Applied Evidence

Examination of Total Hours of Volunteering or Informal Helping Among Older Adults and Risk of Future Functional Disability Using Data From a Large Panel Study.

The American journal of occupational therapy : official publication of the American Occupational Therapy Association · 2026 · Cohort · OT

Raymond Hernandez, Stefan Schneider, Bart Orriens and 1 others

PMID 41576228

More hours helping others was linked to lower risk of daily-activity difficulty in 2,434 adults 65+, but the association disappeared once baseline cognitive and physical capacity and existing health conditions were included.

Those capacity measures stayed significant.

Key findings

1In the unadjusted model, each additional 100 hours of helping others per year was associated with a 26% lower probability of reporting a new daily-activity difficulty (hazard ratio 0.74, β = −0.30, 95% CI [−0.49, −0.12]).

2After adjusting for demographics, intrinsic capacity, and nine preexisting health conditions, the association between helping hours and future ADL difficulty was no longer statistically significant (β = −0.16, 95% CI [−0.34, −0.03]).

3In the fully adjusted model, greater cognitive processing speed (β = −0.22, 95% CI [−0.37, −0.06]) and more frequent moderate physical activity (β = −0.19, 95% CI [−0.34, −0.05]) each remained significant predictors of lower ADL difficulty risk.

Still to come

How it was doneWhat they foundWhat it means for OTs


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What it does not show

The sample is self-selected: only adults who could and chose to complete online surveys were included, so the findings may not extend to older adults with cognitive or physical limitations that would prevent regular online participation. Helping hours were self-reported and subject to social desirability and recall bias. The method of summing formal and informal helping hours into a single variable has not been used in prior research, so the association has not been replicated. Intrinsic capacity was approximated with only two proxies (digital response speed and one physical-activity frequency item) rather than formal multi-domain capacity measures. The panel is still growing, so participants entered at different times and had different numbers of follow-up waves (39% had only one wave), limiting the follow-up window for some.

The easy way to misread this

Do not read the 26% reduction in ADL difficulty risk as evidence that helping others independently protects against disability. The association disappeared once baseline cognitive speed, physical activity, and existing health conditions were included. The authors suggest this means people who help more started out with higher capacity and fewer conditions, rather than helping itself being protective.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →