title: Depression is the strongest independent risk factor for poor social engagement among Chinese elderly veteran assisted-living residents.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Chia-Fen
authors.initials: CF
authors.lastname: Tsai
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Ouyang
authors.forename: Liang-Kung
authors.initials: LK
authors.lastname: Chen
authors.forename: Chung-Fu
authors.initials: CF
authors.lastname: Lan
authors.forename: Shinn-Jang
authors.initials: SJ
authors.lastname: Hwang
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Yang
authors.forename: Tung-Ping
authors.initials: TP
authors.lastname: Su
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012919:Social Behavior; D014728:Veterans / Q000523:psychology*