Depression is the strongest independent risk factor for poor social engagement among Chinese elderly veteran assisted-living residents

Background: Social engagement prolongs the lifespan and preserves cognition in the elderly. However, most studies concerning social engagement have been conducted in Western countries; few have been performed in the Chinese population. This study attempted to identify the risk factors for poor social engagement among elderly veterans in Taiwan.Methods: A total of 597 male veterans were enrolled, with a mean age of 80.8 +/- 5.0 years. This cross-sectional study employed the Resident Assessment Instrument (RAI) Minimum Data Set (MDS), the Geriatric Depression Scale-Short Form (GDS-SF), and the Mini-Mental State Examination (MMSE). Multivariate logistic regression analysis was done to investigate significant independent risk factors for poor social engagement, which were identified using the MDS Index of Social Engagement (ISE).Results: Mean ISE score was 1.5 +/- 1.3 (range, 0-5); 52% of subjects had poor levels of social engagement (ISE < 2; 312/597). Regression analyses suggested that depression (OR, 6.6; 95% CI, 2.7-16.1; p < 0.001), illiteracy (OR, 2.2; 95% CI, 1.3-3.8; p = 0.003), the presence of unsettled relationships (OR, 3.6; 95% CI, 1.5-8.7; p = 0.004), and cognitive impairment (OR, 2.0; 95% CI, 1.1-3.9; p = 0.03) were significant independent risk factors for poor social engagement, after controlling for age, marital status, level of daily living activity and degree of sensory impairment.Conclusion: Poor social engagement is common among Chinese assisted-living veteran home residents. Depression is the greatest risk factor of poor social engagement in this population.

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