The mediating roles of functional limitations and social support on the relationship between vision impairment and depressive symptoms in older adults

AbstractVision impairment is prevalent and it is strongly associated with depressive symptoms in older adults. This study aimed to investigate the mediating roles of functional limitations and social support on the relationship between vision impairment and depressive symptoms in older adults. This study used data from a probability-based sample of 1,093 adults aged 60 and older in Shanghai, China. Structural equation models were used to examine the structural relationships among sets of variables simultaneously, including vision impairment, activities of daily living ADLs, instrumental ADLs (IADLs), friends support, family support, relatives support and depressive symptoms. The bootstrapping method and the program PRODCLIN were used to test the indirect effects of these variables. This study found that vision impairment was directly associated with a higher level of depressive symptoms, and the association was partially mediated by functional limitations (IADLs) and social support (friends support). The study demonstrates that improving social support from friends and enhancing social participation for visually impaired older adults can reduce depressive symptoms. More importantly, this study contributes to the knowledge of mediating mechanisms between vision impairment and depressive symptoms.

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Investigation of the Structural Relationships Between Social Support, Self-Compassion, and Subjective Well-Being in Korean Elite Student Athletes

Psychological Reports ◽

10.1177/0033294116658226 ◽

2016 ◽

Vol 119 (1) ◽

pp. 39-54 ◽

Cited By ~ 11

Author(s):

Hyunsoo Jeon ◽

Keunchul Lee ◽

Sungho Kwon

Keyword(s):

Social Support ◽

Structural Equation ◽

Group Analysis ◽

Well Being ◽

School Level ◽

Subjective Well Being ◽

Multiple Group ◽

Self Compassion ◽

Structural Relationships ◽

The Relationship

The study examined whether self-compassion mediates the relationship between social support and subjective well-being, as perceived by athletes. It also investigated the structural relationships between these variables. Participants were 333 athletes attending high school or university. Structural equation analysis showed that self-compassion partially mediated the relationship between social support and subjective well-being. To test the stability of the model, a multiple group analysis was performed according to sex of participant and school level, and this demonstrated that the model had similar fit to the data regardless of group. The confirmation that self-compassion plays an intermediary role in the relationship between social support and subjective well-being demonstrates that self-compassionate attitudes can be fostered by social support, and that, in turn, has a positive effect on an individual’s subjective well-being.

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Relationship Between Frailty and Depression Among Community-Dwelling Older Adults: The Mediating and Moderating Role of Social Support

The Gerontologist ◽

10.1093/geront/gnaa072 ◽

2020 ◽

Vol 60 (8) ◽

pp. 1466-1475 ◽

Cited By ~ 1

Author(s):

Yaru Jin ◽

Huaxin Si ◽

Xiaoxia Qiao ◽

Xiaoyu Tian ◽

Xinyi Liu ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Rating Scale ◽

Depression Scale ◽

Community Dwelling ◽

Linear Regression Models ◽

Frailty Phenotype ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Background and Objectives Frailty is associated with depression in older adults and reduces their social support. However, the mechanism underlying such relationship remains unclear. We aim to examine whether social support acts as a mediator or moderator in the relationship between frailty and depression. Research Design and Methods This cross-sectional study was conducted among 1,779 community-dwelling older adults aged 60 and older. Frailty, social support, and depressive symptoms were measured by the Physical Frailty Phenotype, Social Support Rating Scale, and five-item Geriatric Depression Scale, respectively. Data were also collected on age, gender, years of schooling, monthly income, cognitive function, number of chronic diseases, physical function, and pain. Results Linear regression models showed that subjective support and support utilization, but not objective support, mediated and moderated the relationship between frailty and depressive symptoms. The Johnson–Neyman technique determined a threshold of 30 for subjective support, but not for support utilization, beyond which the detrimental effect of frailty on depressive symptoms was offset. Discussion and Implications Social support underlies the association of frailty with depression, and its protective role varies by type. Interventions on depression should address improving perceptions and utilization of social support among frail older adults rather than simply providing them with objective support.

