older adults: An analysis of the Health and Retirement Study. J. Soc. Pers. Relatsh. 2014, 31, 141–161. [Google Scholar] [CrossRef]
- Zhu, C.-E.; Zhou, L.; Zhang, X. Effects of Leisure Activities on the Cognitive Ability of Older Adults: A Latent Variable Growth Model Analysis. Front. Psychol. 2022, 13, 838878. [Google Scholar] [CrossRef]
- Fancourt, D.; Aughterson, H.; Finn, S.; Walker, E.; Steptoe, A. How leisure activities affect health: A narrative review and multi-level theoretical framework of mechanisms of action. Lancet Psychiatry 2021, 8, 329–339. [Google Scholar] [CrossRef]
- Abate, M.; Salini, V.; Schiavone, C. Achilles tendinopathy in elderly subjects with type II diabetes: The role of sport activities. Aging Clin. Exp. Res. 2016, 28, 355–358. [Google Scholar] [CrossRef]
- Zhao, W.; Ukawa, S.; Kawamura, T.; Wakai, K.; Ando, M.; Tsushita, K.; Tamakoshi, A. Health benefits of daily walking on mortality among younger-elderly men with or without major critical diseases in the new integrated suburban seniority investigation project: A prospective cohort study. J. Epidemiol. 2015, 25, 609–616. [Google Scholar] [CrossRef] [Green Version]
- Ghisletta, P.; Bickel, J.-F.; Lövdén, M. Does activity engagement protect against cognitive decline in old age? Methodological and analytical considerations. J. Gerontol. B Psychol. Soc. 2006, 61, P253–P256. [Google Scholar] [CrossRef]
- Lövdén, M.; Ghisletta, P.; Lindenberger, U. Social Participation Attenuates Decline in Perceptual Speed in Old and Very Old Age. Psychol. Aging 2005, 20, 423–434. [Google Scholar] [CrossRef] [Green Version]
- Kramer, A.F.; Bherer, L.; Colcombe, S.J.; Dong, W.; Greenough, W.T. Environmental influences on cognitive and brain plasticity during aging. J. Gerontol. 2004, 59, M940–M957. [Google Scholar] [CrossRef] [Green Version]
- Salthouse, T.A. Mental Exercise and Mental Aging Evaluating the Validity of the “Use It or Lose It” Hypothesis. Perspect. Psychol. Sci. 2006, 1, 68–87. [Google Scholar] [CrossRef]
- Kempermann, G.; Fabel, K.; Ehninger, D.; Babu, H.; Leal-Galicia, P.; Garthe, A.; Wolf, S.A. Why and how physical activity promotes experience-induced brain plasticity. Front. Neurosci. 2010, 4, 189. [Google Scholar] [CrossRef] [Green Version]
- Brett, L.; Traynor, V.; Stapley, P. Effects of physical exercise on health and well-being of individuals living with a dementia in nursing homes: A systematic review. J. Am. Med. Dir. Assoc. 2016, 17, 104–116. [Google Scholar] [CrossRef] [Green Version]
- Garber, C.E.; Blissmer, B.; Deschenes, M.R.; Deschenes, M.R.; Franklin, B.A.; Lamonte, M.J.; Lee, I.-M.; Nieman, D.C.; Swain, D.P. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med. Sci. Sports Exerc. 2011, 43, 1334–1359. [Google Scholar] [CrossRef]
- Jiménez-Pavón, D.; Carbonell-Baeza, A.; Lavie, C.J. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog. Cardiovasc. Dis. 2020, 63, 386. [Google Scholar] [CrossRef] [PubMed]
