Relationship between engagement and level of functional status in older adults

Functional status is an important component of quality of life for older adults and for their caregivers. Factors associated with level of functional status include age, comorbidity, cognitive status, depression, social support, and activity. Of the types of activity linked with functional status, the strongest evidence is for physical exercise, with weaker evidence for social and productive activity. Engagement is a construct including motivation, commitment, and participation. OBJECTIVE The objective of this study was to determine whether or not engagement is associated with level of functional status after controlling for age, comorbidity, and depression among older adults. METHODS In all, 92 older adults were recruited from senior living centers and a university-based senior exercise group. The main independent variable was engagement. Other independent variables were age, comorbidity, and depression. The dependent variable was level of functional status. Two different measures of level of functional status were used: the Katz Activities of Daily Living Index and the Lawton-Brody Instrumental Activities of Daily Living Scale. RESULTS Engagement was a significant predictor of Lawton-Brody Instrumental Activities of Daily Living Scale level of function in the Lawton-Brody model (odds ratio: 1.147 (1.011-1.302)) and age was a significant negative predictor (odds ratio: 0.838 (0.769-0.914)). There were no significant predictors in the Katz model. CONCLUSION Engagement is a significant predictor of perfect Lawton-Brody Instrumental Activities of Daily Living Scale score after controlling for age, comorbidity, and depression. Health-care professionals should consider including engagement in their assessment of older clients, whether using formal instruments such as the Engagement with Meaningful Activity Survey or assessing informally.