Effectiveness of religious activity on the quality of life and healthcare outcomes of adults aged 65 and older: a systematic review.
BACKGROUND
The impact of religious activities on individual's health and well-being has attracted the interest of the scientific community and scholars involved in religion-inspired cultural phenomena. As such, several observational studies investigated the relationship between these variables but findings were inconsistent to generate definitive conclusion regarding the link between religion and health/quality of life.


OBJECTIVE
The objective of this systematic review was to evaluate the impact of religious attendance on healthcare outcomes and quality of life of older adults aged 65 and older, living in either residential care units or the wider community.


METHODS
Studies were identified by electronic searches of Medline, CINAHL, PsychLit, EMBASE, Cochrane Collaboration Controlled Trials Register, Australian Medical Index, AUSThealth. Unpublished articles and the reference lists of included studies were also searched.


METHODS
Quantitative studies such as randomized controlled trials, before and after studies, cohort studies, cross-sectional studies and case control studies or case reports/series published in the English language between 1995-2007 were eligible for inclusion. Participants of interest included older adults aged 65 and over who were involved in some form of religious activity. Studies that evaluated at least one health variable, morbidity or mortality data were included. For evaluation of quality of life, validated single or multidimensional tools that addressed spiritual, physical, mental and/or emotional measures of well-being were considered.


METHODS
Studies were assessed for eligibility by the primary reviewer. Quality appraisal was carried out independently by the two reviewers where differences in opinion were resolved by discussion. Data extraction was performed by the primary reviewer. Heterogeneity of the studies prevented pooling of data for meta-analysis. A narrative summary of the study findings was presented.


RESULTS
A total of 34 observational studies were included in this review. In terms of physical health, frequent participation in religious activities appeared to be beneficial. Older persons who participate more frequently in religious activities were significantly less likely to smoke than those who engaged less frequently. In terms of alcohol use, however, studies revealed conflicting results. Participants who have higher religious participation rates demonstrated a slower rate of cognitive decline and dysfunction. Substantial evidence was found that religious service attendance had a protective effect against depression and poor mental health. Greater participation in religious activities is likewise associated with higher levels of life satisfaction. Furthermore, religious participation was associated with higher incidence of survival or lower rates of mortality.


CONCLUSIONS
Despite limitations in the studies that have been included, the evidence tends to support the salutary effects of religion on health and older persons' quality of life. Health care practitioners should consider the value of incorporating religious activities in the care of older adults. From the research perspective, there is still a need to conduct empirical controlled trials investigating the cause and effect relationship of religion and health and well-being of elderly people.
1. The Joanna Briggs Institute, Royal Adelaide Hospital, Adelaide, South Australia.
Lucylynn M
LM
Lizarondo
Craig
C
Lockwood