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Depressive Symptoms and Loneliness Among Black and White Older Adults: The Moderating Effects of Race

Innovation in Aging ◽

10.1093/geroni/igaa048 ◽

2020 ◽

Vol 4 (5) ◽

Cited By ~ 1

Author(s):

Harry O Taylor ◽

Ann W Nguyen

Keyword(s):

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Multivariable Analysis ◽

Depression Scale ◽

Religious Service ◽

Religious Service Attendance ◽

Black And White ◽

The Relationship ◽

Service Attendance

Abstract Background and Objectives Loneliness is consistently linked to worse depression/depressive symptoms; however, there are few studies that have examined whether the relationship between loneliness and depressive symptoms varies by race. The purpose of this study was to determine whether race moderated the relationship between loneliness and depressive symptoms. Research Design and Methods Data come from the 2014 wave of the Health and Retirement Study (HRS) Core survey and Psychosocial Leave-Behind Questionnaire; only black and white older adults were included in the analysis (N = 6,469). Depressive symptoms were operationalized by the eight-item Center for Epidemiological Studies—Depression scale; however, the “felt lonely” item was removed given concerns with collinearity. Loneliness was operationalized using the Hughes 3-Item Loneliness Scale. Sociodemographic variables included gender, age, education, household income, employment status, marital status, and living alone or with others. Furthermore, social support and negative interactions from family members and friends, and religious service attendance were included in the analysis. Lastly, we created an interaction term between race and loneliness. All analyses used survey weights to account for the complex multistage sampling design of the HRS. Missing data were multiply imputed. Results In multivariable analysis, we found race significantly moderated the relationship between loneliness and depressive symptoms while controlling for sociodemographic covariates, social support and negative interaction variables, and religious service attendance. Discussion and Implications Our findings demonstrate a differential racial effect for loneliness and depressive symptoms. For both blacks and whites, greater loneliness affected depressive symptoms; however, the effect was stronger among whites than it was for blacks. Given this is one of the first studies to examine the differential effects of race on loneliness and depressive symptoms, more research is necessary to determine the consistency of these results.

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Modeling Longitudinal Relationships Between Habit and Physical Activity: Two Cross-Lagged Panel Design Studies in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2016-0212 ◽

2017 ◽

Vol 25 (3) ◽

pp. 464-473 ◽

Cited By ~ 3

Author(s):

Rob J.H. van Bree ◽

Catherine Bolman ◽

Aart N. Mudde ◽

Maartje M. van Stralen ◽

Denise A. Peels ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Structural Equation ◽

Functional Limitations ◽

Equation Modeling ◽

Design Studies ◽

Mediation Effects ◽

Measurement Results ◽

The Relationship ◽

Longitudinal Relationships

These longitudinal studies in older adults targeted mediated relationships between habit and physical activity (PA). In The Netherlands two independent studies were conducted among 1976 (Study 1: Mage = 63.63, SD = 8.66, 30% functional limitations) and 2140 (Study 2: Mage = 62.75, SD = 8.57, 45% functional limitations) adults aged 50 years or older. Cross-lagged panel designs were applied to examine whether habit mediates the relationship between prior and later PA and whether PA simultaneously mediates the relationship between prior and later habit. Data on habit and PA were collected by means of questionnaires at baseline (t0) and at 6 (t1) and 12 (t2) months after baseline measurement. Results of structural equation modeling analyses were not unambiguous. Indications for the existence of both hypothesized mediation effects were found, but no clear, unequivocal pattern appeared. Somewhat more support was found for the PA-habit-PA path than for the habit-PA-habit path. More research is needed to draw more definitive conclusions.

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CHRONIC CONDITIONS, FUNCTIONAL LIMITATIONS, AND DEPRESSION IN OLDER ADULTS: ANALYSIS OF A LONGITUDINAL STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.2118 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S572-S572

Author(s):

Jyotsana Parajuli ◽

Diane Berish ◽

Ying-Ling Jao

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Direct Effect ◽

Chronic Conditions ◽

Functional Limitations ◽

Mediation Effect ◽

High Risk Population ◽

Longitudinal Impact ◽

The Relationship ◽

Retirement Study

Abstract Background: Chronic conditions, functional limitations, and depression are highly prevalent in older adults. Evidence suggests the links between chronic conditions, functional limitations, and depressive symptoms separately. However, few studies have considered these three conditions together longitudinally. This study examined the longitudinal relationship between chronic conditions and depressive symptoms and evaluated the mediation effect of functional limitations on the relationship between chronic conditions and depressive symptoms in older adults. Methods: This study analyzed longitudinal data from the Health and Retirement Study collected in 2012 and 2014. Mediation analysis was used to examine the direct and indirect effects of chronic conditions and functional limitations measured at the year 2012 on depressive symptoms measured at the year 2014 controlling for demographics. Results: Results revealed that chronic conditions predicted depressive symptoms. Specifically, one additional chronic condition in 2012 corresponded to an increase of 0.35 in depressive symptoms in 2014 (p<.001). After adding functional limitations as a mediator, the direct effect was reduced to 0.26 and the indirect effect was .088 (p<.001). In other words, functional limitations explained approximately 25% of the direct effect of chronic diseases on depression. Discussion: Findings reveal the longitudinal impact of chronic conditions and functional limitations on depressive symptoms in older adults. Findings help identify the high-risk population of depressive symptoms and intervene early.

