Abstract
BackgroundDepression among the elderly is well-documented and associated with socio-economic factors, physical and mental health conditions. Few studies have focused on older adults’ physical limitations and depressive symptoms. However, very little is known about marital status’ role in such associations, especially in India. The present study examines the association between physical limitations and self-reported depressive symptoms and moderating role of marital status in such association separately for men and women.MethodsThe present study used data from the Longitudinal Ageing Study in India (LASI) wave 1, 2017–2018, a nationally and state representative longitudinal large-scale survey of ageing and health. For the present research, a total sample of 20,806 older adults aged 60+ years was selected after excluding missing values. Along with descriptive statistics, binary logistic regression analysis and interaction effect of marital status were applied to examine the association between physical limitations (functional limitations and mobility difficulty) with the depressive symptoms separately for men and women.ResultsAbout 58, 50, and 45% elderly reported having depressive symptoms and had difficulty in 2+ ADLs, 2+ IADLs, and 2+ mobility difficulties, respectively. By the marital status, the prevalence of depressive symptoms was higher among currently unmarried than currently married, irrespective of type and number of physical limitations. The unadjusted, marital and multivariate-adjusted association suggested that elderly with more than two ADLs, IADLs, and mobility difficulty had higher odds of depressive symptoms. The gender stratified interaction effect of marital status and physical limitations on depressive symptoms indicated that currently unmarried elderly, particularly unmarried older women with 2+ ADLs (OR = 2.85; CI 95% = 1.88–3.09), 2+ IADLs (OR = 2.01; CI 95% = 1.74–2.31) and 2+ mobility difficulty (OR = 2.20; CI 95% = 1.86–2.60) had higher odds of depressive symptoms. However, such association was only valid for unmarried men having mobility difficulty.ConclusionThe study highlights that the elderly with physical limitations such as ADLs, IADLs, and mobility difficulty require attention and care. Although married elderly are less likely to have depressive symptoms even with all the mentioned physical limitations, unmarried women are more vulnerable to have depressive symptoms with physical limitations.
Highlights
Depression among the elderly is well-documented and associated with socio-economic factors, physical and mental health conditions
This study has examined the association between physical limitations and depressive symptoms and examined the moderating role of marital status in this association
We found a significant moderating role of marital status in the association between physical limitations and depressive symptoms among women, contradicting the results of previous literature, which reported a lower level of depressive symptoms among women irrespective of their marital status [30, 44]
Summary
Depression among the elderly is well-documented and associated with socio-economic factors, physical and mental health conditions. Few studies have focused on older adults’ physical limitations and depressive symptoms. A substantial amount of research conducted in developed countries has suggested a strong relationship between functional impairment and levels of depressive symptoms in older individuals [12,13,14,15]. The physical limitations have negatively influenced participation in social activity and affect subjective health and psychological well-being [21,22,23,24,25,26]. Additional studies have appeared to confirm such a reciprocal relationship [14] These studies considered the temporal and reciprocal associations between physical limitations and depressive symptoms. In his study, Gayman et al (2008) indicated that prior levels of physical limitations predicted changes in depressive symptoms but did not find the reverse association [19]
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