year 9, Issue 4 (Winter 2021)                   Ann Appl Sport Sci 2021, 9(4): 0-0 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Kim J, Park M. A Meta-Analysis of the Association between Leisure Participation and Depressive Symptoms among Older Adults. Ann Appl Sport Sci. 2021; 9 (4)
1- Recreation Professions Program, School of Human Sciences, Southern Illinois University, Carbondale, IL 62901 -4310 USA ,
2- Sport Administration Program, School of Human Sciences, Southern Illinois University, Carbondale, IL 62901 -4310 USA
Abstract:   (1404 Views)
Background. Depression is one of the major public health concerns among older adults. Participation in preferred leisure activities has been found to be effective for reducing the symptoms of depression among this population.
Objectives. The purpose of this study was to conduct a meta-analysis of the association between leisure participation and depression.
Methods. A systematic review of PubMed, Academic Search Complete, PsycINFO, and Google Scholar yielded 12 studies published between 2010 and 2020 (total participants = 10,681) that met the criteria for a meta-analysis. Comprehensive Meta-Analysis Software (CMA) was used to conduct the data analysis, and the correlation coefficient r was used as the effect size.
Results. The average effect size across all 12 studies was -.221 (Fisher’s Z = -5.696, P < .001), indicating that participation in leisure activities had a significant negative effect on depression for the elderly. In addition, the Q-value (116.003, P < .001) and the I-squared value (90.517) proved substantial heterogeneity between the 12 studies in the meta-analysis. The symmetrical funnel plot produced by the CMA analysis demonstrated a possible absence of publication bias.
Conclusion. This meta-analytic study reinforced the effectiveness of leisure participation in reducing the symptoms of depression among older adults.
Full-Text [PDF 274 kb]   (643 Downloads)    
• Considering the benefit of conducting meta-analysis by combining the results of multiple studies, it would be worthwhile to investigate the impact of leisure activities among different ethnic/cultural/gender groups to determine if the effect sizes are homogeneous.
• Additionally, the categorization or classification of preferred leisure activities can also be determined depending on different aspects of the group.
• Given our current study used depressive symptoms as a dependent variable, a future study may examine similar mental health outcomes including anxiety, distress, or sadness.
• The results of the present study may be applicable not only to older adults without disabilities but also to those who have specific disabilities (e.g., dementia, Alzheimer, or arthritis).
• A majority of older adults have limited access to leisure programs and are lacking social contacts outside their homes during the COVID-19 pandemic. Thus, it is important for health care and leisure professionals to develop preferred leisure activities that older adults can safely participate in during COVID-19 restrictions.

Type of Study: Systematic Review/Meta Analysis | Subject: Sport Psychology and its Related Branches
Received: 2020/12/15 | Accepted: 2021/02/11 | Published: 2021/12/28 | ePublished: 2021/12/28

1. United Nations (UN). World population aging: Highlights. 2020. Available from:
2. Wei J, Xie L, Song S, Wang T, Li C. Isotemporal substitution modeling on sedentary behaviors and physical activity with depressive symptoms among older adults in the U.S.: The national health and nutrition examination survey, 2007-2016. J Affect Disord. 2019;257:257-262. [DOI:10.1016/j.jad.2019.07.036] [PMID]
