Healthy Aging: Impact of Social Interaction on Psychological Well-Being in Older Adults— Longitudinal Study

1. Introduction

Health and Wellness is one of the Sustainable Development Goals that according to the 2016-2030 agenda The United Nations Organization approved to ensure a healthy life and promote the well-being of all at all ages for the construction of prosperous societies. In this sense and within the purposes that Higher Education Institutions have is to activate processes of intervention promotion in groups of vulnerability with the purpose of contributing to society with plans and interventions to improve each human process that generates a healthy life allowing to decrease physical and psychological diseases that increase higher rates of inequalities. One of the age groups that are within the group of vulnerability in the development of Health and Wellness are people over 65 years old. Both in Latin America and in European countries, studies have been conducted to observe psychological well-being at this stage of life (Bukov et al., 2002; Schwingel et al., 2009) and especially analyzing the role of social interaction in gerontological centers (Ferrand et al., 2014; Van Willingen, 2000).According to studies, it can be indicated that group dynamics can contribute to the development of psychological mechanisms that activate thoughts based on the contribution we give to the group and what we receive from it (Rubio L. et al., 2016). It is also suggested that for adults to carry out an optimal aging process they must remain active in their social relationships (Ferrand et al., 2014; La Guardia et al., 2000).

The United Nations General Assembly named the period 2021-2030 as the "Decade of Healthy Aging" from this the WHO leads shared mechanisms with various actors such as professionals, academia, media and governments to undertake efforts for actions that can promote longer and concerted lives (World Health Organizational , 2022). Prior to this, in 2017 the United Nations Organization registered approximately 962 million people over 60 years of age. According to studies, it is projected that in 2050 this figure will double to 2.1 billion and in 2100 it will triple to 3.1 billion (United Nation, 2017).

Globally, the aging rate has become an indicator of demographic structure by age. In the Latin American region, Chile is the most aged country, with 61 older adults for every 100 people under 15 years of age. The least aged country is Bolivia with 22 older adults for every 100 people under 15 years of age. In Ecuador, 7% of its inhabitants are over 65 years old, but by 2025 it will exceed 10%, which will place it among the countries with an aging population (INEC, 2017). In this sense Ecuador ranks fourth in Latin America with the highest level of aging. This result could indicate that life expectancy is increasing at the same time that the number of births is decreasing (Inclusión, 2019).

The Decade of Healthy Aging aims to mitigate the effects of aging on the older adult population. Since this age group is considered as an age group that presents high vulnerability indexes characterized by indicators of loneliness, cognitive and physical deterioration (Sentandreu-Mañó et al., 2022; Palomo-Vélez et al., 2020). In addition, stress, such as depression can cause disease or worsen it as it has been shown that high stress index can cause problems in the immune system (Dávila Hernándeza y González González, 2016).

On the contrary, positive emotions can cause well-being, the feeling of joy can generate improvement in certain pathologies or avoid them in adulthood (Alexander et al., 2021); In this sense the theories of perceived isolation, the need for social connection is an intensely rooted human particularity that has developed from different neural, hormonal and genetic mechanisms directly related to the social bond, the companionship that is crucial to ensure survival in life (Santini et al., 2020).

Social connection can generate positive emotions but as people advance in age, they may experience the physical absence of family and friends in various areas of life thus reducing social interaction (Charles y Cartensen, 2010) these experiences can produce loneliness which is considered a major health problem (Freedman y Nicolle, 2020) loneliness, in the older adult, can become a negative factor that impacts all dimensions of psychological well-being; but even more, loneliness, becomes a predictive component in difficulties in autonomy and pleasure (Sancho et al., 2022). On the other hand, socialization may increase with age (Cornwell et al., 2008), likewise socialization promotes active and healthy aging (Turcotte et al., 2018). Social Participation is related to significant associations with self-rated health and life satisfaction regardless of variables such as gender, age and socioeconomic status (Dawson-Townsend, 2019).

Different studies indicate that psychological well-being has yielded in recent years considerable theoretical and empirical development; (Sharifian y Grühn, 2018) as satisfaction with body and mind favors in older people an active attitude in everyday life and a sense of feeling needed (Kleinspehn-Ammerlahn y Kotter Grühn, 2008; Borglin et al., 2005). As older adults perceive their lives as meaningful and purposeful they develop greater longevity (Tymoszuk et al., 2020), better physical and mental health, as well as higher social engagement (Jia R.-x. et al., 2019); among other prse suggests people "should adopt physical activity and exercise to alleviate the negative impact of aging on their cognitive function" (Jia et al., 2019).

