Abstract
Due to the social isolation imposed by chronic illness and functional limitations, homebound older adults are more vulnerable to depression than their mobility-unimpaired peers. In this study, we compared 81 low-income homebound older adults, aged 60 and older, with their 130 ambulatory peers who attended senior centers, with respect to their depressive symptoms, depression risk and protective factors, and self-reported coping strategies. Even controlling for sociodemographics, health problems, and other life stressors, being homebound, as opposed to participating in senior centers, was significantly associated with higher depressive symptoms. However, when the coping resources–social support and engagement in frequent physical exercise, in particular–were added to the regression model, the homebound state was no longer a significant factor, showing that the coping resources buffered the effect of the homebound state on depressive symptoms. In terms of self-reported coping strategies, even among the depressed respondents, only a small proportion sought professional help, and that was largely limited to consulting their regular physician and social workers, who may not have had professional training in mental health interventions.
Acknowledgement
The authors are grateful to the MOW clients and senior center participants and staff members of the MOW program and the senior centers who helped us recruit the study participants and supported the study in many other ways. This study was funded by the Center for Health Promotion and Disease Prevention Research in Underserved Populations (NIH/NINR grant #5P30NR005051 [Dr. A. Stuifbergen, PI]), The University of Texas at Austin School of Nursing.