SRDR+

1. Review ID

(surname of first author and year first full report of study was published e.g. Smith 2001)


	Anderson 2014

2. Review title


	The Benefits Associated With Volunteering Among Seniors: A Critical Review and Recommendations for Future Research

3. Date form completed


	14/08/22

4. Initials of person extracting


	KH

5. Review funding source


	This research was supported by Grant MOP 97844 from the Canadian Institutes of Health Research

6. Possible conflicts of interest


	None stated

7. Aim of review


	To review critically the evidence on the benefits associated with formal volunteering among older adults, propose a theoretical model of how volunteering may reduce functional limitations and dementia risk, and offer recommendations for future research.

8. Number of databases searched


	4

9. Names of databases searched; date ranges of databases searched


	PsycInfo, Scopus, PubMed, and MedLine; prior to April 2014

10. Date of last search


	April 2014

11. Number of included studies


	73

12. Exclusion criteria for participants

(e.g age, comorbidities) 


	studies were included if they involved older adults (defined liberally as age 50+), either alone or in direct comparison with younger cohorts; thus, articles that sampled volunteers from across the adult lifespan but did not analyze the results as a function of age were excluded.

13. Exclusion criteria for volunteering

(e.g type of volunteering, for a specific organistion/purpose)


	Review restricted to formal volunteering, which the International Labour Organization (2011) defines as “unpaid noncompulsory work; that is, time individuals give without pay to activities performed either through an organization or directly for others outside their own household” (p. 13). Articles focusing on informal volunteering (e.g., care giving, providing social support to friends, family, and neighbors) or on membership in voluntary associations or groups (e.g., the YMCA) were excluded.

14. Exclusion criteria for study type


	Studies had to have a nonvolunteering control group; studies that lacked this control were excluded. One important exception to these criteria was that authors included descriptive studies (both qualitative and quantitative) of the benefits of volunteering.

15. Exclusion criteria for outcome measures


	Only studies that examined the correlates of formal volunteering, distinct from or in comparison to other productive activities such as working, belonging to community groups, and so forth, were included; thus, studies that merged volunteering with other productive activities were excluded. Studies that examined only demographic differences between older volunteers and nonvolunteers or older adults’ motivations for or barriers to volunteering were excluded. One additional study that summed survey items across different benefit types was also excluded. Importantly, this review focuses on the benefits associated with volunteering and not its potential costs. This review only analyses that controlled for or included in the statistical models demographic characteristics (e.g., age, gender, education, income) when it was possible for the authors to do so.

16. Outcomes studied

(select all that apply)


	Psychological Physical Social General

17. Primary reported outcomes


	Psychosocial, physical, and cognitive functioning

18. Secondary reported outcomes (if applicable)


	Functional decline/dementia

19. Number of participants included in the review


	Not reported as a whole

20. Review’s included study type (% of quant studies)


	17 descriptive studies (both qualitative and quantitative) 14 Cross sectional studies 36 Prospective cohort (longitudinal) studies 1 Randomised controlled trial (reported in 6 papers)

21. Included studies countries of publication


	Not reported as a whole (USA, Spain, Canada, England, Wales, New Zealand, Australia, Israel, Europe, Taiwan)

22. Range of included studies years of publication


	Not reported as a whole (1968-2014)

23. Review’s population

(age, ethnicity, SES)


	Various reported by individual study, aged 50 +

24. Social outcomes reported


	Volunteering has been associated with greater life satisfaction (descriptive: Jirovec & Hyduk, 1998; Newman, Vasudev, & Onawola, 1985; but see Young & Janke, 2013; cross-sectional: Aquino, Russell, Cutrona, & Altmaier, 1996; Bond, 1982; Hunter & Linn, 1980-81; McMunn et al., 2009; Pilkington et al., 2012; Windsor et al., 2008; but see Shmotkin et al., 2003; prospective cohort: ACL: Thoits & Hewitt, 2001; Van Willigen, 2000; other: Kahana et al., 2013; but see Menec, 2003). However, it should be noted that the bulk of the evidence in favour of an association between senior volunteering and both positive affect (see below) and life satisfaction comes from cross-sectional rather than prospective cohort or randomised controlled trials. Volunteerism among seniors has been related to improvements in social support and social networks. Descriptive studies have consistently found senior volunteers to report that their volunteering allowed them to meet new people, make friends, and develop a sense of community (Arnstein et al., 2002; Hainsworth & Barlow, 2001; Kerschner & Rousseau, 2008; Misener, Doherty, & Hamm-Kerwin, 2010; Morrow-Howell, Kinnevy, & Mann, 1999; Narushima, 2005; Piercy et al., 2011; but see Young & Janke, 2013). This same association between seniors’ volunteering and improved social networks or support has been reported in crosssectional studies (Aquino et al., 1996; Shmotkin et al., 2003; but see Carp, 1968). Moreover, measures of the quantity and quality of social support completely mediated the above-mentioned greater life satisfaction among seniors who volunteered compared to seniors who did not volunteer reported by Aquino et al. (1996) and Pilkington et al. (2012).

