The impact of chronic diseases on psychological distress among the older adults: the mediating and moderating role of activities of daily living and perceived social support

Abstract

Objectives

Previous literature has shown that chronic diseases and psychological distress are correlated. However, the mediating and moderating mechanisms underlying this relationship have not been sufficiently studied. The purpose of this study was to explore the role played by activities of daily living (ADL) and perceived social support.

Method

Face-to-face questionnaire-based surveys were conducted with 3250 valid participants (age ≥60 years). Participants were assessed using the Barthel Index, Perceived Social Support Scale, and Depression Anxiety Stress Scale-21.

Results

1) Chronic diseases had a significant direct effect on psychological distress in older adults; 2) the relationship between chronic diseases and psychological distress was partially mediated by ADL; and 3) the impact of chronic diseases on psychological distress was significantly moderated by perceived social support. More importantly, perceived social support was a protective factor that could effectively alleviate the adverse effects of chronic diseases on psychological distress.

Conclusion

The results add to the existing literature by uncovering the underlying mechanisms between chronic diseases and mental health. These findings have implications for early intervention and prevention of mental health problems in older adults.

Keywords:

• Older adults
• chronic diseases
• psychological distress
• activities of daily living
• perceived social support

Acknowledgements

We thank all participants and staffs at the study sites for their cooperation. We wish to thank the reviewers for their insightful comments and suggestions.

Disclosure statement

The authors report no conflict of interest.

Ethical approval

All study procedures were approved by the Ethics Committee of Shanxi Medical University.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China under Grant [number: 71874104]; Key Laboratory Development Project for Philosophy and Social Sciences in Guangdong under Grant [number: G620369695]; National Key R&D Program of China under Grant [number: 2020YFC2006400].The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.