- Jopp, D.; Hertzog, C. Activities, self-referent memory beliefs, and cognitive performance: Evidence for direct and mediated relations. Psychol. Aging 2007, 22, 811–825. [Google Scholar] [CrossRef] [PubMed]
- Hultsch, D.F.; Hertzog, C.; Small, B.J.; Dixon, R.A. Use it or lose it: Engaged lifestyle as a buffer of cognitive decline in aging? Psychol. Aging 1999, 14, 245–263. [Google Scholar] [CrossRef] [PubMed]
- Rieker, J.A.; Reales, J.M.; Muiños, M.; Ballesteros, S. The effects of combined cognitive-physical interventions on cognitive functioning in healthy older adults: A systematic review and multilevel meta-analysis. Front. Hum. Neurosci. 2022, 112, 838968. [Google Scholar] [CrossRef] [PubMed]
- Ball, K.; Berch, D.B.; Helmers, K.F.; Jobe, J.B.; Leveck, M.D.; Marsiske, M.; Morris, J.N.; Rebok, G.W.; Smith, S.M.; Tennstedth, S.I.; et al. Effects of cognitive training interventions with older adults: A randomized controlled trial. JAMA 2002, 288, 2271–2281. [Google Scholar] [CrossRef] [PubMed]
- Dalgaard, C.; Hansen, C.W.; Strulik, H. Fetal origins—A life cycle model of health and aging from conception to death. Health Econ. 2021, 30, 1276–1290. [Google Scholar] [CrossRef]
- Bäckman, L.; Ginovart, N.; Dixon, R.A.; Wahlin TB, R.; Wahlin, Å.; Halldin, C.; Farde, L. Age-related cognitive deficits mediated by changes in the striatal dopamine system. Am. J. Psychiatry 2000, 157, 635–637. [Google Scholar] [CrossRef]
Variables | Definition | Mean (SD) |
---|---|---|
ADL | The total score of ADL (0~6) | 5.97 (0.29) |
IADL | The total score of IADL (0~8) | 7.04 (1.82) |
COG | The total score of cognitive ability (0~30) | 26.68 (−4.53) |
ADL disorder | The total score of ADL < 6 = 1; other = 0 | 0.13 (−0.33) |
IADL disorder | The total score of IADL < 8 = 1; other = 0 | 0.48 (−50) |
COG impairment | The total score of COG < 24 = 1; other = 0 | 0.20 (−40) |
Age | The true age of older adults in 2008 (61~108) | 75.37 (−28) |
Gender | male = 1; female = 0 | 0.46 (0.50) |
Region | urban = 1; rural = 0 | 0.08 (0.27) |
Living arrangement | living with family = 1; living alone = 2; living in an institution = 3 | 1.18 (0.40) |
Education | The years of schooling (0~20) | 2.75 (3.61) |
Marriage | married = 1; others = 0 | 0.60 (0.49) |
Smoking | smoked = 1; others = 0 | 0.36 (0.48) |
Alcohol drinking | drunk = 1; others = 0 | 0.35 (0.48) |
Income | Ln(salary) | 9.08 (1.29) |
Social security | yes = 1; no = 0 | 0.81 (0.39) |
Community service | The total score of community service (0~8) | 0.55 (1.28) |
Variables | Models | χ2(df) | p | CFI | RMSEA | SRMR | Model Comparison | p |
---|---|---|---|---|---|---|---|---|
LA | Linear model (1) | 557 (5) | <0.001 | 0.563 | 0.239 | 0.104 | / = 520.3 (4) | <0.005 |
Nonlinear model (2) | 36.7 (1) | <0.001 | 0.972 | 0.136 | 0.028 | |||
ADL | Linear model (3) | 115 (5) | <0.001 | 0.624 | 0.107 | 0.057 | / = 61.4 (4) | <0.005 |
Nonlinear model (4) | 53.6 (1) | <0.001 | 0.821 | 0.165 | 0.039 | |||
IADL | Linear model (5) | 225 (5) | <0.001 | 0.888 | 0.151 | 0.061 | / = 205.1 (4) | <0.005 |
Nonlinear model (6) | 19.9 (1) | <0.001 | 0.99 | 0.099 | 0.018 | |||