3. Gadzhanova S, Roughead EE, Pont LG. Antidepressant switching patterns in the elderly. Int Psychogeriatr. 2018;30(9):1365-1374. [DOI:10.1017/S1041610217002964] [PMID]
4. Olfson M, Marcus SC. National patterns in antidepressant medication treatment. Arch Gen Psychiatry. 2009;66(8):848-856. [DOI:10.1001/archgenpsychiatry.2009.81] [PMID]
5. Jung JY, Park SY, Kim JK. The effects of a client-centered leisure activity program on satisfaction, self-esteem, and depression in elderly residents of a long-term care facility. J Phys Ther Sci. 2018;30(1):73-76. [DOI:10.1589/jpts.26.73] [PMID] [PMCID]
6. Mahmud AA, Mubin O, Shahid S, Martens JB. Designing social games for children and older adults: two related case studies. Entertain Comput. 2010;1(3-4). [DOI:10.1016/j.entcom.2010.09.001]
7. Kang HW, Park M, Wallace Hernandez JP. The impact of perceived social support, loneliness, and physical activity on quality of life in South Korean older adults. J Sport Health Sci. 2018;7(2):237-244. [DOI:10.1016/j.jshs.2016.05.003] [PMID] [PMCID]
8. Vankova H, Holmerova I, Machacova K, Volicer L, Veleta P, Celko AM. The effect of dance on depressive symptoms in nursing home residents. J Am Med Dir Assoc. 2014;15(8):582-587. [DOI:10.1016/j.jamda.2014.04.013] [PMID]
9. Chang PJ, Wray L, Lin Y. Social relationships, leisure activity, and health in older adults. Health Psychol. 2014;33(6):516-523. doi: 10.1037/hea0000051 pmid: 24884905 [DOI:10.1037/hea0000051] [PMID] [PMCID]
10. Sala G, Jopp D, Gobet F, Ogawa M, Ishioka Y, Masui Y, et al. The impact of leisure activities on older adults' cognitive function, physical function, and mental health. PLoS One. 2019;14(11):e0225006. [DOI:10.1371/journal.pone.0225006] [PMID] [PMCID]
11. Lam MHS, Bik C, Cheung SY, Lee KY, Li WHC, Ho E, et al. A systematic review of recreation therapy for depression in older adults. J Psyc Psychother. 2017;7(2):000298. [DOI:10.4172/2161-0487.1000298]
12. Akobeng AK. Understanding systematic reviews and meta-analysis. Arch Dis Child. 2005;90(8):845-848. [DOI:10.1136/adc.2004.058230] [PMID] [PMCID]
13. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557-560. [DOI:10.1136/bmj.327.7414.557] [PMID] [PMCID]
14. Stanley TD. Wheat from chaff: Meta-analysis as quantitative literature review. J Econ Persp. 2001;15(3):131-150. [DOI:10.1257/jep.15.3.131]
15. Greenland S, O'Rourke K. Meta-analysis: modern Epidemiology. 3rd ed. Philadelphia (PA): Lippincott Williams; 2008.
16. Nimrod G, Kleiber DA, Berdychevsky L. Leisure in coping with depression. J Leis Res. 2017;44(4):419-449. [DOI:10.1080/00222216.2012.11950272]
17. Sharifian N, Gu Y, Manly JJ, Schupf N, Mayeux R, Brickman AM, et al. Linking depressive symptoms and cognitive functioning: The mediating role of leisure activity. Neuropsychology. 2020;34(1):107-115. [DOI:10.1037/neu0000595] [PMID] [PMCID]
18. Bradshaw M, Ellison CG, Fang Q, Mueller C. Listening to Religious Music and Mental Health in Later Life. Gerontologist. 2015;55(6):961-971. [DOI:10.1093/geront/gnu020] [PMID]
19. Chen SW, Chippendale T. Factors associated with IADL independence: implications for OT practice. Scand J Occup Ther. 2017;24(2):109-115. [DOI:10.1080/11038128.2016.1194464] [PMID]
20. Heo J, Ryu J, Yang H, Kim KM. Serious leisure and depression in older adults: a study of pickleball players. Leisure Stud. 2018;37(5):561-573. [DOI:10.1080/02614367.2018.1477977]
