Functional Independence and Social Support as Mediators in the Maintenance of Mental Health among Elderly Persons with Chronic Diseases

Abstract

The presence of chronic disease and lack of social support have negative impact on functional capacity in later life. The aim of this study was to determine the possible connections between the alteration in functional abilities and access to sources of social support with the occurrence of depression in elderly persons with chronic disease. A cross-sectional survey was conducted among 151 subjects with cardiovascular diseases at the age of 60 and above using standardized questionnaires. Groningen Activity Restriction Scale (GARS), Duke-UNC Functional Social Support Questionnaire (FSSQ), and Geriatric Depression Scale Short Form (GDS) were used to identify the presence of limitations in functional status, availability of social support and symptoms of depression. Multivariate binary logistic regression model was used to assess multivariate influence of significant variables on inclusion in the indicative depression group. Spearman’s rho coefficient was used to analyze correlation between GARS, GDS and FSSQ. GDS score ≥10 (indicative depression) was obtained by 15 (9.9%) participants and scores in the range 6–9 (suspected depression) by 21 (13.9%) participants. There were no significant correlations between the scores on the depression assessment scale and the sociodemographic characteristics of the participants. Binary logistic regression showed that with GARS increasing by a single unit, the chance of having depression significantly rises by 7% (OR: 1.07, 95% confidence interval (CI): 1.01–1.13; P=0.013) while when FSSQ increases by a single unit, that chance drops nearly 2.5 times (OR: 0.40, 95% CI: 0.23–0.70; P=0.001). The development of functional limitations and reduced level of social support are connected with the occurrence of depression. Creation of programs that will encourage the preservation of functional independence and enable effective social assistance can make a significant contribution to maintaining the mental health of elderly persons with chronic diseases.