Functional Limitations and Depressive Symptoms Among Older Adults in Korea: Gender Differences in the Moderating Roles of Relationship Satisfaction With Family,Friends,and Neighbors

Abstract

Objectives

This study investigated the association between functional limitations and depressive symptoms among older adults in South Korea, focusing on gender differences in the moderating roles of relationship satisfaction with family, friends, and neighbors.

Methods

Fixed-effect models were applied to five waves of data from the Korean Retirement and Income Study, encompassing 19,180 observations.

Results

Increases in functional limitations were associated with higher levels of depressive symptoms, regardless of gender. However, the moderating effects of relationship satisfaction differed by gender: For older women, satisfaction with family moderated the association, whereas for older men, satisfaction with friends played a moderating role.

Discussion

The findings suggest tailoring interventions to improve family relationships for women and friendships for men in mitigating depressive symptoms among functionally vulnerable older adults in Korea, where rapid population aging poses significant challenges to protect functional and mental health among older adults.

Keywords

functional limitations depressive symptoms relationship satisfaction fixed-effects models South Korea Korean retirement and income study

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References

Allison

P. D.

(2009). Fixed effects regression models. Sage Publications.

Antonucci

T. C.

Ajrouch

K. J.

Birditt

K. S.

(2014). The convoy model: Explaining social relations from a multidisciplinary perspective. The Gerontologist, 54(1), 82–92. https://doi.org/10.1093/geront/gnt118

Antonucci

T. C.

Lansford

J. E.

Akiyama

Smith

Baltes

M. M.

Takahashi

Fuhrer

Dartigues

(2002). Differences between men and women in social relations, resource deficits, and depressive symptomatology during later life in four nations. Journal of Social Issues, 58(4), 767–783. https://doi.org/10.1111/1540-4560.00289

Backe

I. F.

Patil

G. G.

Nes

R. B.

Clench-Aas

(2018). The relationship between physical functional limitations, and psychological distress: Considering a possible mediating role of pain, social support and sense of mastery. SSM - Population Health, 4(1), 153–163. https://doi.org/10.1016/j.ssmph.2017.12.005

Barbee

A. P.

Cunningham

M. R.

Winstead

B. A.

Derlega

V. J.

Gulley

M. R.

Yankeelov

P. A.

Druen

P. B.

(1993). Effects of gender role expectations on the social support process. Journal of Social Issues, 49(3), 175–190. https://doi.org/10.1111/j.1540-4560.1993.tb01175.x

Bierman

(2012). Functional limitations and psychological distress: Marital status as moderator. Society and Mental Health, 2(1), 35–52. https://doi.org/10.1177/2156869312442884

Bird

C. E.

Rieker

P. P.

(2008). Gender and health: The effects of constrained choices and social policies. Cambridge University Press. https://doi.org/10.1017/CBO9780511807305

Brown

Battista

D. R.

Sereika

S. M.

Bruehlman

R. D.

Dunbar-Jacob

Thase

M. E.

(2007). Primary care patients’ personal illness models for depression: Relationship to coping behavior and functional disability. General Hospital Psychiatry, 29(6), 492–500. https://doi.org/10.1016/j.genhosppsych.2007.07.007

Burns

S. D.

Drentea

(2023). Masculine ideals and health in older men: Findings from the Wisconsin longitudinal study. American Journal of Men's Health, 17(6), Article 15579883231220714. https://doi.org/10.1177/15579883231220714

10.

Calasanti

(2004). Feminist gerontology and old men. The Journals of Gerontology: Series B, 59(6), S305–S314. https://doi.org/10.1093/geronb/59.6.S305

11.

Chao

S.-F.

(2012). Functional disability and psychological well-being in later life: Does source of support matter? Aging & Mental Health, 16(2), 236–244. https://doi.org/10.1080/13607863.2011.596809

12.

Chao

S.-F.

(2014). Functional disability and depressive symptoms: Longitudinal effects of activity restriction, perceived stress, and social support. Aging & Mental Health, 18(6), 767–776. https://doi.org/10.1080/13607863.2013.878308

13.

Chiao

Weng

L.-J.

Botticello

A. L.

(2011). Social participation reduces depressive symptoms among older adults: An 18-year longitudinal analysis in Taiwan. BMC Public Health, 11(1), 292. https://doi.org/10.1186/1471-2458-11-292

14.

Cho

M. J.

Kim

K. H.

(2015). Diagnostic validity of the CES-D(Korean version) in the assessment of DSM-III-R major depression. Journal of Korean Neuropsychiatric Association, 32(3), 381–399.