21. Lifshitz R, Nimrod G, Bachner YG. Internet use and well-being in later life: a functional approach. Aging Ment Health. 2018;22(1):85-91. [DOI:10.1080/13607863.2016.1232370] [PMID]
22. Lu L. Leisure Experiences and Depressive Symptoms Among Chinese Older People: A National Survey in Taiwan. Edu Gerontol. 2011;37(9):753-771. [DOI:10.1080/03601271003744632]
23. Mausbach BT, Chattillion E, Roepke SK, Ziegler MG, Milic M, von Kanel R, et al. A longitudinal analysis of the relations among stress, depressive symptoms, leisure satisfaction, and endothelial function in caregivers. Health Psychol. 2012;31(4):433-440. [DOI:10.1037/a0027783] [PMID] [PMCID]
24. Ouyang Z, Chong AM, Ng TK, Liu S. Leisure, functional disability and depression among older Chinese living in residential care homes. Aging Ment Health. 2015;19(8):723-730. [DOI:10.1080/13607863.2014.962009] [PMID]
25. Park MJ, Park NS, Chiriboga DA. A latent class analysis of social activities and health among community-dwelling older adults in Korea. Aging Ment Health. 2018;22(5):625-630. [DOI:10.1080/13607863.2017.1288198] [PMID]
26. Peterson RA, Brown SP. On the use of beta coefficients in meta-analysis. J Appl Psychol. 2005;90(1):175-181. [DOI:10.1037/0021-9010.90.1.175] [PMID]
27. Herrera AP, Meeks TW, Dawes SE, Hernandez DM, Thompson WK, Sommerfeld DH, et al. Emotional and cognitive health correlates of leisure activities in older Latino and Caucasian women. Psychol Health Med. 2011;16(6):661-674. [DOI:10.1080/13548506.2011.555773] [PMID] [PMCID]
28. Bax L, Yu LM, Ikeda N, Moons KG. A systematic comparison of software dedicated to meta-analysis of causal studies. BMC Med Res Methodol. 2007;7:40. [DOI:10.1186/1471-2288-7-40] [PMID] [PMCID]
29. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. The Atrium, Southern Gate, Chichester, West Sussex, UK: John Wiley & Sons; 2009. [DOI:10.1002/9780470743386]
30. Soeken KL, Sripusanapan A. Assessing publication bias in meta-analysis. Nurs Res. 2003;52(1):57-60. [DOI:10.1097/00006199-200301000-00009] [PMID]
31. Homberg F, McCarthy D, Tabvuma V. A meta-analysis of the relationship between public service motivation and job satisfaction. Public Adm Rev. 2015;75(5):711-722. [DOI:10.1111/puar.12423]
32. Poelke G, Ventura MI, Byers AL, Yaffe K, Sudore R, Barnes DE. Leisure activities and depressive symptoms in older adults with cognitive complaints. Int Psychogeriatr. 2016;28(1):63-69. [DOI:10.1017/S1041610215001246] [PMID] [PMCID]
33. World Health Organization (WHO). Coronavirus disease (COVID-19) 2020. Available from: 198.pdf?sfvrsn=f99d1754_2.
34. Nidadavolu L, Walston J. Underlying Vulnerabilities to the Cytokine Storm and Adverse COVID-19 Outcomes in the Aging Immune System. J Gerontol A Biol Sci Med Sci. 2020. [DOI:10.1093/gerona/glaa209] [PMID] [PMCID]
35. Fernandez RS, Crivelli L, Guimet NM, Allegri RF, Pedreira ME. Psychological distress associated with COVID-19 quarantine: Latent profile analysis, outcome prediction and mediation analysis. J Affect Disord. 2020;277:75-84. [DOI:10.1016/j.jad.2020.07.133] [PMID] [PMCID]
36. Yalon-Chamovitz S, Weiss PL. Virtual reality as a leisure activity for young adults with physical and intellectual disabilities. Res Dev Disabil. 2008;29(3):273-287. [DOI:10.1016/j.ridd.2007.05.004] [PMID]
37. Riverside. Healthy Aging. COVID-19: Keeping seniors engaged during social distancing. 2020. Available from:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2022 CC BY-NC 4.0 | Annals of Applied Sport Science

Designed & Developed by : Yektaweb