The Role of Social Support for Depressive Symptoms in Dementia: A Four-Year Longitudinal Study.

Abstract

Background and objectives: Depressive symptoms are common in people with dementia, significantly reducing well-being and potentially exacerbating dementia symptoms. The objective of the present study was to investigate the role of support from the social environment for depressive symptoms in people with dementia over a 4-year period.

Research design and methods: We used data from a cohort of 334 community-dwelling people with dementia (M _age = 80.2, 59.3% female) who were interviewed annually in their homes by specially qualified nurses. We used multilevel growth curve models with random intercepts and slopes to model depressive symptoms over time. We modeled both the role of between-person differences and the role of within-person changes in social support for depressive symptoms.

Results: At the beginning of the study, 13.8% of people with dementia reported mild to severe depressive symptoms. People with more social support showed fewer depressive symptoms overall over the 4-year period (% change per point on a scale from 22 to 110: -1.2, 95% CI: -1.8, -0.4). In addition, a decline in a person's social support was associated with more depressive symptoms (% change: -0.9, 95% CI: -1.7, -0.2). These effects were stable even after controlling for sociodemographic (age, sex, education) and clinical factors (cognitive and functional status, comorbidities).

Discussion and implications: The social environment plays an important role in depressive symptoms in people with dementia-beyond clinical factors like cognitive and functional abilities. Improving support from the social environment could be a lever for alleviating depressive symptoms. In the care of people with dementia, not only medical needs but also psychosocial needs should come to the forefront.