Namkee G Choi, Angelina Gutierrez, Brian Fons, Kelly Vences, C Nathan Marti
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Depressive/Anxiety Symptoms in Homebound Older Adults: Mediation Effects of Loneliness and Psychological Well-Being.
Objectives: To examine the direct effect of a homebound state (defined as never/rarely going outside the home in the preceding month) on depressive/anxiety symptoms and the mediation effect of loneliness and psychological well-being on the associations between homebound state and depressive/anxiety symptoms.
Methods: Data came from the 2023 National Health and Aging Trend Study (N = 7,547 community-dwelling Medicare beneficiaries age 65+). We fitted a path model to examine the research questions. To test the statistical significance of the mediation effect, we used bootstrapped analysis to obtain estimates of the indirect effects and their 95% CIs.
Results: We found significant direct and indirect effects. The ratio of the indirect effect of loneliness on a homebound state (0.13) to the total effect of a homebound state on depressive/anxiety symptoms was 0.14. The ratio of the indirect effect of psychological well-being on a homebound state (0.28) to the total effect of a homebound state on depressive/anxiety symptoms was 0.26.
Conclusions: Loneliness and psychological well-being, or lack thereof, significantly mediate the relationship between homebound state and depression/anxiety in homebound older adults.
Clinical implications: Interventions to decrease loneliness and improve psychological well-being among homebound older adults are needed to alleviate their depression/anxiety.
期刊介绍：
Clinical Gerontologist presents original research, reviews, and clinical comments relevant to the needs of behavioral health professionals and all practitioners who work with older adults. Published in cooperation with Psychologists in Long Term Care, the journal is designed for psychologists, physicians, nurses, social workers, counselors (family, pastoral, and vocational), and other health professionals who address behavioral health concerns found in later life, including:
-adjustments to changing roles-
issues related to diversity and aging-
family caregiving-
spirituality-
cognitive and psychosocial assessment-
depression, anxiety, and PTSD-
Alzheimer’s disease and other neurocognitive disorders-
long term care-
behavioral medicine in aging-
rehabilitation and education for older adults.
Each issue provides insightful articles on current topics. Submissions are peer reviewed by content experts and selected for both scholarship and relevance to the practitioner to ensure that the articles are among the best in the field. Authors report original research and conceptual reviews. A unique column in Clinical Gerontologist is “Clinical Comments." This section features brief observations and specific suggestions from practitioners which avoid elaborate research designs or long reference lists. This section is a unique opportunity for you to learn about the valuable clinical work of your peers in a short, concise format.
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