COMMUNITY COHESION AND PSYCHOLOGICAL WELL-BEING AMONG ELDERS WITH AND WITHOUT DEMENTIA

摘要

Community cohesion, feelings of trust and belonging in physical living places, may encourage elders’ participation in social activities and enhance psychological well-being. Using two waves (R1, R2) of the National Health and Aging Trend Study, we examined the direct effect of community cohesion on psychological well-being and the indirect effect of social activity participation among elders living in the community. Both the dementia (n=806) and the no dementia (n=3754) groups rated community cohesion (R1) and psychological well-being (R2; quality of life, positive and negative affect). Elders also reported the number of social activities in the last month (visiting others, religious services, clubs/classes, going out for enjoyment) at R2. Stratified structural equation models were estimated for elders with and without dementia. For the dementia group, community cohesion had direct effects on quality of life (β=0.195, p<.001) and positive affect (β=0.19, p<.001), but not negative affect. For the no dementia group, community cohesion was directly associated with quality of life (β=0.175, p<.001), positive affect (β=0.15, p<.001), and negative affect (β=-0.14, p<.001). Indirect effects of social activity participation were found with quality of life (dementia group: β=0.05, p<.001; no dementia group: β=0.04, p<.001), positive affect (β=0.04, p<.001; β=0.04, p<.001), and negative affect (β=-0.04, p<.001; β=-0.03, p<.001) in elders with and without dementia, respectively. Better psychological well-being among elders with high levels of community cohesion was associated with increasing participation in social activities. These findings demonstrate the importance of developing and maintaining community-level social cohesion for sustaining well-being among elders regardless of dementia status.