Volunteering has been associated with greater life satisfaction (descriptive: Jirovec & Hyduk, 1998; Newman, Vasudev, & Onawola, 1985; but see Young & Janke, 2013; cross-sectional: Aquino, Russell, Cutrona, & Altmaier, 1996; Bond, 1982; Hunter & Linn, 1980-81;
McMunn et al., 2009; Pilkington et al., 2012; Windsor et al., 2008; but see Shmotkin et al., 2003; prospective cohort: ACL: Thoits & Hewitt, 2001; Van Willigen, 2000; other: Kahana et al., 2013; but see Menec, 2003). However, it should be noted that the bulk of the evidence in favour of an association between senior volunteering and both positive affect (see below) and life satisfaction
comes from cross-sectional rather than prospective cohort or randomised controlled trials.
Volunteerism among seniors has been related to improvements in social support and social networks. Descriptive studies have
consistently found senior volunteers to report that their volunteering allowed them to meet new people, make friends, and develop
a sense of community (Arnstein et al., 2002; Hainsworth & Barlow, 2001; Kerschner & Rousseau, 2008; Misener, Doherty, & Hamm-Kerwin, 2010; Morrow-Howell, Kinnevy, & Mann, 1999; Narushima, 2005; Piercy et al., 2011; but see Young & Janke, 2013). This same association between seniors’ volunteering and improved social networks or support has been reported in crosssectional
studies (Aquino et al., 1996; Shmotkin et al., 2003; but see Carp, 1968). Moreover, measures of the quantity and quality of
social support completely mediated the above-mentioned greater life satisfaction among seniors who volunteered compared to seniors who did not volunteer reported by Aquino et al. (1996) and Pilkington et al. (2012).

25. Social outcomes not supported

(e.g cited as non-significant)


	While improvements in self-esteem or a sense of mastery associated with volunteering in seniors have not been found in the two cross-sectional studies that have included these measures (Hunter & Linn, 1980–1981; Krause et al., 1992), these associations have been identified in both descriptive and prospective cohort studies (descriptive: Arnstein, Vidal, Wells-Federman, Morgan, & Caudill, 2002; Hainsworth & Barlow, 2001; Morrow-Howell, Hong, & Tang, 2009; Newman et al., 1985; prospective cohort: ACL: Li, 2007; Thoits & Hewitt, 2001; but see Han & Hong, 2013). Two other studies measured other closely related concepts. In the descriptive study by Celdrán and Villar (2007), only seniors volunteering for social services or cultural organizations, and not for a management organization, endorsed feeling useful and self-fulfilled as benefits of their volunteering. Similarly, in the cross-sectional study by Okun et al. (2011), seniors who volunteered reported greater resilience than did their nonvolunteering counterparts. The attrition in the control group may mitigate firm conclusions about the effects of volunteering on feelings of social support.

While improvements in self-esteem or a sense of mastery associated with volunteering in seniors have not been found in the two
cross-sectional studies that have included these measures (Hunter & Linn, 1980–1981; Krause et al., 1992), these associations have been identified in both descriptive and prospective cohort studies (descriptive: Arnstein, Vidal, Wells-Federman, Morgan, & Caudill,
2002; Hainsworth & Barlow, 2001; Morrow-Howell, Hong, & Tang, 2009; Newman et al., 1985; prospective cohort: ACL: Li,
2007; Thoits & Hewitt, 2001; but see Han & Hong, 2013). Two other studies measured other closely related concepts. In the descriptive study by Celdrán and Villar (2007), only seniors volunteering for social services or cultural organizations,
and not for a management organization, endorsed feeling useful and self-fulfilled as benefits of their volunteering. Similarly,
in the cross-sectional study by Okun et al. (2011), seniors who volunteered reported greater resilience than did their nonvolunteering
counterparts.
The attrition in the control group may mitigate firm conclusions about the effects of volunteering on feelings of social support.

