Environment profiles, social participation patterns, depressive symptoms and quality of life of disabled older adults: a longitudinal investigation

Figures & data

Table 1. Means, standard deviations, characteristics of the sample.

Variables	T1	T1	T1	T2
	Total (N = 1,314)	Drop-out (N = 484)	With f/u (T2) (N = 830)	(N = 830)
Age (60–103)	79.16 (7.94)	80.16 (7.91)	78.58 (7.90)	80.19 (8.32)
Gender
-Male	32.4%	37.2%	29.6%	–
-Female	67.6%	62.8%	70.4%	–
Education
-No formal education	37.5%	37.8%	37.2%	–
-Elementary school	36.6%	35.7%	37.2%	–
-Junior high school or above	25.9%	26.3%	25.7%	–
Marital status
-With a spouse	39.8%	39.9%	39.8%	35.2%
Monthly income (NTD)
-Less than 5,999	27.3%	37.0%	27.4%	22.7%
−6,000 to 11,999	38.7%	38.8%	38.7%	39.2%
−12,000 to 17,999	19.7%	17.8%	20.8%	17.9%
−18,000 or above	14.3%	16.4%	13.1%	20.2%
ADL disability (0–18)	1.83 (2.31)	2.17 (2.50)	1.63 (2.16)	2.07 (2.42)
Cognitive impairment (0–10)	4.03 (4.03)	4.84 (4.71)	3.56 (3.71)	3.80 (4.48)
Social participation
Visit others	52.7%	44.4%	57.6%	53.3%
Invite others to home	60.0%	53.1%	64.0%	58.0%
Go out with others	53.8%	46.3%	58.2%	51.7%
Travel	36.8%	30.0%	40.7%	36.3%
Help others	33.9%	27.5%	37.6%	34.5%
Volunteering	19.8%	14.5%	22.9%	23.4%
Group activity	43.8%	37.2%	47.7%	43.6%
Religious activity	43.0%	37.0%	46.5%	40.1%
Active leisure	18.7%	15.7%	20.5%	18.3%
Physical exercise	45.3%	35.7%	50.8%	39.9%
Depressive symptoms (0–30)	9.99 (6.67)	10.57 (6.90)	9.65 (6.51)	9.69 (6.88)
QOL (11–50)	33.39 (6.33)	32.52 (6.50)	33.90 (6.18)	33.29 (6.50)

Note: ADL: activities of daily living; n.s: not significant; NTD: New Taiwan Dollars; QOL: quality of life.

* p≤ .05; **p≤ .01; ***p≤.001.

Table 2. Exploratory factor analysis for environment at T1 (N = 1,314).

Factors	Measure	Rate of being helpful (%)	Factor loading
Physical environment	Design and layout of home	46.7	0.705
	Design and layout of buildings and places used to go	33.8	0.779
	Natural environment (e.g. temperature, terrain, climate)	29.9	0.866
	Other aspects of surrounding (e.g. lighting, noise, crowds)	27.3	0.787
Information, transportation & medical care	Availability of public transportation	48.3	0.535
	Availability of health care services and medical care	71.5	0.930
	Availability of other information needed (e.g. social welfare)	56.6	0.686
Attitude & help: family	Assist from others at home	70.7	0.985
	Attitude of others at home	71.2	0.995
	Support and encouragement from other at home	70.5	0.971
Attitude & help: community	Assist from others in the community	68.7	0.967
	Attitude of others in the community	71.5	0.965
	Support and encouragement from others in the community	68.5	0.973
Programs & policies	Programs and services in the community	40.1	0.784
	Policies and rules of businesses and organizations in the community	29.1	0.880
	Government programs and policies	56.6	0.544
Model fit	$x_{\left(73\right)}^2$=302.096***; RMSEA = 0.049; CFI = 0.996; TLI = 0.991

Note: RMSEA: Root mean square error of approximation; CFI: Comparative fit index; TLI: Tucker-Lewis index.

