Comparison of depressive symptoms between homebound older adults and ambulatory older adults.

School of Social Work, University of Texas at Austin, Austin, TX 78712-0358, USA.
Aging and Mental Health (Impact Factor: 1.78). 06/2007; 11(3):310-22. DOI: 10.1080/13607860600844614
Source: PubMed

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.

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    ABSTRACT: A report of the Surgeon General revealed Blacks are underrepresented in mental health research (USDHHS, 2001). The purpose of the current study is to investigate the relation between physical activity (PA) and depressive symptoms in Black U.S. adults. Various mechanisms by which PA are proposed to decrease depressive symptoms are explored, including biological, psychological, social, cultural, seasonal and geographical factors. Since the exact mechanism of action is unknown, PA may not decrease depressive symptoms in all populations. A systematic literature review performed to determine the effects of PA on depressive symptoms in Black adults found inconclusive results, partly due to convenience sampling, predominantly female samples, and lack of reported guidance by theory. A secondary data analysis was subsequently performed on the National Survey of American Life (n=4,716), guided by Stokols’ Social Ecology of Health Promotion. Multiple regression for complex samples examined the relationship between PA and depressive symptoms while controlling for personal (sex, age, body mass index, disability, family history of depression and perceived discrimination) and environmental factors (ethnic origin, household income, region of country, neighborhood safety). Three separate analyses were performed for each type of PA, with a Bonferroni correction of p<.0167 test for significance. Depressive symptoms were associated with sports/exercise in women (b= -.40, R2 = .22) and men (b= -73, R2 = .17) and walking in women (b= -.28, R2 = .22). In contrast to sports/exercise and walking, gardening/yardwork was significantly correlated with increased age in women (r =.22) and men (r =.03). Family history of depressive symptoms was associated with depressive symptoms in women but not men. Longitudinal studies are needed to establish causality. Validation of self-report measures is recommended, such as DNA analyses for genetic factors. Consideration should be given to differentiating among leisure, transportation, occupation and household PA to avoid collapsing all types of PA into one variable. Studies should examine gardening and yard work separately, paying particular attention to whether this type of PA increases with age. PA measurements should include intensity, frequency, duration and type in order to compare results to national PA guidelines. Better measurements of the environment are needed. Ph.D. Nursing University of Michigan, Horace H. Rackham School of Graduate Studies