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THE ASSOCIATION BETWEEN PHYSICAL FRAILTY AND DEPRESSIVE SYMPTOMS: DOES SOCIAL SUPPORT MATTER?

Innovation in Aging ◽

10.1093/geroni/igz038.3546 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S978-S979

Author(s):

Shuting Liang ◽

Dexia Kong ◽

XinQi Dong

Keyword(s):

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Family Members ◽

Female Gender ◽

Physical Frailty ◽

Cross Sectional ◽

Chinese Older Adults ◽

Interaction Terms ◽

The Relationship

Abstract This research will present the association between physical frailty and depressive symptoms among U.S. Chinese older adults, and the extent to which social support moderates the relationship. Cross-sectional data were obtained from the Population Study of Chinese Elderly in Chicago collected between 2011 and 2013 (N=3,157). Physical frailty was assessed by the Short Performance Physical Battery (range=0-15). A cut-off point of 6 was used to define physical frailty as suggested by prior research. Depressive symptoms were assessed by the nine-item Patient Health Questionnaire. Social support was measured by a scale assessing positive support and negative strain from spouse, family members, and friends. Logistic regression analyses with interaction terms were conducted. In our sample, 1,682 (54.3%) had depressive symptoms, and 16.1% had physical frailty. Having physical frailty was positively associated with depressive symptoms (Odds Ratio [OR] 1.15, 1.11-1.18). Additionally, female gender (OR 1.39, 1.20-1.61), education (OR 1.03, 1.01-1.04), and chronic conditions (OR 1.18, 1.12-1.25) were positively associated with depressive symptoms. Social support (OR 0.85, 0.83-0.87) and children (OR=0.92, 0.87-.97) were negatively associated with depressive symptoms. Furthermore, family members (OR 0.96, 0.94-0.98) and friends (OR 0.96, 0.94-0.98) has moderating effect on the relationship between physical frailty and depressive symptoms. However, the interaction between social support from spouse and physical frailty was not significant. The findings highlight the interconnections among physical frailty, social support, and depressive symptoms. Intervention strategies focusing on social support may have the potential to reduce depressive symptoms among frail U.S. Chinese older adults.

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The relationship between caregiving self-efficacy and depressive symptoms in family caregivers of patients with Alzheimer disease: a longitudinal study

International Psychogeriatrics ◽

10.1017/s1041610217000059 ◽

2017 ◽

Vol 29 (7) ◽

pp. 1095-1103 ◽

Cited By ~ 20

Author(s):

Caterina Grano ◽

Fabio Lucidi ◽

Cristiano Violani

Keyword(s):

Depressive Symptoms ◽

Caregiver Burden ◽

Self Efficacy ◽

Structural Equation ◽

Structural Equation Models ◽

Initial Assessment ◽

Negative Consequences ◽

Considerable Length ◽

One Year ◽

The Relationship

ABSTRACTBackground:Caregiving for a relative with dementia has been associated with negative consequences for mental health. Self-efficacy has been shown to correlate negatively with depression but the long-term association between caregiver burden, caregiver self-efficacy, and depressive symptoms, remains still largely unexplored. The aim of the present study was to evaluate whether different self-efficacy domains partially mediated the relationship between caregiving burden and depression.Methods:A three-wave design was used, with initial assessment and follow-ups three months later and one year later. One hundred seventy caregivers of patients with AD responded to measures of caregiver burden, caregiving self-efficacy, and depressive symptoms. Data were analyzed by means of structural equation models.Results:The tested model provided support for the guiding hypothesis. Burden at the time of the first assessment (T1) significantly influenced depression one year later and the relationship between burden at time one and depressive symptoms one year later was partially mediated by self-efficacy for controlling upsetting thoughts.Conclusions:The findings of the present study provide evidence that, along a considerable length of time, the effects of caregiver burden on depressive symptoms can be explained by the caregivers’ efficacy beliefs in controlling upsetting thoughts related to the caregiving tasks. Interventions for caregivers of patients with AD may help them in tackling negative thoughts about the caregiving role.

