Association between Social Support and Frailty among Older People with Depressive Disorders

ABSTRACT

Objectives

This study aimed at examining the association between social support and frailty status, specifically amongst older people with depressive disorders.

Methods

It was conducted in older people, aged 65 and over, with depressive disorders at the Psychiatry Outpatient Unit of Songklanagarind Hospital, Thailand. The main independent variable, level of social support, was assessed using the Inventory of Social Support Behaviors (ISSB) – Thai. The main dependent variable, frailty status, was assessed via the adapted Fried Frailty Phenotype. Bivariate and ordinal regression analyses were conducted to examine the relationships between variables.

Results

In our study sample, 32% of the 147 participants were considered frail, 51% pre-frail, and 17% robust. From the ordinal regression analysis, four variables – social support score, current depressive symptoms, level of education, and key family caregivers – were statistically significantly associated with frailty status. The odds of having pre-frailty and frailty were statistically significantly reduced by a factor of 0.99, or around 1.0 percent, for each 1-point increment of the social support scale (Ordinal OR 0.99, 95% CI = 0.97–0.99, p-value = 0.015).

Conclusions

Social support interventions should be designed to influence multiple items of the social support scale at the same time, which might, therefore, have a substantial effect on frailty status among the older population.

Clinical implications

We recommend a regular practice that focuses not only on biological (i.e., prescribing medications) and psychological aspects (i.e., providing psychotherapy) but also on the social dimension of older people living with frailty and depressive disorders.

KEYWORDS:

• Aged
• caregivers
• depression
• family
• frailty
• social support

Clinical implications

• High prevalence of pre-frailty and frailty among older people with depression should draw the attention of mental health professionals to the assessment and management of frailty.

• Social support interventions should be designed and provided to promote multiple domains of social support.

• We recommend a regular practice that focuses not only on biological (i.e., prescribing medications) and psychological aspects (i.e., providing psychotherapy) but also on the social dimension of older people living with frailty and depressive disorders.

Acknowledgments

The researchers would like to express their gratitude to all the participants of the study. We would also like to thank all the professors and lecturers at the Epidemiology Unit, Faculty of Medicine, Prince of Songkla University for guiding the conceptualization of this research. We would also like to acknowledge the invaluable contribution of Kreuwan Jongbvorwiwat, who recruited the participants and collected the data, and Nisan Werachattawan, who analysed and interpreted the data. We would also like to extend our appreciation to all the colleagues at the Psychiatry Outpatient Clinic, who helped recruit the participants. Moreover, we thank Edmond Subashi, an English advisor at the International Affairs Office, Faculty of Medicine, Prince of Songkla University, for proofreading the manuscript. The ideas and opinions expressed herein are those of the authors alone, and endorsement by the authors’ institutions is not intended and should not be inferred.

Disclosure statement

No potential conflict of interest was reported by the authors.

Role of the Funder

The funder of this research did not have any role in the design and conduct of the study; collection, management, analysis, and interpretation of data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Data availability statement

The data described in this article are openly available in the Open Science Framework at DOI:10.17605/OSF.IO/TPA6U.

Additional information

Funding

This work was supported by the Faculty of Medicine, Prince of Songkla University, Thailand.