Abstract
INTRODUCTION: To assist with aging in place, occupational therapy practitioners consider a range of factors that can affect future functional ability. Engagement in volunteering has often been associated with improved future functional ability, but the effect of total helping hours inclusive of volunteering and informal helping has received less attention. OBJECTIVE: To examine whether total hours helping others, inclusive of formal volunteering and informal helping, was associated with better future functional status. DESIGN: Time-to-event analysis (Cox regression) was conducted on data collected between May 2015 and August 2023 from the Understanding America Study (UAS), a U.S. internet-based longitudinal panel. PARTICIPANTS: UAS participants age 65 yr and older who did not report difficulties with activities of daily living (ADLs) at baseline (N = 2,434). MEASURES: Measures used included self-reports of ADL status, total hours helping others (i.e., volunteering, informal helping), an approximate indicator of physical capacity (i.e., level of engagement in moderate physical activity), an approximation of mental capacity (i.e., speed of digital device use), and self-reports of preexisting conditions. RESULTS: More hours helping others was associated with a subsequently lower risk of developing ADL difficulty at older ages, but the effect was no longer significant after accounting for differences in baseline cognitive capacity, physical capacity, and preexisting conditions. CONCLUSIONS AND RELEVANCE: Findings suggest that past helping behaviors may influence future functional status by improving intrinsic capacity and general health. To support aging in place, occupational therapy practitioners may consider encouraging older adult clients to engage in more hours formally or informally helping others. Plain-Language Summary: Older adults often prefer aging in place, but functional limitations can prevent this from being possible. Among older adults, volunteering has consistently been associated with improved functional status in the future. Informal helping, or helping people outside of one's household in a way that is not structured by an institution (e.g., a charity), has some evidence supporting its association with better physical functioning. In this article, we examine the effect of total time spent formally or informally helping others on future risk of developing difficulty with an activity of daily living. Among adults age 65 and older, more total time helping others was associated with lower risk of developing difficulty with an activity of daily living at older ages. The effect was no longer significant after accounting for an individual's baseline physical and mental capacity and general health. This may suggest that past helping behaviors could influence future functional status by improving intrinsic capacity and general health.