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OLDER ADULTS’ HEALTH AND SOCIAL ENGAGEMENT: THE MEDIATING ROLE OF SUBJECTIVE LIFE EXPECTANCY

Innovation in Aging ◽

10.1093/geroni/igz038.2555 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S694-S694

Author(s):

Dahee Kim ◽

Kyuho Lee

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Life Expectancy ◽

Social Engagement ◽

Structural Equation ◽

Close Relationships ◽

Functional Limitations ◽

Functional Limitation ◽

Mediating Effect ◽

Equation Modeling

Abstract Older adults’ mental and physical health is likely to limit social engagement, but their perception of how much time they have left, according to the socio-emotional selectivity theory, might influence it as well. The aim of the research is to investigate the mediating effect of subjective life expectancy (SLE) on the pathways from older adults’ mental health and functional limitation to volunteering and contacts with close relationships. The current research used data of 5,285 older adults aged 50 to 75 from the Health and Retirement Study collected in 2014. Structural equation modeling was performed to investigate the direct effect of older adults’ depressive symptoms and functional limitation on volunteering and contact with close relationships. Predictors’ indirect effects via SLE was also assessed. The results indicated that older adults’ higher depressive symptoms and functional limitations significantly decreased volunteering time and frequency of contacts with close relationships. Older adults’ SLE attenuated the effects of depressive symptoms and functional limitations on their volunteering time and frequency of contact with close relationships. The findings describe the mechanism of how older adults engage in volunteering and contact with close relationships through their perception of remaining time. Further, this research highlights SLE as a motivator for encouragement of older adults’ social engagement.

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The Relationships Among Structural Social Support, Functional Social Support, and Loneliness in Older Adults: Analysis of Regional Differences Based on a Multigroup Structural Equation Model

Frontiers in Psychology ◽

10.3389/fpsyg.2021.732173 ◽

2021 ◽

Vol 12 ◽

Author(s):

Haifeng Li ◽

Cong Wang

Keyword(s):

Social Support ◽

Older Adults ◽

Structural Equation Model ◽

Rural Areas ◽

Regional Differences ◽

Structural Equation ◽

Equation Model ◽

Support Network ◽

Functional Social Support ◽

The Relationship

Objective: This study investigated the relationship between structural social support and loneliness and explored whether functional social support had an intermediate role therein. It also employed a multigroup structural equation model to compare mediation models among older adults living in cities, towns, and rural areas.Methods: Using a self-made demographics questionnaire, the structural-functional social support scale, and the 3-item UCLA loneliness scale, this study collected information from 1,325 older adults identified via convenient sampling.Results: The results showed that as: (1) compared with older adults living in towns, older urban, and rural adults had higher structural social support and experienced less loneliness, while older adults’ functional social support showed no difference among the three regions (2) An analysis of the models of regional differences indicated that functional social support served as a full mediator in the relationship between structural social support and loneliness in urban older adults, and a partial mediator for older adults living in towns and rural areas.Conclusion: The relationship between structural social support and loneliness is mediated by functional social support, and this mediation model varies between older adults in cities and towns/rural areas. This study helps us understand possible mechanisms through which structural social support impacts loneliness. It suggests that nursing strategies for older adults should be adjusted according to the region and direct greater focus on the function (or quality) of the social support network and older adults living in towns.

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Baseline Body Mass Predicts Average Depressive Symptoms over the Next Two Decades for White but Not Black Older Adults

Geriatrics ◽

10.3390/geriatrics4010014 ◽

2019 ◽

Vol 4 (1) ◽

pp. 14 ◽

Cited By ~ 3

Author(s):

Shervin Assari

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Racial Differences ◽

Body Mass ◽

Structural Equation ◽

Structural Equation Models ◽

The United States ◽

Bidirectional Association ◽

National Cohort ◽

Baseline Bmi

Background: Although obesity and depression have a bidirectional association, this link may vary based on race. The current study tested racial variation in bidirectional links between depressive symptoms and body mass index (BMI) over 24 years of follow-up in older adults over the age of 50 in the United States. We hypothesized weaker bidirectional links in Blacks compared to Whites. Methods: Data came from waves 1 to 12 (1990 to 2014) of the Health and Retirement Study (HRS), an ongoing state-of-the-art national cohort. The study followed a representative sample of Americans (n = 15,194; 2,200 Blacks and 12,994 Whites) over the age of 50. Dependent variables were average depressive symptoms and BMI over 24 years, based on measurements every other year, from 1990 to 2014. Independent variables included baseline depressive symptoms and BMI. Covariates included age, gender, marital status, veteran status, and activities of daily living. Structural equation models were fitted to the data for data analysis. Results: In the pooled sample, bidirectional associations were found between BMI and depressive symptoms as baseline BMI predicted average depressive symptoms over time and baseline depressive symptoms predicted average BMI over 24 years. Racial differences were found in the bidirectional association between BMI and depressive symptoms, with both directions of the associations being absent for Blacks. For Whites, baseline BMI predicted average depressive symptoms over the next 24 years. Conclusion: Reciprocal associations between BMI and depressive symptoms over a 24-year period among individuals over the age of 50 vary for Blacks and Whites. As these associations are stronger for Whites than Blacks, clinical and public health programs that simultaneously target comorbid obesity and depression may be more appropriate for Whites than Blacks.

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