COG | Linear model (7) | 233 (5) | <0.001 | 0.824 | 0.154 | 0.095 | / = 213.9 (4) | <0.005 |
Nonlinear model (8) | 19.1 (1) | <0.001 | 0.986 | 0.097 | 0.019 |
Variables | Means of Growth Factors | Variance of Growth Factors | ||||
---|---|---|---|---|---|---|
Intercept | Slope | Quadratic | Intercept | Slope | Quadratic | |
LA | 21.90 *** | −1.61 *** | 8.27 *** | 0.22 | ||
20.66 *** | 1.98 *** | −1.16 *** | 4.61 | 0.78 | 0.20 | |
ADL | 5.97 *** | −0.13 *** | 0.04 *** | 0.05 *** | ||
5.97 *** | −0.01 | −0.06 *** | 0.10 *** | 0.13 ** | 0.01 | |
IADL | 7.19 *** | −0.62 *** | 1.52 *** | 0.24 *** | ||
7.01 *** | 0.08 | −0.26 *** | 1.88 *** | 1.13 ** | 0.14 *** | |
COG | 27.20 *** | −0.69 *** | 3.96 *** | 0.96 *** | ||
26.61 *** | 1.12 *** | −0.68 *** | 9.60 *** | 7.29 ** | 0.62 * |
Variables | ADL Disorder | IADL Disorder | COG Impairment | ||||||
---|---|---|---|---|---|---|---|---|---|
B | OR | 95% CI | B | OR | 95% CI | B | OR | 95% CI | |
Leisure activities | −0.08 *** | 0.92 *** | [0.9015, 0.9475] | −0.08 *** | 0.92 *** | [0.9062, 0.9360] | −0.11 *** | 0.90 *** | [0.8793, 0.9125] |
(0.01) | (0.01) | (0.01) | (0.01) | (0.01) | (0.01) | ||||
Community service | −0.02 | 0.98 | [0.9210, 1.0439] | 0.00 | 1.00 | [0.9574, 1.0462] | −0.07 * | 0.93 * | [0.8827, 0.9843] |
(0.03) | (0.03) | (0.02) | (0.02) | (0.03) | (0.03) | ||||
Age | 0.24 *** | 1.27 *** | [1.2332, 1.3176] | 0.20 *** | 1.22 *** | [1.1880, 1.2457] | 0.08 *** | 1.09 *** | [1.0611, 1.1139] |
(0.02) | (0.02) | (0.01) | (0.02) | (0.01) | (0.01) | ||||
Region | −0.21 | 0.81 | [0.4606, 1.4219] | −0.25 | 0.78 | [0.5113, 1.1959] | −0.13 | 0.88 | [0.5802, 1.3420] |
(0.29) | (0.23) | (0.22) | (0.17) | (0.21) | (0.19) | ||||
Living arrangement | −0.34 * | 0.71 * | [0.5367, 0.9430] | −0.24 * | 0.78 * | [0.6171, 0.9939] | −0.03 | 0.97 | [0.7651, 1.2393] |
(0.14) | (0.10) | (0.12) | (0.10) | (0.12) | (0.12) | ||||
Years of education | 0.04 | 1.04 | [0.9841, 1.1089] | −0.02 | 0.98 | [0.9441, 1.0267] | −0.03 | 0.97 | [0.9157, 1.0288] |
(0.03) | (0.03) | (0.02) | (0.02) | (0.03) | (0.03) | ||||
Marriage | −0.06 | 0.95 | [0.6158, 1.4530] | −0.38 * | 0.68 * | [0.5025, 0.9287] | −0.18 | 0.84 | [0.6005, 1.1622] |
(0.22) | (0.21) | (0.16) | (0.12) | (0.17) | (0.14) | ||||
Smoking | 0.02 | 1.02 | [0.6683, 1.5608] | 0.09 | 1.10 | [0.8258, 1.4595] | 0.03 | 1.03 | [0.7166, 1.4892] |
(0.22) | (0.22) | (0.15) | (0.16) | (0.19) | (0.19) | ||||
Alcohol drinking | 0.13 | 1.14 | [0.7836, 1.6497] | −0.08 | 0.92 | [0.7194, 1.1789] | −0.02 | 0.98 | [0.7326, 1.3182] |
(0.19) | (0.22) | (0.13) | (0.12) | (0.15) | (0.15) | ||||
Ln(income) | −0.04 | 0.96 | [0.9013, 1.0290] | −0.04 | 0.96 | [0.9194, 1.0064] | 0.02 | 1.02 | [0.9709, 1.0696] |
(0.03) | (0.03) | (0.02) | (0.02) | (0.03) | (0.03) | ||||
Social security | 0.02 | 1.02 | [0.7155, 1.4552] | 0.16 | 1.17 | [0.9190, 1.4999] | −0.08 | 0.92 | [0.6959, 1.2197] |
(0.18) | (0.18) | (0.13) | (0.15) | (0.14) | (0.13) |
Model | k | AIC | BIC | aBIC | Entropy | LMR | BLRT | Class Probabilities |
---|---|---|---|---|---|---|---|---|