Berk's (2001) research has shown that humor produces psychological and physiological effects similar to aerobic exercise, likewise he mentions in the study by Law et al., (2018) that laughter has similar effects. In addition, an indicator of well-being is physical activity, which becomes a component that is associated with levels of resilience, greater positive affect and less depressive symptomatology (Ejiri et al., 2021; Carriedo et al., 2020). These components derived from self-esteem can become a predictor of subjective well-being (Zamarrón Cassinello, 2006). Research finds that active and healthy lifestyles increase life satisfaction (Kudo et al., 2007) and that life satisfaction is linked to a better perception of cognitive function (Rudolf et al., 2000; Okumiya et al., 1999 ),The confluence of these factors may favor a positive image of aging, which is associated with greater longevity and independence (Fernandez, 2003).

Social interaction and group activity provide life satisfaction to the elderly (García et al., 1996) (Villar et al., 2006) Social interaction can contribute to the development of psychological mechanisms that activate thoughts based on the contribution we give to the group and what is received from it (Rubio et al., 2016). Likewise, it is proposed that for adults to carry out an optimal aging process they must remain active in their social (Ferrada y Zavala, 2014); (La Guardia et al., 2000). According to (Wen Ku et al., 2016) physical activity has been widely established as a contribution to health and physical function.

Activity theory indicates that it is essential for older people to be active in social relationships to maintain good health (Engestrom, 2008) within the three dimensions of health is psychological well-being (Dixon y DIxon, 1984) participation in social activities correlate positively with psychological well-being (Fu et al., 2018) loneliness and social isolation are risk factors for psychological well-being (Shankar et al., 2015). Both in Latin America and elsewhere in the world, studies have been conducted to observe psychological well-being at this stage of life (Chang et al., 2020; Schwingel et al., 2009; Bukov et al., 2002) especially analyzing the role of social interaction in gerontological centers (Ferrand et al., 2014; Van Willingen, 2000). Psychological well-being is viewed as a result of social interaction or participation in activities such as music, thogeater (Tymoszuk et al., 2020) quality of life and psychological well-being increase as a result of physical activity and social integration (Clare et al., 2016). "Making' things accumulates more social contacts than looking at or listening to things. Making things refers to productivity and involves action and creativity and is often directed toward a certain end." Social capital and cognitive reserve are important factors in coping with declining cognitive abilities to maintain well-being in old age (Ihle et al., 2020).

Ryff (1989) operationalized a model of eudaimonic well-being composed of 6 dimensions: self-acceptance, positive relationships with other people, autonomy, mastery of the environment, purpose in life and personal growth. For their part, Vera Villarroel et al. (2012) observed, in a sample of 1,646 Latin American subjects between 18 and 90 years of age, that Ryff's original theoretical model is the one that best fit in all age groups. Also in older people, Tomás, Meléndez and Navarro (2009) showed that the 5- and 6-factor models showed very similar fit indices, so it would be problematic to choose one or the other (Didino et al., 2019). Over the years, the well-being construct has a broader approach, not only objective but also subjective, so there are reasons to analyze well-being in older adults. According to the study by Espinoza et al., (2018) suggests applying the Ryff scale to the older adult population in order to have a better understanding about the psychological well-being over the suggested population.

The purpose of this study is to evaluate psychological well-being in older adults participating in social interaction groups during the intervention period to determine longitudinally if there are significant differences at each time. In addition, to analyze whether the levels of psychological well-being are different between people over 65 years of age who attend the social interaction groups and those who do not attend. The study will allow us to establish an approximation to important indicators of psychological well-being in the study samples. The study questions have been posed as follows:

- H1: If older adults attend group dynamics programs, then they will improve their levels of psychological well-being over time.

H01: If older adults do not attend group dynamics programs, then they will not improve their levels of psychological well-being over time.

- H2: There are significant differences between the psychological well-being of the group of older adults who attend group dynamics programs with respect to the group that does not attend.

- H02: There are no significant differences between the psychological well-being of the group of older adults who attend group dynamics programs with respect to the group that does not attend.

Are there sociodemographic variables associated with social interaction components? We expect to identify significant differences associated with the variables gender, age, place of residence, and level of education.

2. Materials and Methods