Lee Jin-Kyung, Lee Jinhee, Hwang Sangwon, Chung Moo-Kwon, Park Ji Young, Shin Taeksoo, Lee Kyoung-Joung, Lim Hyo-Sang, Urtnasan Erdenebayar, Kim Min-Hyuk
Institute for Poverty Alleviation and International Development, Yonsei University, Mirae Campus, Wonju 26493, Gangwon, Republic of Korea.
Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju 26426, Gangwon, Republic of Korea.
Depress Anxiety. 2024 Sep 24;2024:6462853. doi: 10.1155/2024/6462853. eCollection 2024.
Depressive symptoms and stress exposure fluctuate over time in community-dwelling older adults, but they are frequently assessed using one-time retrospective self-report measures. Social support viewed as a multifaceted construct can play diverse moderating roles in this association although it is typically gauged through the measure of perceived social support. This study aims to explore the relationships between stress, social support, and depressive symptoms among older adults by utilizing the longitudinal data collected through a smartphone application and supplemented by annual face-to-face interviews conducted over a 2-year period. Using longitudinal multilevel analysis, we analyzed the data on PHQ-9, stress exposure, and four distinct measures of social support collected from 354 community-dwelling older adults in South Korea. The results demonstrated that 59% of the variability in depressive symptoms was attributable to differences between individuals. Stress exposure was a strong predictor ( = 3.01 , 95% CI = 2.34-3.67). As expected, positive functional social support alleviated the effects of stress on depression ( = -1.12 , 95% CI = -1.92 ~ -0.32) while negative functional social support ( = 2.36 , 95% CI = 1.29-3.44) and negative structural social support ( = 3.22 , 95% CI = 0.79-5.64) worsened the effects of stress on depression. A notable finding is that stress-amplifying effects from the negative functional and structural social support, in addition to well-known stress-buffering effects from positive functional social support, should be regarded as indispensable components in safeguarding the mental health of older adults. Considering the decline in social interactions and the lower probability of older adults establishing new social connections, it is essential to consider approaches that prevent a lack of functional and structural social support and foster a high-quality of functional and structural social support, particularly for those facing greater stressors, as a preventative method against depressive symptoms.
在社区居住的老年人中，抑郁症状和压力暴露会随时间波动，但通常使用一次性回顾性自我报告测量方法对其进行评估。社会支持被视为一个多层面的概念，尽管通常通过感知社会支持的测量来衡量，但它可以在这种关联中发挥多种调节作用。本研究旨在利用通过智能手机应用程序收集的纵向数据，并辅以在两年期间进行的年度面对面访谈，探讨老年人压力、社会支持和抑郁症状之间的关系。我们使用纵向多层次分析，分析了从韩国354名社区居住老年人那里收集到的关于PHQ-9、压力暴露和四种不同社会支持测量的数据。结果表明，抑郁症状59%的变异性可归因于个体差异。压力暴露是一个强有力的预测因素（β = 3.01，95%置信区间 = 2.34 - 3.67）。正如预期的那样，积极的功能性社会支持减轻了压力对抑郁的影响（β = -1.12，95%置信区间 = -1.92 ~ -0.32），而消极的功能性社会支持（β = 2.36，95%置信区间 = 1.29 - 3.44）和消极的结构性社会支持（β = 3.22，95%置信区间 = 0.7
