OBJECTIVES Although a substantive body of research has shown a protective association between leisure activities and cognitive function, consistent evidence is lacking about which specific types of activities should be promoted. The objective of this analysis was to examine the unique contribution of generative leisure activities, defined as activities motivated by “a concern for others and a need to contribute something to the next generation” (Erikson). DESIGN Cross-sectional survey. SETTING Peri-urban and rural area in southern Sri Lanka. PARTICIPANTS Community dwelling adults aged 60+ (n=252). MEASUREMENTS Main predictors were leisure activities grouped into generative, social, or solitary. Main outcome was cognitive function assessed with Montreal Cognitive Assessment (MoCA) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). RESULTS We found that more frequent engagement in generative leisure activities was associated with higher levels of cognitive function, independent of the impact of other social and solitary leisure activities. In a fully adjusted model combining all three leisure activities, generative activities independently predicted cognitive function as measured with the MoCA (β =0.47 (0.11 to 0.83) and the IQCODE (β = -0.81 (-1.54 to -0.09)). In this combined model, solitary activities were also independently associated with slower cognitive decline with the MoCA (β =0.40 (0.16, 0.64), but not with IQCODE (β =-0.38 (-0.88, 0.12)); the association with social activities did not reach statistical significance with either measure. These associations did not differ meaningfully by gender. CONCLUSION Generative leisure activities are a promising area for the development of interventions aimed at reducing cognitive decline among the elderly.
Female foreign domestic workers (FDWs) are an important and growing occupational group, especially in the Middle East. Although Sri Lankan female FDWs comprise a significant percentage of those employed in this region, little is known about the health issues this population experiences during their employment. Prompted by this dearth in the extant literature, this study aimed to explore self-reported health problems and perceived causes, as well as health behaviors, beliefs, coping, and concerns of Sri Lankan female FDWs through the narratives of returnees formerly employed in the Middle East. Implementing a multi-faceted qualitative approach, focus group discussions and in-depth interviews were utilized to investigate FDWs’ health problems, behaviors, and coping mechanisms. Participants’ health beliefs and concerns were explored through free listing and pile sorting. Data was analyzed using thematic analysis and descriptive statistics. Headaches, backache, irregular meals and symptoms of depression were the most frequently self-reported health issues, most commonly attributed to overwork. Cleanliness was the most commonly adopted health maintaining behavior. The presence of cultural health beliefs in terms of illness causation was revealed, and FDWs’ spoke of the perceived health benefits of social interaction and religious practice as coping strategies. Findings of this study have several implications for policy and future research. FDWs’ concerns and recommendations prompt the need for greater accountability, legal enforcement of policies, and strengthened training and health monitoring. Policy, prevention and intervention measures may be more effective if they consider FDWs’ self-reported health problems, health belief models, health maintaining behaviors, concerns and coping strategies
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