The association between higher social support and lower depressive symptoms among aging services clients is attenuated at higher levels of functional impairment

Orden, Kimberly A. Van; Yan, Li; Podgorski, Carol; Conwell, Yeates

doi:10.1002/gps.4266

Cited by 11 publications

(9 citation statements)

References 36 publications

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“…Among HCBS recipients, over a quarter (27%) had, in the past year, reported clinically meaningful depressive symptoms, a two-fold greater frequency compared to non-recipients. These findings are consistent with local studies such as a report of HCBS recipients in Monroe County, NY, which found 27% of participants met criteria for major depressive episode (1, 25). The current study finds relatively higher levels of depressive symptoms, however, than found in community-area studies of home delivered meal recipients.…”

Section: Discussionsupporting

confidence: 91%

Depressive Symptoms in Recipients of Home- and Community-Based Services in the United States: Are Older Adults Receiving the Care They Need?

Pepin

Leggett

Sonnega

et al. 2017

The American Journal of Geriatric Psychiatry

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Objective To understand unmet depression needs of older adults, the current study investigates depressive symptoms, psychiatric treatment, and home- and community-based service (HCBS) use in a nationally representative sample of older adults in the U.S. Methods Participants included 5,582 adults aged 60 and over from the 2010–2012 waves of the nationally representative Health and Retirement Study (HRS). Weighted bivariate analyses were used to examine the frequency of depressive symptoms (CES-D) and psychiatric treatment among HCBS recipients compared to non-HCBS recipients. Weighted logistic regression models were used to evaluate the effect of depressive symptoms on HCBS use. Results HCBS recipients had a higher frequency of depressive symptoms compared to non-recipients (27.5% vs 10.4%). In particular, transportation service recipients had the highest frequency of depressive symptoms (37.5%). HCBS recipients with depressive symptoms were no more likely than non-recipients to receive psychiatric services. Depressive symptoms were associated with HCBS use, above and beyond sociodemographic and health risk factors. Conclusions Depressive symptoms are more frequent among HCBS recipients compared to non-recipients, however, depressed HCBS recipients are no more likely to receive psychiatric services, suggesting unmet depression needs. HCBS may be a key setting for depression detection and delivery of mental health interventions.

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Section: Discussionsupporting

confidence: 91%

Depressive Symptoms in Recipients of Home- and Community-Based Services in the United States: Are Older Adults Receiving the Care They Need?

Pepin

Leggett

Sonnega

et al. 2017

The American Journal of Geriatric Psychiatry

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“…This is consistent with findings demonstrating that depression and low social support are associated with suicidal ideation and suicide risk in older adults [36, 37, 38]. The effect of both treatments on reducing suicidal ideation in patients with low social support compared to patients with high social support may reflect a floor effect as rates of suicidal ideation were lower in participants with high social support.…”

Section: Discussionsupporting

confidence: 90%

Depression and Suicidal Ideation During Two Psychosocial Treatments in Older Adults with Major Depression and Dementia

Kiosses

Rosenberg

McGovern

et al. 2015

JAD

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Background Depression is prevalent in dementia and contributes to poor outcomes for patients and their families. Antidepressants have limited efficacy in older adults with major depression and dementia and psychosocial interventions are under-investigated. Objective To examine the course and predictors of depression and suicidal ideation during 12 weeks of home-delivered Problem Adaptation Therapy (PATH) vs. Supportive Therapy for Cognitively Impaired Older Adults (ST-CI) in 39 older adults with major depression and dementia. Methods Thirty-nine older adults with major depression, mild or moderate dementia, and disability participated in an RCT that compared the efficacy of PATH versus ST-CI. Depression and suicidal ideation were assessed with Cornell Scale for Depression in Dementia (CSDD) Total Score and Suicide Item. Results PATH participants had significantly greater reduction in depression than ST-CI participants over 12 weeks of treatment. PATH participants with high social support had the greatest reduction in depression. Both treatments had comparable reduction in suicidal ideation. Conclusion PATH is more effective in reducing depression in older adults with major depression and dementia compared to ST-CI. These results are clinically significant as antidepressant medication treatments have limited efficacy in this population. Home-delivered psychosocial treatments may reduce suicidal ideation in this population.

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“…Moreover, Vietnamese elderly are exposed to less social interactions due to the limited social activities held by the local authority as compared to other developed countries [6]. Elderly with lower levels of social support are more likely to be physically inactive [38], depressed [36,39,40], which are reported to be closely related to FoF [18,41]. In addition, we found that the mean MMSE score of the participants with low-moderate perceived social support levels was 25.5, which was significantly lower than that of those with a high perceived level of social .…”

Section: Cognitive Impairment and Fof Among Different Perceived Sociamentioning

confidence: 99%

Fear of falling and cognitive impairment in elderly with different social support levels: findings from a community survey in Central Vietnam

Nakamura

Seino

et al. 2020

BMC Geriatr

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Background: Fear of falling (FoF) in the elderly is one of the major public health concerns in this era of aging of the population. As there is limited evidence on how cognitive function may differ by social support level in relation to FoF among the elderly, this cross-sectional study aims to investigate the prevalence of FoF and the associations between cognitive impairment and FoF by the social support level, after adjustments for potential confounders. Methods: Data from the "Health needs assessment of elderly in Thua Thien Hue Province, Vietnam in 2018" survey of 725 elderly aged 60 years or older were used for analysis. FoF was assessed using the Fall Efficacy Scale-International. High FoF was defined as a score above 28. The Multidimensional Scale of Perceived Social Support was used to measure the perception of support. Logistic regression analysis was performed to investigate the association between cognitive function and FoF by social support levels (p < 0.05). Results: The prevalence of high FoF among the elderly was 40.8%. Female gender, advanced age, a marital status of single or formerly married, living alone, history of injury, history of falls, chronic diseases (arthritis and/or hypertension), limitations of the IADL and BADL, visual difficulty and walking difficulty, low social support, and cognitive impairment were all significantly associated with a high FoF. After adjustments for the age, gender, marital status, history of falls and health-related factors, cognitive impairment remained significantly associated with a high FoF among the elderly with a low to moderate social support level (OR = 2.97, 95% CI 1.49-5.89), but not in those with a high social support level. Conclusions: A high FoF was associated with impairment of cognitive function among the elderly who perceived themselves as having low or moderate support levels, even after adjustments for socio demographic and physical functional factors. However, this association was not observed among the elderly who perceived themselves as having high social support levels. Fall prevention programs for the elderly with various levels of social support should be carefully devised, keeping in mind the cognitive function levels of the target recipients.

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The association between higher social support and lower depressive symptoms among aging services clients is attenuated at higher levels of functional impairment

Cited by 11 publications

References 36 publications

Depressive Symptoms in Recipients of Home- and Community-Based Services in the United States: Are Older Adults Receiving the Care They Need?

Depressive Symptoms in Recipients of Home- and Community-Based Services in the United States: Are Older Adults Receiving the Care They Need?

Depression and Suicidal Ideation During Two Psychosocial Treatments in Older Adults with Major Depression and Dementia

Fear of falling and cognitive impairment in elderly with different social support levels: findings from a community survey in Central Vietnam

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