Depressive symptoms and physical disability among older adults: A longitudinal analysis using hierarchical linear modeling

Introduction: Depression has a negative influence on quality of life and is correlated with decreased functioning, disability, and mortality. As people age, deteriorating physical health and chronic disease can lead to physical disabilities, which in turn can negatively impact mental health. Physical disability, a person's perception of their health, and social support have been shown to predict depression. This paper will examine the relationships between physical disability and depressive symptoms among older adults over time, specifically testing health perceptions as a mediator and social support as a moderator. Methods: This study is a secondary data analysis of the Aging, Status, and Sense of Control survey. Data were collected in three waves in 1995, 1998, and 2001 by telephone survey. Hierarchical Linear Modeling is used for repeated measures analyses on data from 868 adults over the age of 65. Results and Conclusions: In this sample, older adults experience more depressive symptoms as they age. This trend disappears, however, when demographic control variables are introduced. The relationship between physical disability and depressive symptoms does not appear to be mediated by health perceptions or moderated by social support. While the hypothesized relationships are not supported by the data, this analysis shows that gender, race, and education appear to have significant effects on some of the relationships between physical disability, health perceptions, social support and depressive symptoms. The results suggest that it is important to consider the factors and disparities that affect depressive symptoms among different groups of older adults.