Productive Engagement and Psychological Distress Among Older Adults: Evidence from a Propensity Score–Matched Longitudinal Study in Thailand

Objectives: Causal evidence on productive engagement and psychological distress among older adults in middle-income Southeast Asian settings remains limited. This study examined whether continued employment and social participation were prospectively associated with psychological distress among Thai adults aged ≥60 years using propensity score matching.Methods: Longitudinal data from two consecutive waves of the Health, Aging, and Retirement in Thailand study were analysed. Propensity score matching yielded a balanced sample of 748 older adults. Hierarchical linear regression models were estimated on the matched sample.Results: Continued employment was associated with lower subsequent psychological distress (coefficient −0.172, 95% CI −0.344 to −0.001). Social participation showed an independent inverse association (coefficient −0.054, 95% CI −0.107 to −0.002). Conclusion: Productive engagement was associated with lower psychological distress among older Thai adults after addressing selection bias, though modest effect sizes and method sensitivity warrant cautious interpretation.