Association between Social Support and Frailty among Older People with Depressive Disorders.

Objectives: This study aimed at examining the association between social support and frailty status, specifically amongst older people with depressive disorders.

Methods: It was conducted in older people, aged 65 and over, with depressive disorders at the Psychiatry Outpatient Unit of Songklanagarind Hospital, Thailand. The main independent variable, level of social support, was assessed using the Inventory of Social Support Behaviors (ISSB) - Thai. The main dependent variable, frailty status, was assessed via the adapted Fried Frailty Phenotype. Bivariate and ordinal regression analyses were conducted to examine the relationships between variables.

Results: In our study sample, 32% of the 147 participants were considered frail, 51% pre-frail, and 17% robust. From the ordinal regression analysis, four variables - social support score, current depressive symptoms, level of education, and key family caregivers - were statistically significantly associated with frailty status. The odds of having pre-frailty and frailty were statistically significantly reduced by a factor of 0.99, or around 1.0 percent, for each 1-point increment of the social support scale (Ordinal OR 0.99, 95% CI = 0.97-0.99, -value = 0.015).

Conclusions: Social support interventions should be designed to influence multiple items of the social support scale at the same time, which might, therefore, have a substantial effect on frailty status among the older population.

Clinical Implications: We recommend a regular practice that focuses not only on biological (i.e., prescribing medications) and psychological aspects (i.e., providing psychotherapy) but also on the social dimension of older people living with frailty and depressive disorders.