***p≤.001.

Table 3. Model fit statistics for latent class analysis on environment and social participation.

Class	AIC	BIC	Entropy	LMR Test
T1 Environment profiles
2-class	15616.776	15787.744	0.586	517.126***
3-class	15521.760	15780.801	0.659	127.968***
4-class	15489.634	15836.750	0.642	65.588
T1 Social participation profiles
2-class	12667.855	12776.652	0.909	4114.830***
3-class	12137.131	12302.918	0.835	545.814***
4-class	12039.524	12262.300	0.802	118.111
T2 Social participation profiles
2-class	7893.31	7992.462	0.912	2758.380***
3-class	7489.700	7640.786	0.846	419.933***
4-class	7360.664	7563.685	0.844	149.020**

Note: AIC: Akaike Information Criterion; BIC: Bayesian Information Criterion; LMR: Lo-Mendell-Rubin.

* p≤ .05; **p≤ .01; ***p≤.001.

Table 4. Effects of personal factors, environment profiles, and social participation profiles on depressive symptoms and quality of life at T1 (N = 1,314).

	High-SP vs. Low-SP	Moderate-SP vs. Low-SP	Depressive symptoms		QOL
Variables	Model 1	Model 2	Model 3	Model 4	Model 5	Model 6
	OR (SE)	OR (SE)	b (SE)	b (SE)	b (SE)	b (SE)
Age	0.929 (0.013)***	0.982 (0.010)	−0.0608(.023)**	−0.084(.022)***	.051(.020)*	.080(.020)***
Gender (ref. male)	1.188 (0.295)	0.831 (0.144)	.250(.392)	.287(.385)	1.134(.348)***	1.072(.334)***
Education (ref. no formal education)
-Elementary school	0.958 (0.248)	1.016 (0.188)	−0.221(.420)	−0.203(.412)	.009(.373)	.001(.358)
-Junior high school or above	1.293 (0.389)	0.993 (0.217)	−1.270(.491)**	−1.148(.481)*	1.187(.435)**	1.030(.418)*
Marital status (ref. w/o a spouse)	1.714 (0.397)*	1.007 (0.168)	−1.092(.375)**	−0.878(.370)*	.709(.333)*	.418(.321)
Monthly income (ref. less than NTD 5,999)
−6,000 to 11,999	1.255 (0.337)	0.757 (0.142)	.314(.423)	.369(.416)	−0.503(.375)	−0.589(.361)
−12,000 to 17,999	1.556 (0.496)	0.774 (0.176)	.860(.511)	.946(.501)	−0.379(.453)	−0.490(.435)
−18,000 or above	0.686 (0.263)	0.761 (0.186)	1.735(.570)**	1.528(.560)**	−0.289(.506)	−0.040(.487)
ADL disability	0.550 (0.027)***	0.748 (0.0190)***	.452(.043)***	.291(.048)***	−0.465(.038)***	−0.268(.042)***
Cognitive impairment	0.823 (0.048)***	0.881 (0.034)***	.174(.083)*	.123(.082)	−0.472(.074)***	−0.406(.071)***
Environment profiles (ref. Weakly-FE)
-Moderately-FE	0.771 (0.316)	1.799 (0.528)*	−2.752(.635)***	−2.689(.624)***	2.985(.564)***	2.906(.543)***
-Highly-FE	3.667 (1.566)**	3.410 (1.075)***	−3.933(.675)***	−3.323 (.668)***	5.650(.600)***	4.890(.581)***
Social Participation profiles (ref. low-SP)
- Moderate-SP				−2.021(.424)***		2.317(.368)***
-High-SP				−3.786(.521)***		4.787(.453)***
Log likelihood	−297.57	−564.282	−4239.2461	−4212.7528	−4073.3165	−4019.4039
AIC	623.156	1158.564	8510.492	8461.506	8178.633	8074.808
BIC	689.704	1232.624	8593.361	8554.733	8261.478	8168.008

Note: SP: social participation; FE: facilitating environment; OR: odds ratio; AIC = Akaike Information Criterion; BIC: Bayesian Information Criterion.

