Dr Emma Harley: Social support in later life: Cross-sectional and longitudinal analyses of inter-relationships between psychosocial variables in the The Australian Longitudinal Study on Women’s Health study.
This study examined the roles of psychosocial variables including social support and optimistic appraisal in understanding the mental health transitions of older Australian women. Data were drawn from a community-dwelling sample of 9514 older Australian women aged 72-79 years, as part of the Australian Longitudinal Study on Women's Health (ALSWH).Cross-sectional analyses were conducted for data collected in 1999 for the general sample of women, as well as for subgroups of women considered to be at greater risk of mental health problems - those with the poorest physical health; those having experienced higher numbers of negative life events; and women from non-English speaking backgrounds.Results of multiple regression analyses indicated optimism, social satisfaction, and social interaction to be significant predictors of mental health in all subsamples. The role of protective factors appeared to be diminished for women with poorer physical health.Data for 8646 older women collected in 1999 and 2002 were then analysed longitudinally via multinomial logistic regression analyses. Women whose mental health had stayed adequate over the three year period were compared to subgroups of women whose mental health had stayed poor, declined, or improved. SF-36 Mental Health scores, in addition to doctor diagnosed depression and anxiety were used as criterion variables. Comparison of means across transition groups of women suggested these groups represented distinct mental health trends in ageing.
Results indicated optimism, social satisfaction, and social interaction to be significantly lower for all groups of women, other than those with adequate ongoing mental health. Women with poor or declining mental health were more likely to have poorer social satisfaction at Time 1; social interaction was seen to decline in unison with mental health for women with chronic or declining mental health. Physical health had little explanatory value in predicting mental health transitions. Data provided additional evidence for a significant role of life events in effecting change in mental health status over time.Public health recommendations are outlined, including increased research funding for the study of psychosocial variables in healthy ageing; improved mental health education both within public and primary care settings; and additional resources for mental health treatment services for older Australian women. Clinical implications of the project are also discussed, and include the enhanced training of clinical psychologists in the area of ageing, and improved recruitment of psychologists into the aged care sector; further treatment of late-life depression and anxiety; and the use of appropriate psychological interventions such as cognitive behaviour therapy for late-life depression and anxiety; interpersonal therapy is recommended for older women experiencing depressive symptoms and relational deficits.