Activity participation and affect among nursing home residents: support for a behavioural model of depression

One focus of interventions being developed for depression in nursing homes is increasing pleasant events. The conceptual foundation of such interventions requires establishing links among activity levels, depressive symptoms and positive affect. We observed activity and affect among 28 nursing home residents, five-days-a-week for four weeks, and concurrently collected self-reported affect and depression data. Inclusion of intra-individual analyses using random effects models demonstrated considerable individual variability in the relationship between positive affect and activity, although the results broadly supported the association. Participants differed with regard to what types of events were pleasurable and with regard to the relationships among pleasure, interest and activity. Depression levels were related to some of these individual differences. Activity was related primarily to interest rather than pleasure and higher interest was related to fewer depressive symptoms. Our findings emphasize the importance of individually tailoring pleasant events interventions and suggest that prescriptive group activities are unlikely to prove effective as means for improving positive affect.