15.

Cho

M. S.

Kwon

M. Y.

(2023). Factors associated with aging in place among community-dwelling older adults in Korea: Findings from a national survey. International Journal of Environmental Research and Public Health, 20(3), 2740. https://doi.org/10.3390/ijerph20032740

16.

Choi

K.-W.

Jeon

G.-S.

(2021). Social network types and depressive symptoms among older Korean men and women. International Journal of Environmental Research and Public Health, 18(21), Article 11175. https://doi.org/10.3390/ijerph182111175

17.

Chung

Park

N. S.

(2021). Editorial comment: Intergenerational issues in a changing society of South Korea. Journal of Intergenerational Relationships, 19(1), 1–4. https://doi.org/10.1080/15350770.2021.1868215

18.

Cohn-Schwartz

Schmitz

(2024). From attitudes to social networks: National gender-role attitudes and gender differences in late-life social relationships. Social Networks, 76(4), 79–87. https://doi.org/10.1016/j.socnet.2023.08.001

19.

Connolly

Garvey

McKee

(2017). Factors associated with ADL/IADL disability in community dwelling older adults in the Irish longitudinal study on ageing (TILDA). Disability and Rehabilitation, 39(8), 809–816. https://doi.org/10.3109/09638288.2016.1161848

20.

Cornwell

Laumann

E. O.

Schumm

L. P.

(2008). The social connectedness of older adults: A national profile. American Sociological Review, 73(2), 185–203. https://doi.org/10.1177/000312240807300201

21.

Cornwell

Schumm

L. P.

Laumann

E. O.

Graber

(2009). Social networks in the NSHAP study: Rationale, measurement, and preliminary findings. The Journals of Gerontology: Series B, 64(Suppl 1), i47–i55. https://doi.org/10.1093/geronb/gbp042

22.

Dabelko-Schoeny

Anderson

K. A.

Spinks

(2010). Civic engagement for older adults with functional limitations: Piloting an intervention for adult day health participants. The Gerontologist, 50(5), 694–701. https://doi.org/10.1093/geront/gnq019

23.

Ferri

Yang

Girgus

J. S.

(2023). Predicting the gender difference in depressive symptoms in older adults. Aging and Mental Health, 27(7), 1411–1418. https://doi.org/10.1080/13607863.2022.2084712

24.

Fiori

K. L.

Antonucci

T. C.

Cortina

K. S.

(2006). Social network typologies and mental health among older adults. The Journals of Gerontology: Series B, 61(1), P25–P32. https://doi.org/10.1093/geronb/61.1.P25

25.

Fischer

C. S.

Beresford

(2015). Changes in support networks in late middle age: The extension of gender and educational differences. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70(1), 123–131. https://doi.org/10.1093/geronb/gbu057

26.

Fiske

Wetherell

J. L.

Gatz

(2009). Depression in older adults. Annual Review of Clinical Psychology, 5(1), 363–389. https://doi.org/10.1146/annurev.clinpsy.032408.153621

27.

Fuller-Iglesias

H. R.

(2015). Social ties and psychological well-being in late life: The mediating role of relationship satisfaction. Aging and Mental Health, 19(12), 1103–1112. https://doi.org/10.1080/13607863.2014.1003285

28.

Haber

M. G.

Cohen

J. L.

Lucas

Baltes

B. B.

(2007). The relationship between self-reported received and perceived social support: A meta-analytic review. American Journal of Community Psychology, 39(1-2), 133–144. https://doi.org/10.1007/s10464-007-9100-9

29.

Haigh

E. A. P.

Bogucki

O. E.

Sigmon

S. T.

Blazer

D. G.

(2018). Depression among older adults: A 20-year update on five common myths and misconceptions. American Journal of Geriatric Psychiatry, 26(1), 107–122. https://doi.org/10.1016/j.jagp.2017.06.011

30.

Harling

Morris

K. A.

Manderson

Perkins

J. M.

Berkman

L. F.

(2020). Age and gender differences in social network composition and social support among older rural South Africans: Findings from the HAALSI study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 75(1), 148–159. https://doi.org/10.1093/geronb/gby013

31.

Hausman

J. A.

(1978). Specification tests in econometrics. Econometrica, 46(6), 1251–1271. https://doi.org/10.2307/1913827

32.