26. Physical outcomes reported


	Cross-sectional studies have reported that older adults who volunteer report better physical health than do their nonvolunteering counterparts. Moreover, improvements in self-reported physical health associated with volunteering have been identified in both descriptive and prospective studies. Using data from the ACL study, Van Willigen (2000) reported that improvements in physical health over time were more than 2.5 times greater among volunteers over the age of 60 than they were in their younger volunteering counterparts. The prospective studies have also identified increasing improvements in physical health ratings with increasing volunteer hours (ACL: Tang, 2009), up to a point, beyond which the benefit tapers off (ACL: Morrow-Howell et al., 2003; Thoits & Hewitt, 2001; Van Willigen, 2000; AHEAD: Luoh & Herzog, 2002; Lum & Lightfoot, 2005). Similar benefits of volunteering have been reported for maintenance of functional independence (basic and instrumental activities of daily living). Prospective cohort studies and the Experience Corps study (Hong & Morrow-Howell, 2010) have all reported associations between volunteering and reductions in functional limitations. Indeed, in the ACL study, this relationship was magnified with increased volunteer hours and the prototypical relationship between increasing age and increasing functional dependency was found to be weaker among volunteers than nonvolunteers. A moderate amount of volunteering has been shown to be related to less hypertension at least among Caucasian volunteers —over time in the HRS prospective cohort study, and fewer hip fractures among seniors who volunteer than among their matched nonvolunteering peers. Other studies have repeatedly (with a few exceptions) found volunteering to be inversely associated with the final arbiter of health—mortality—within the period of time prospectively observed.

Cross-sectional studies have reported that older adults who volunteer report better physical health than do their nonvolunteering
counterparts. Moreover, improvements in self-reported physical health associated with volunteering have been identified in both descriptive and prospective studies. Using data from the ACL study, Van Willigen (2000) reported that improvements in physical health over time were more than 2.5 times greater among volunteers over the age of 60 than they were in their younger volunteering counterparts. The prospective studies have also identified increasing improvements in physical health ratings with increasing volunteer hours (ACL: Tang, 2009), up to a point, beyond which the benefit tapers off (ACL: Morrow-Howell et al., 2003; Thoits & Hewitt, 2001; Van Willigen, 2000; AHEAD: Luoh & Herzog, 2002; Lum & Lightfoot, 2005).
Similar benefits of volunteering have been reported for maintenance of functional independence (basic and instrumental activities
of daily living). Prospective cohort studies and the Experience Corps study (Hong & Morrow-Howell, 2010) have all reported associations between volunteering and reductions in functional limitations. Indeed, in the ACL study, this relationship was magnified with increased volunteer hours and the prototypical relationship between increasing age and increasing functional dependency was found to be weaker among volunteers than nonvolunteers. A moderate amount of volunteering has been shown to be related to less hypertension at least among Caucasian volunteers —over time in the HRS prospective cohort study, and fewer hip fractures among seniors who volunteer than among their matched nonvolunteering peers.
Other studies have repeatedly (with a few exceptions) found volunteering to be inversely associated with the final arbiter of health—mortality—within the period of time prospectively observed.

27. Physical outcomes not supported

(e.g cited as non-significant)


	There are three exceptions to this pattern of volunteering being associated with better self-reported health. The descriptive studies by Jirovec and Hyduk (1998) and Young and Janke (2013) combined questions about number of days of illness and functional capacity and used a gross 3-point scale, respectively, and one could argue that neither is a particularly sensitive measure of overall health. In addition, in one report of the Experience Corps data, participants in that study showed smaller declines in physical health than a matched comparison sample from the HRS study, but these differences were not significant (Hong & Morrow-Howell, 2010). However, associations between volunteering and maintenance of physical health may have been underestimated in that comparison, as the researchers did not exclude participants who volunteered from the HRS comparison sample. Neither the number of selfreported physician-diagnosed medical conditions (Shmotkin et al., 2003; Tang, 2009; Lum & Lightfoot, 2005) nor rates of admission to a nursing home (Lum & Lightfoot, 2005) have been found to associate with volunteering.

There are three exceptions to this pattern of volunteering being associated with better self-reported health. The descriptive studies by Jirovec and Hyduk (1998) and Young and Janke (2013) combined questions about number of days of illness and functional capacity and used a gross 3-point scale, respectively, and one could argue that neither is a particularly sensitive measure of overall health. In addition, in one report of the Experience Corps data, participants in that study showed smaller declines in physical health than a matched comparison sample from the HRS study, but these differences were not significant (Hong & Morrow-Howell, 2010). However, associations between volunteering and maintenance of physical health may have been underestimated in that comparison, as the researchers did not exclude participants who volunteered from the HRS comparison sample.
Neither the number of selfreported physician-diagnosed medical conditions (Shmotkin et al., 2003; Tang, 2009; Lum & Lightfoot, 2005) nor rates of admission to a nursing home (Lum & Lightfoot, 2005) have been found to associate with volunteering.

