Social Support, Self-Care and Depression

Older adults face increasing risk of being unable to perform basic self-care tasks, also called activities of daily living (ADLs). ADL limitations affect older adults’ ability to live independently and can result in loss of social roles and depression. A study by Alex Bierman and Denise Statland examines how social support influences the relationship between limitations in ADLs and depressive symptoms.

This study is unique in that it combines the life course and stress process perspectives to explore this relationship. According to the life course perspective, events or transition can have different outcomes depending on when they happen relative to when they are expected to happen. For example, some degree of hearing loss is thought to be relatively common in older age while relatively uncommon for adults in their 20s. Consequently, younger individuals with hearing loss will likely perceive themselves as more different from their peers and may experience more stigma than would older adults with the same impairment.  A stress process perspec­tive assumes an individual’s social resources affect his or her experience of a stressful event.

Study subjects were recruited from the Aging, Stress, and Health (ASH) study, a longitudinal study of people 65 years and older. A random sample of 4,800 individuals was selected, of which 1,167 agreed to participate in interviews. Of these, 925 subjects were interviewed again two years later. Interview items included measures of psychological distress, ADL limitations, age, and perceived social support.

Researchers found that the extent to which ADL limitations result in depressive symptoms depends in part on the age at which they occur. ADLs occurring in younger individuals are non-normative and are thus experienced more negatively. In addition, the range of difference in age-based variations is in turn influenced by levels of perceived social sup­port.  These findings are consistent with both life course and stress process perspectives.

This study focused specifically on ADL limitations as stressful events; however, the dual theory approach the researchers employed has potential to enhance our understanding of how perceived social support and timing interact to affect the experience of other stressful life events as well.

Source: Bierman, A., & Statland, D. (2010). Timing, social support, and the effects of physical limitations on psychological distress in late life. Journal of Gerontology: Social Sciences, 65B(5), 631–639, doi:10.1093/geronb/gbp128.