Leisure in late life : Patterns of participation and relationship with health

Sammanfattning: The overall aim of this thesis was to investigate aspects of leisure participation in late life. More specifically, differences in participation rates between two cohorts of older adults and changes in leisure activities from middle age to old age were examined, as well as the association between leisure activities and survival. All studies used nationally representative data from the Level of Livings Surveys (LNU) and SWEOLD studies, which together comprise a longitudinal database where individuals have been followed from 1968 to 2004. Forecasts have suggested that coming cohorts of older adults will be more active and resourceful than earlier cohorts. In line with this proposition, Study I showed that older individuals in 2002 were more engaged in leisure activities than their predecessors ten years earlier. The higher level of leisure participation was not due to improvements in health, since health status was worse in the more recent cohort. Despite the late-life transitions of retirement, bereavement and disability, individuals seem to preserve patterns of habits and activities with increasing age. Study II followed individuals over a 34-year period with regard to participation in different leisure activities. Although participation levels declined for the group as a whole, individuals maintained their activities to a large extent. Activities in middle age were more important than late-life functional ability in predicting leisure participation in old age. Thus, although there is considerable variation between individuals and activities, participation in old age is often a continuation of earlier participation. Positive effects of activities on well-being, health and survival have been reported. Studies III and IV investigated the association between activities and survival among older individuals. In Study III, people aged 65 and older and participating in only a few activities had a doubled mortality risk compared to those with the highest participation levels, even after controlling for age, education and health indicators. Women benefited more from activities involving social interaction, while men seemed to benefit from solitary activities. As late-life leisure activities seem to be a continuation of earlier habits, late-life benefits of activities may be due to earlier participation. Thus, Study IV examined the health associations with both earlier and recent activities. Individuals were followed for twenty years until the age of 77 or older. Recent and earlier participation in activities were analyzed with regard to four-year mortality. Stronger associations were found between recent leisure participation and survival, especially for men. Results remained after controls for age, education, health indicators, changes in health status, and lifestyle. Among women, earlier participation in activities involving social interaction was associated with a lower mortality risk. While men seemed to benefit from recent leisure participation in line with the disuse hypothesis, women benefited from earlier participation, supporting the reserve hypothesis. The expanding leisure pursuits of new cohorts will increase demands on authorities and organizations to provide opportunities for activity participation and to address accessibility issues. Considering the accumulated evidence suggesting health benefits from activities, especially physical and social activities, health promotion programs targeting middle-aged and older individuals may be worthwhile.