1 C | 16 | 223,666.097 | 223,777.323 | 223,726.478 | —— | —— | —— | 1 |
2 C | 25 | 205,586.142 | 205,759.931 | 205,680.487 | 0.991 | 0.0000 | 0.0000 | 0.69262/0.30738 |
3 C | 34 | 200,001.442 | 200,237.795 | 200,129.750 | 0.987 | 0.0000 | 0.0000 | 0.56684/0.30363/0.12953 |
4 C | 43 | 200,464.376 | 200,763.293 | 200,626.648 | 0.984 | 0.9997 | 1.0000 | 0.54352/0.27241/0.10544/0.07863 |
Types of Health | Year | Type I (Relaxation) | Type II (Entertainment) | Type III (Intellectual-Learning) | p | p (1 vs. 2) | p (2 vs. 3) | p (1 vs. 3) |
---|---|---|---|---|---|---|---|---|
ADL disorder | 2008 | 0.03 | 0.00 | 0.02 | 0.0008 | <0.001 | 0.455 | 0.752 |
2011 | 0.12 | 0.07 | 0.09 | 0.0031 | 0.002 | 0.984 | 0.436 | |
2014 | 0.15 | 0.10 | 0.10 | 0.0016 | 0.004 | 1.000 | 0.056 | |
2018 | 0.31 | 0.14 | 0.12 | <0.001 | <0.001 | 1.000 | <0.001 | |
IADL disorder | 2008 | 0.42 | 0.24 | 0.18 | <0.001 | <0.001 | 0.284 | <0.001 |
2011 | 0.52 | 0.32 | 0.25 | <0.001 | <0.001 | 0.111 | <0.001 | |
2014 | 0.60 | 0.38 | 0.37 | <0.001 | <0.001 | 1.000 | <0.001 | |
2018 | 0.75 | 0.51 | 0.51 | <0.001 | <0.001 | 1.000 | <0.001 | |
COG impairment | 2008 | 0.22 | 0.11 | 0.03 | <0.001 | <0.001 | 0.014 | <0.001 |
2011 | 0.19 | 0.13 | 0.03 | <0.001 | 0.002 | 0.000 | <0.001 | |
2014 | 0.23 | 0.11 | 0.06 | <0.001 | <0.001 | 0.252 | <0.001 | |
2018 | 0.39 | 0.18 | 0.08 | <0.001 | <0.001 | 0.044 | <0.001 |
Variables | Low-Aged (60~74) | Middle-Aged (75~89) | High-Aged (≥90) |
---|---|---|---|
ADL disorder | 0.04 | −0.06 ** | −0.18 *** |
IADL disorder | −0.01 * | −0.08 *** | −0.20 *** |
COG impairment | −0.10 * | −0.11 *** | −0.14 *** |
Variables | p (Low-Aged vs. Middle Aged) | p (Middle-Aged vs. High Aged) | p (Low-Aged vs. High-Aged) |
---|---|---|---|
ADL disorder | 0.030 | 0.360 | <0.001 |
IADL disorder | 0.010 | 0.120 | <0.001 |
COG impairment | 0.040 | 0.390 | 0.020 |
(1) | (2) | (3) | |
---|---|---|---|
Variables | ADL ability | IADL ability | COG ability |
Leisure activities | 0.03 *** | 0.13 *** | 0.22 *** |
(0.003) | (0.006) | (0.014) |
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Zhu, C.; Walsh, C.; Zhou, L.; Zhang, X. Latent Classification Analysis of Leisure Activities and Their Impact on ADL, IADL and Cognitive Ability of Older Adults Based on CLHLS (2008–2018). Int. J. Environ. Res. Public Health 2023, 20, 1546. https://doi.org/10.3390/ijerph20021546
Zhu C, Walsh C, Zhou L, Zhang X. Latent Classification Analysis of Leisure Activities and Their Impact on ADL, IADL and Cognitive Ability of Older Adults Based on CLHLS (2008–2018). International Journal of Environmental Research and Public Health. 2023; 20(2):1546. https://doi.org/10.3390/ijerph20021546
Chicago/Turabian StyleZhu, Change, Christine Walsh, Lulin Zhou, and Xinjie Zhang. 2023. "Latent Classification Analysis of Leisure Activities and Their Impact on ADL, IADL and Cognitive Ability of Older Adults Based on CLHLS (2008–2018)" International Journal of Environmental Research and Public Health 20, no. 2: 1546. https://doi.org/10.3390/ijerph20021546