Social Participation and Psychological Well-Being Among Older Adults With Dementia

The positive physical, mental, and cognitive health effects of social participation in late life have been well established. However, the facilitators and barriers of social participation among older adults with dementia and the effects of social participation on their psychological well-being have been understudied. Using the cross-sectional 2023 National Health and Aging Trends Studies (N = 7,547; 13.2% of them classified as having possible or probable dementia), we examined the correlates of social participation among older adults with dementia, compared to those among their peers without dementia, the moderating effect of dementia on the associations between social participation and psychological well-being, and the mediation effects of SSNS and depressive/anxiety symptoms on the associations between social participation and psychological well-being among older adults with dementia. Results from linear regression models show negative associations between dementia and social participation (<i>B [SE]</i> = -0.36 [0.07], <i>t</i> = -5.38, <i>p</i> < .001 for possible dementia; <i>B [SE]</i> = -0.31 [0.09], <i>t</i> = -3.42, <i>p</i> = .001 for probable dementia). However, regardless of dementia status, higher education, larger social network, greater neighborhood social cohesion, and engagement in exercise were facilitators of social participation. Perceived health-related and transportation barriers and vision impairment among those with dementia were barriers to social participation. The positive association between social participation and psychological well-being (<i>B [SE]</i> = 0.18 [0.01], <i>t</i> = 13.01, <i>p</i> < .001) was not moderated by dementia status, although both possible and probable dementia were independently negatively associated with psychological well-being. Path model results show that among older adults with dementia, increased social network size (ratio of indirect to total effects = 0.13) and reduced depressive/anxiety symptoms (ratio of indirect to total effects = 0.17) mediated the association between social participation and psychological well-being. Implications of the findings for enhancing social participation among older adults with dementia are discussed.