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Does social support buffer functional decline in elderly patients with unipolar depression?
J C Hays1, D C Steffens, E P Flint
1Center for the Study of Aging and Human Development, Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA. judith.hays@duke.edu
The American Journal of Psychiatry
|November 3, 2001
Summary
Social support offers protection against functional decline in elderly patients with major depressive disorder. Instrumental support aids daily living, while subjective and structural support buffers the most depressed patients.
Area of Science:
- Gerontology
- Psychiatry
- Sociology
Background:
- Major depressive disorder (MDD) is a prevalent condition in the elderly.
- Functional decline is a significant concern for older adults with MDD.
- The role of social support in mitigating functional decline in this population requires further investigation.
Purpose of the Study:
- To determine if social support protects against general or selective functional decline in elderly patients with MDD.
- To examine the impact of different dimensions of social support on functional abilities.
Main Methods:
- Prospective cohort study of 113 elderly patients with unipolar depression over 12 months.
- Assessed basic and instrumental activities of daily living (ADL) performance.
- Utilized Hamilton Depression Rating Scale scores and social support domains as predictors in multivariable regression models.
Main Results:
- Instrumental social support showed marginal protection against decline in instrumental ADLs.
- Larger social networks, frequent interaction, and perceived support adequacy buffered against declines in basic ADLs, particularly in severely depressed patients.
- Patients generally showed improved instrumental ADL scores and stable basic ADL scores.
Conclusions:
- Instrumental social support generally protects against worsening instrumental ADLs in elderly patients with recurrent unipolar depression.
- Subjective and structural social support dimensions protect severely depressed elderly patients from losing basic functional abilities.
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