Hawton

Casañas i Comabella

Haw

Saunders

(2013). Risk factors for suicide in individuals with depression: A systematic review. Journal of Affective Disorders, 147(1-3), 17–28. https://doi.org/10.1016/j.jad.2013.01.004

33.

HIRA Bigdata Open portal . (2024). Disease statistics of public interest. https://opendata.hira.or.kr/op/opc/olapMfrnIntrsIlnsInfoTab3.do

34.

Zhao

Luo

Yang

(2022). Prevalence of depression in older adults: A systematic review and meta-analysis. Psychiatry Research, 311(1), Article 114511. https://doi.org/10.1016/j.psychres.2022.114511

35.

Jeong

K.-H.

Yoon

J.-Y.

Lee

Cho

Woo

H.-J.

Kim

(2022). Changes in the suicide rate of older adults according to gender, age, and region in South Korea from 2010 to 2017. Healthcare, 10(11), 2333. https://doi.org/10.3390/healthcare10112333

36.

Kim

Yoon

(2022). Longitudinal associations between expectations of receiving care in the future and life satisfaction among older adults in Korea. The Journals of Gerontology: Series B, 77(3), 604–614. https://doi.org/10.1093/geronb/gbab121

37.

Kubzansky

L. D.

Subramanian

S. V.

Kawachi

Fay

M. E.

Soobader

M.-J.

Berkman

L. F.

(2005). Neighborhood contextual influences on depressive symptoms in the elderly. American Journal of Epidemiology, 162(3), 253–260. https://doi.org/10.1093/aje/kwi185

38.

Lawton

M. P.

Brody

E. M.

(1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3), 179–186. https://doi.org/10.1093/geront/9.3_Part_1.179

39.

Leavy

R. L.

(1983). Social support and psychological disorder: A review. Journal of Community Psychology, 11(1), 3–21. https://doi.org/10.1002/1520-6629(198301)11:1<3::AID-JCOP2290110102>3.0.CO;2-E

40.

Lin

Woelfel

M. W.

Light

S. C.

(1985). The buffering effect of social support subsequent to an important life event. Journal of Health and Social Behavior, 26(3), 247–263. https://doi.org/10.2307/2136756

41.

Maier

Riedel-Heller

S. G.

Pabst

Luppa

(2021). Risk factors and protective factors of depression in older people 65+. A systematic review. PLoS One, 16(5), Article e0251326. https://doi.org/10.1371/journal.pone.0251326

42.

McDonald

Mair

C. A.

(2010). Social capital across the life course: Age and gendered patterns of network resources. Sociological Forum, 25(2), 335–359. https://doi.org/10.1111/j.1573-7861.2010.01179.x

43.

Newall

N. E. G.

Menec

V. H.

(2019). Loneliness and social isolation of older adults: Why it is important to examine these social aspects together. Journal of Social and Personal Relationships, 36(3), 925–939. https://doi.org/10.1177/0265407517749045

44.

Nicolaisen

Thorsen

(2024). Gender differences in loneliness over time: A 15-year longitudinal study of men and women in the second part of life. The International Journal of Aging and Human Development, 98(1), 103–132. https://doi.org/10.1177/00914150231194243

45.

Ormel

Rijsdijk

F. V.

Sullivan

van Sonderen

Kempen

G. I. J. M.

(2002). Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life. The Journals of Gerontology: Series B, 57(4), P338–P347. https://doi.org/10.1093/geronb/57.4.P338

46.

Pan

Sun

Okereke

O. I.

Rexrode

K. M.

F. B.

(2011). Depression and risk of stroke morbidity and mortality: A meta-analysis and systematic review. JAMA, 306(11), 1241–1249. https://doi.org/10.1001/jama.2011.1282

47.

Pearlin

L. I.

Lieberman

M. A.

Menaghan

E. G.

Mullan

J. T.

(1981). The stress process. Journal of Health and Social Behavior, 22(4), 337–356. https://doi.org/10.2307/2136676

48.

Pearlin

L. I.

Schooler

(1978). The structure of coping. Journal of Health and Social Behavior, 19(1), 2–21. https://doi.org/10.2307/2136319

49.

Radloff

L. S.

(1977). The CES-D Scale: A Self-Report Depression Scale for Research in the General Population. Applied Psychological Measurement, 1(3), 358–401. https://doi.org/10.1177/014662167700100306

50.

Raymo

J. M.

Park

Xie

Yeung

W. J.

(2015). Marriage and family in east asia: Continuity and change. Annual Review of Sociology, 41(41), 471–492. https://doi.org/10.1146/annurev-soc-073014-112428

51.

