Methods: Data was obtained from the New Haven, Connecticut site of a large U.S. survey that began in 1982 and was repeated in 1985 and 1988. The subject population numbered 2,812 non-institutionalized men and women age 65 and older in 1982, and was representative of the overall New Haven population. Data was collected for the following: basic socio-demographic information; social engagement, based on six questions measuring "productive activity" (including paid and volunteer work, gardening, and household chores) and six questions measuring social or leisure activities; physical activity levels, based on a subset of three of the social engagement questions; health status measures such as disease diagnoses, self-reported condition, and body mass index; and depression score based on a commonly used assessment tool (CES-D). The association between social engagement and depression scores, after controlling for the effects of all other variables, was measured for all periods, with a particular emphasis on the association between social engagement in the first period (1982) and depression scores thereafter.

Findings: High levels of social engagement were significantly associated with lower depression. The size of the effect of social engagement was reduced when marital status, functional disability, number of chronic conditions, and level of fitness activities - all potentially related to social engagement - were considered, but the effect of social engagement remained significant. With all of these variables accounted for, age was not found to be an important contributor to depression. Not only was the level of social engagement found to contribute to lower likelihood of depression, it also appeared to lead to smaller increases in depressive symptoms in subsequent measurements. Among individuals with low depression scores at baseline, those with the highest levels of social engagement in 1982 experienced the lowest rate of increase in depressive scores in the following six years to 1988.

Conclusions: Social engagement levels appear to have a significant protective effect against depression in the elderly who are not already depressed. Even after factors associated with social engagement such as marital status and chronic conditions are taken into account, those seniors who remain connected to their communities through volunteer work, or social and leisure activities are less likely to become depressed. Clinically, these results suggest that social engagement might be a target for interventions in elderly care programs. While pilot programs built with social engagement objectives in mind have been promising thus far, relatively little has been done to expand the effort beyond narrow clinical trials. This study suggests that founding new and expanding existing programs that promote social engagement could have a material benefit for the elderly.

Reference: Glass, TA, Mendes de Leon, CF, Bassuk, SS, and LF Berkman. "Social Engagement and Depressive Symptoms in Late Life" Journal of Ageing and Health, August 2006; 18(4) 604-628.

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