Dynamics of Unmet Social Care Needs and Depressive Symptoms Among Older Adults: Evidence From a Prospective Study in England

Abstract

This study examines the dynamics of unmet social care needs and the impact on depressive symptoms in a longitudinal study of older people in England. Using data from Waves 8 and 9 of the English Longitudinal Study of Ageing, we explore the relationship between trajectories of unmet needs amongst disabled or frail older adults aged 65 and over and depressive symptoms, taking into account changes in care needs across time and loneliness. Nested regression models are used to explore the independent impact of trajectories of unmet needs upon depressive symptoms. We find a significant difference in the prevalence of depressive symptoms between those older adults reporting difficulties in performing activities of daily living or instrumental activities of daily living and those who do not, with these differences outweighing those between older adults with met or unmet care needs. Receiving timely care helps to reduce further overall care needs and, in turn, alleviates depressive symptoms. In contrast, delays or repeat lack of care can increase future social care needs, worsening depressive symptoms. Moreover, loneliness moderates the association between the dynamic pattern of unmet social care needs and depression, while it amplifies one’s depression risk when care is delayed or repeatedly absent. Our results highlight that timely access to social care services alongside interventions to reduce loneliness could play a role in supporting mental health in later life.