Reinhardt

J. P.

Boerner

Horowitz

(2006). Good to have but not to use: Differential impact of perceived and received support on well-being. Journal of Social and Personal Relationships, 23(1), 117–129. https://doi.org/10.1177/0265407506060182

52.

Statistics Korea . (2023). 2023 statistics—older adults. https://kostat.go.kr/board.es?mid=a10301060500&bid=10820&act=view&list_no=427252

53.

Stevens

N. L.

Van Tilburg

T. G.

(2011). Cohort differences in having and retaining friends in personal networks in later life. Journal of Social and Personal Relationships, 28(1), 24–43. https://doi.org/10.1177/0265407510386191

54.

Sung

(2003). Women reconciling paid and unpaid work in a confucian welfare state: The case of South Korea. Social Policy and Administration, 37(4), 342–360. https://doi.org/10.1111/1467-9515.00344

55.

Tannenbaum

Frank

(2011). Masculinity and health in late life men. American Journal of Men's Health, 5(3), 243–254. https://doi.org/10.1177/1557988310384609

56.

The KLoSA Task Force . (2023). User’s Guide for the 2020 Korean longitudinal Study of ageing (KLoSA) (wave 8). Korea Employment Information Service. https://survey.keis.or.kr/eng/klosa/klosa01.jsp

57.

Thoits

P. A.

(2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52(2), 145–161. https://doi.org/10.1177/0022146510395592

58.

Tian

Yang

Pan

(2022). Association between functional disability and long-term trajectories of depressive symptoms: Evidence from the China Health and Retirement Longitudinal Study. Journal of Affective Disorders, 310(1), 10–16. https://doi.org/10.1016/j.jad.2022.05.001

59.

Umberson

Lin

Cha

(2022). Gender and social isolation across the life course. Journal of Health and Social Behavior, 63(3), 319–335. https://doi.org/10.1177/00221465221109634

60.

United Nations . (2023). Leaving No one behind in an ageing world (world social report 2023). Department of Economic and Social Affairs.

61.

Wallsten

S. M.

Tweed

D. L.

Blazer

D. G.

George

L. K.

(1999). Disability and depressive symptoms in the elderly: The effects of instrumental support and its subjective appraisal. International Journal of Aging and Human Development, 48(2), 145–159. https://doi.org/10.2190/E48R-W561-V7RG-LL8D

62.

Wassink-Vossen

Oude Voshaar

R. C.

Naarding

Collard

R. M.

(2022). Effectiveness of late-life depression interventions on functional limitations: A systematic review. International Journal of Mental Health Nursing, 31(4), 823–842. https://doi.org/10.1111/inm.12982

63.

Weyerer

Eifflaender-Gorfer

Wiese

Luppa

Pentzek

Bickel

Bachmann

Scherer

Maier

Riedel-Heller

S. G.

(2013). Incidence and predictors of depression in non-demented primary care attenders aged 75 years and older: Results from a 3-year follow-up study. Age and Ageing, 42(2), 173–180. https://doi.org/10.1093/ageing/afs184

64.

Wheaton

(1985). Models for the stress-buffering functions of coping resources. Journal of Health and Social Behavior, 26(4), 352–364. https://doi.org/10.2307/2136658

65.

Yang

(2006). How does functional disability affect depressive symptoms in late life? The role of perceived social support and psychological resources. Journal of Health and Social Behavior, 47(4), 355–372. https://doi.org/10.1177/002214650604700404

66.

Yang

George

L. K.

(2005). Functional disability, disability transitions, and depressive symptoms in late life. Journal of Aging and Health, 17(3), 263–292. https://doi.org/10.1177/0898264305276295

67.

Yoon

H.-S.

Koo

B.-M.

(2009). The mediating effects of social support on health status and ddepression of the elderly. Korean Journal of Social Welfare, 61(2), 303–324. https://doi.org/10.20970/kasw.2009.61.2.012

68.

Yuan

Bing

Zhao

Sun

(2023). Gender differences in depressive symptoms among Chinese older adults based on fairlie decomposition analysis. Heliyon, 9(11), Article e21555. https://doi.org/10.1016/j.heliyon.2023.e21555

69.

Zhang

Jackson

S. L.

Gillespie

Merritt

Yang

(2023). Depressive symptoms and mortality among US adults. JAMA Network Open, 6(10), Article e2337011. https://doi.org/10.1001/jamanetworkopen.2023.37011

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