Effectiveness of Social Support for Community-Dwelling Elderly with Depression: A Systematic Review and Meta-Analysis

The impact of community services usage on geriatric depression: a ten-year follow-up study

BACKGROUND

This study explores whether the impact of environmental factors (community services usage, CSU) on geriatric depression is mediated by psychological resilience and moderated by the COMT (catechol-O-methyltransferase) gene val158met polymorphism.

METHODS

The data consists of 13,512 entries from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) collected in the years 2008, 2011, 2014, and 2018. The study employed a Random Intercept Cross-Lagged Panel Model (RI-CLPM) to examine the relationship between CSU and geriatric depression, including the mediating effect of psychological resilience and the moderating role of the comt gene val158met gene polymorphism in this relationship.

RESULTS

Lower CSU at earlier assessments were significantly associated with more severe geriatric depression in subsequent evaluations.Psychological resilience was found to partially mediate the relationship between CSU and depression.Differential impacts were observed among various gene genotypes; specifically, the val genotype demonstrated a significantly greater influence of CSU on subsequent psychological resilience and on subsequent depression compared to the met genotype.

CONCLUSION

Enhancement in CSU can predict subsequent geriatric depression. The relationship between the CSU and depression can be mediated by psychological resilience, with genetics modulating the pathway from CSU through psychological resilience to depression. Multidisciplinary interventions focused on enhancing community service quality, boosting psychological resilience, and mitigating depression are likely to benefit the older adults's emotional and psychological well-being.

Sources of Social Support and Depressive Symptoms Among Chinese Older Adults: A Moderated Mediation of Social Adaptation and Filial Piety

This study examined the mediating effect of social adaptation on the associations between sources of social support and depressive symptoms among Chinese older adults, and explored how filial piety moderated these associations in different ways. Data were drawn from the China Longitudinal Aging Social Survey in 2018 (N = 6617). Regression analysis and bootstrap test were used to assess the mechanisms underlying the inconsistency between different sources of social support and depressive symptoms. We found that social support, except for pension, significantly affected depressive symptoms through social adaptation. Moreover, filial piety positively moderated the mediating effect of social adaptation on the association between social support inside the family and depressive symptoms, while negatively moderating it in regard to social support outside the family, except for pension, and depressive symptoms. The results showed filial piety may affect the extent to which older adults convert different sources of social support into personal subjective welfare.

Attitudes towards seeking psychological help among community dwelling older adults enrolled in primary care in Chile

BACKGROUND

Depression and anxiety are common mental disorders among older adults, but they are frequently underdiagnosed. Attitudes towards seeking professional mental health care is one of the barriers to access to treatment. This study was aimed at assessing the attitudes towards seeking psychological help among older adults who are enrolled in primary care in Chile, and to determine the associated factors.

METHODS

This cross-sectional study recruited 233 primary care users aged 65 or more years. The Attitudes Towards Seeking Professional Psychological Help was used. Reliability and factor analysis of this scale were carried out. The average scores of the scale and factors were calculated and compared, by selected variables. Multivariate linear regression was estimated to determine factors associated with attitudes towards seeking psychological help.

RESULTS

Three factors were identified in the attitudes towards seeking psychological help: confidence in psychologists, coping alone with emotional problems, and predisposition to seek psychological help. On average, participants had a favorable attitude towards seeking psychological help, compared with previous research. Lower level of education, and risk of social isolation were inversely associated with these attitudes.

CONCLUSION

Strategies to improve mental health literacy and social connection among older adults, could have an impact on factors that mediate the access to mental health care, such as attitudes towards seeking psychological help, among people who have a lower level of education or are at risk of social isolation.

Social Support, Health Behaviors, Self-Esteem, and Successful Aging in a Sub-Saharan African Sample of Older Adults: Test of a Sequential Mediation Model

Background and Objectives

Previous research demonstrates that social support facilitates successful aging across all cultures. However, the factors that potentially mediate the link between social support and successful aging remain unclear. This study examined whether a healthy lifestyle and self-esteem mediate the association between social support and successful aging. It was hypothesized that the relationship between social support (family, friends, and significant other) and successful aging would be serially mediated by both healthy lifestyle and self-esteem.

Research Design and Methods

Participants were 479 Nigerian retirees (53.4% female) aged 60 to 90 years (Mage = 64.81, SD = 6.86). They provided information on relevant demographic variables and completed the following measures: Fantastic Lifestyle Checklist (Fitness Appraisal), Rosenberg Self-esteem Scale, Multidimensional Scale of Perceived Social Support Scale, and Successful Aging Inventory. Three separate regression models (family, friends, and significant other dimensions of social support) were conducted using the Hayes PROCESS macro for SPSS with 5,000 bootstrap estimates.