28. Psychological outcomes reported


	The majority of studies on the benefits associated with volunteering among older adults have reported psychosocial outcomes. A number of cross-sectional and prospective cohort studies, together with the Experience Corps study, have reported positive associations between volunteering and reduced symptoms of depression. Many studies have also found volunteering to be associated with higher levels and improvements in seniors’ positive affect or happiness (descriptive: Larkin, Sadler, & Mahler, 2005; cross-sectional: Dulin, Gavala, Stephens, Kostick, & McDonald, 2012; McIntosh & Danigelis, 1995; Okun, Rios, Crawford, & Levy, 2011; Pilkington et al., 2012; Windsor et al., 2008; but see Carp, 1968; prospective cohort: ACL: Thoits & Hewitt, 2001; AHEAD: Fonda & Herzog, 2001; other: Kahana et al., 2013; but see Menec, 2003). Improvements in composite measures of psychological wellbeing have been reported in prospective cohort studies of volunteering (Choi & Kim, 2011; WLS: Piliavin & Siegl, 2007), and a number of studies have reported an association between volunteering and better maintenance of quality of life (descriptive: Morrow-Howell et al., 2009; cross-sectional: McMunn et al., 2009; Wahrendorf et al., 2006; prospective cohort: Wahrendorf & Siegrist, 2010). In three descriptive qualitative studies, seniors reported existential benefits of volunteering; participants reported that their volunteering gave them the opportunity to refine their selfdefinition and reexamine what was important in their lives (Cook, 2013; Narushima, 2005; Piercy, Cheek, & Teemant, 2011).

The majority of studies on the benefits associated with volunteering among older adults have reported psychosocial outcomes. A number of cross-sectional and prospective cohort studies, together with the Experience Corps study, have reported positive associations between volunteering and reduced symptoms of depression.
Many studies have also found volunteering to be associated with higher levels and improvements in seniors’ positive affect or happiness (descriptive: Larkin, Sadler, & Mahler, 2005; cross-sectional: Dulin, Gavala, Stephens, Kostick, & McDonald, 2012; McIntosh & Danigelis, 1995; Okun, Rios, Crawford, & Levy, 2011; Pilkington et al., 2012; Windsor et al., 2008; but see Carp, 1968; prospective cohort: ACL: Thoits & Hewitt, 2001; AHEAD: Fonda & Herzog, 2001; other: Kahana et al., 2013; but see Menec, 2003).
Improvements in composite measures of psychological wellbeing have been reported in prospective cohort studies of volunteering (Choi & Kim, 2011; WLS: Piliavin & Siegl, 2007), and a number of studies have reported an association between volunteering
and better maintenance of quality of life (descriptive: Morrow-Howell et al., 2009; cross-sectional: McMunn et al., 2009; Wahrendorf
et al., 2006; prospective cohort: Wahrendorf & Siegrist, 2010). In three descriptive qualitative studies, seniors reported existential benefits of volunteering; participants reported that their volunteering gave them the opportunity to refine their selfdefinition
and reexamine what was important in their lives (Cook, 2013; Narushima, 2005; Piercy, Cheek, & Teemant, 2011).

29. Psychological outcomes not supported

(e.g cited as non-significant)


	The one exception to this association between volunteering and lower levels of depression is a cross-sectional study reported by Shmotkin et al. (2003), who found that although their participants who volunteered reported less depression than those who did not volunteer, this difference was reversed after controlling for sociodemographic variables, the self-reported amount of physical and other everyday activity in participants’ lives, and other functional markers including subjective health, social support, and life satisfaction.

30. General outcomes reported

(i.e general health and wellbeing)

31. General outcomes not supported

(e.g cited as non-significant) 

32. Interactions reported

(i.e between each other or demographic variables)


	See results above

33. Was a meta-analysis performed?

34. Number of included studies in the meta-analysis

35. Heterogeneity

(e.g I squared)

36. Pooled estimates

37. Confidence intervals (95%)

38. Key conclusions from study authors


	Volunteering is associated with reduced symptoms of depression, better self-reported health, fewer functional limitations, and lower mortality. The extant evidence provides the basis for a model proposing that volunteering increases social, physical, and cognitive activity (to varying degrees depending on characteristics of the volunteer placement) which, through biological and psychological mechanisms, leads to improved functioning; we further propose that these volunteering-related functional improvements should be associated with reduced dementia risk.

39. Review limitations


	Non stated by authors but no meta analysis, mixed study design, no protocol, not dual sifted/extracted etc.

40. AMSTAR 2 quality appraisal rating


	-12

41. Quality appraisal tool used by review (if applicable)


	None

42. Quality of included studies (if applicable)


	Not stated

43. Publication bias reported (if applicable)


	No

44. Was correspondence required for further study information?

45. What further correspondence was required, and from whom?

46. What further study information was requested (from whom, what and when)?

47. What correspondence was received (from whom, what and when)?

Extraction form for project: The effect of volunteering on the health and wellbeing of volunteers: an umbrella review

Design Details