* p≤ .05; **p≤ .01; ***p≤.001.

Table 5. Effects of T1 personal factors, T1 environment profiles, and T2 social participation profiles on T2 depressive symptoms and quality of life (N = 830).

	T2 High-SP vs. Low-SP	T2 Moderate-SP vs. Low-SP	T2 Depressive symptoms		T2 QOL
	Model 1	Model 2	Model 3	Model 4	Model 5	Model 6
T1 variables	OR (SE)	OR (SE)	b (SE)	b (SE)	b (SE)	b (SE)
Depressive symptoms			0.454(0.035)***	0.415 (0.034)***	–	–
Quality of life			–	–	0.444(0.036)***	0.390(0.036)***
Age	0.921(0.170)***	0.981 (0.012)	−0.005(0.028)	−0.042(0.028)	−0.011(0.026)	0.022(0.026)
Gender (ref. male)	1.189(0.354)	1.021(0.211)	−0.092(0.474)	−0.004(0.460)	0.335(0.444)	0.330(0.429)
Education (ref. no formal education)
-Elementary school	0.880(0.281)	0.938(0.205)	−0.372(0.501)	−0.399(0.486)	0.667(0.464)	0.666(0.448)
-Junior high school or above	0.716(0.279)	1.153(0.289)	−0.787(0.595)	−0.878(0.578)	0.955(0.546)	1.086(0.529)*
Marital status (ref. w/o a spouse)	3.836(1.119)***	1.364(0.278)	−1.188(0.450)**	−0.662(0.444)	1.250(0.415)**	0.786(0.408)
Monthly income (ref. less than NTD 5,999)
−6,000 to 11,999	1.875(0.615)	1.162(0.256)	−0.716(0.509)	−0.432(0.495)	0.724(0.473)	0.506(0.459)
−12,000 to 17,999	2.062(0.798)	0.900(0.240)	−0.811(0.607)	−0.599(0.591)	1.089(0.561)	0.960(0.544)
−18,000 or above	1.065(0.496)	1.084(0.326)	−0.285(0.702)	−0.267(0.681)	−0.001(0.648)	−0.002(0.626)
ADL disability	0.578(0.040)***	0.841(0.023)***	0.279(0.059)***	0.124(0.062)*	−0.273(0.056)***	−0.128(0.057)*
Cognitive impairment	0.816(0.062)**	0.931(0.041)	−0.063(0.108)	−0.120(0.105)	−0.129(0.102)	−0.094(0.098)
Environment profiles (ref. Weakly-FE)
-Moderately-FE	1.843(1.076)	1.347(0.477)	−0.256(0.831)	−0.124(0.806)	0.354(0.774)	0.317(0.747)
-Highly-FE	6.423(3.913)**	2.405(0.920)*	−1.007(0.880)	−0.379(0.858)	0.915(0.827)	0.460(0.801)
T2 Variables
Social participation profiles (ref. low-SP)
- Moderate-SP				−2.032(0.491)***		2.740(0.454)***
-High-SP				−4.226(0.593)***		3.850(0.553)***
Log likelihood	−220.958	−376.436	−2576.370	−2551.692	−2522.453	−2491.101
AIC	782.872	782.8715	5186.741	5141.384	5078.907	5020.203
BIC	848.975	848.9747	5266.632	5230.674	5158.861	5109.540

Note: SP: social participation; FE: facilitating environment; OR: odds ratio; AIC: Akaike Information Criterion; BIC: Bayesian Information Criterion.

* p≤ .05; **p≤ .01; ***p≤.001.

Figure 1. 3-class environment profiles at T1.

Figure 2. 3-class social participation profiles at T1.

Figure 3. 3-class social participation profiles at T2.