Results

Controlling for age and sex, family support, significant other support, friends support, healthy lifestyle, and self-esteem were directly associated with successful aging. The association between family support and successful aging was mediated by healthy lifestyle; and this was also seen for friends' support and significant other support. The sequential path from social support to successful aging through healthy lifestyle, and then via improved self-esteem, was significant for family support and significant other support, but not friends support.

Discussion and Implications

Findings suggest that middle-aged to older adults who have strong support from their families and significant others may be more likely to engage in healthy behaviors and, in turn, experience higher levels of self-esteem, thereby aging well.

Reducing Loneliness and Improving Social Support among Older Adults through Different Modalities of Personal Voice Assistants

This study examines the potential of AI-powered personal voice assistants (PVAs) in reducing loneliness and increasing social support among older adults. With the aging population rapidly expanding, innovative solutions are essential. Prior research has indicated the effectiveness of various interactive communication technologies (ICTs) in mitigating loneliness, but studies focusing on PVAs, particularly considering their modality (audio vs. video), are limited. This research aims to fill this gap by evaluating how voice assistants, in both audio and video formats, influence perceived loneliness and social support. This study examined the impact of voice assistant technology (VAT) interventions, both audio-based (A-VAT) and video-based (V-VAT), on perceived loneliness and social support among 34 older adults living alone. Over three months, participants engaged with Amazon Alexa™ PVA through daily routines for at least 30 min. Using a hybrid natural language processing framework, interactions were analyzed. The results showed reductions in loneliness (Z = -2.99, p < 0.01; pre-study loneliness mean = 1.85, SD = 0.61; post-study loneliness mean = 1.65, SD = 0.57), increases in social support post intervention (Z = -2.23, p < 0.05; pre-study social support mean = 5.44, SD = 1.05; post-study loneliness mean = 5.65, SD = 1.20), and a correlation between increased social support and loneliness reduction when the two conditions are combined (ρ = -0.39, p < 0.05). In addition, V-VAT was more effective than A-VAT in reducing loneliness (U = 85.50, p < 0.05) and increasing social support (U = 95, p < 0.05). However, no significant correlation between changes in perceived social support and changes in perceived loneliness was observed in either intervention condition (V-VAT condition: ρ = -0.24, p = 0.37; A-VAT condition: ρ = -0.46, p = 0.06). This study's findings could significantly contribute to developing targeted interventions for improving the well-being of aging adults, addressing a critical global issue.

Socioeconomic inequalities in depressive symptoms in China: The role of social capital

This cohort study used the China Health and Retirement Longitudinal Study (CHARLS, 2015-2018) to investigate the effects of socioeconomic status and social capital to the incidence of depressive symptoms among middle-aged and older individuals in China, incorporating a sample size of 9949 participants. Socioeconomic status, social capital and other explanatory variables were collected in 2015, while depressive symptoms were assessed in 2018. Basic characteristics and social capital measures were compared between urban and rural residents using the chi-square test. Logistic regression was used to explore the relationship between socioeconomic status, social capital and depressive symptoms, and the Karlson, Holm, and Breen (KHB) method was employed to verify the mediating role of social capital. We reported persistent socioeconomic inequalities in depressive symptoms, with rural residents and the illiterate having 1.45 times and 1.34 times higher odds of depression. We ascertained social capital from both the cognitive and structural constructs, where we enriched the measurement of structural social capital from three specific dimensions, i.e., informal interaction, altruism, and formal social participation. We found that both cognitive and structural social capital were associated with lower incidence of depressive symptoms, where informal interaction had the largest effect. The mediation analysis further illustrated that informal interaction contributed most to explain 6 %-12 % of the socioeconomic inequalities in depressive symptoms. These results highlighted the unsatisfied mental wellbeing of the vulnerable older people living in rural areas. The finding suggested that older people may benefit more from personal interactions than formal participations. To fulfill the Health in All vision, government and social organizations should consider how to create opportunities to better integrate the older people into the community.

Psychological aspects of rehabilitation nutrition: A position paper by the Japanese Association of Rehabilitation Nutrition (secondary publication)

Psychological aspects of rehabilitation nutrition affect physical, cognitive, and social rehabilitation nutrition. When depression is recognized, not only pharmacotherapy and psychotherapy, but also non-pharmacological therapies such as exercise, nutrition, psychosocial, and other interventions can be expected to improve depression. Therefore, accurate diagnosis and intervention without overlooking depression is important. Psychological aspects of preventive rehabilitation nutrition is also important because depression can be partially prevented by appropriate exercise and nutritional management. Even in the absence of psychological negatives, increasing more psychological positives from a positive psychology perspective can be useful for both patients and healthcare professionals. Positive rehabilitation nutrition interventions can increase more psychological positives, such as well-being, through cognitive-behavioral therapy and mindfulness on their own, as well as through interventions on environmental factors. Consequently, physical, cognitive, and social positives are also expected to be enhanced.