The effect of depressive symptoms on the association between functional status and social participation

The aim of the current study was to examine the interactive effects of depressive symptoms and lower extremity functioning on social participation for a group of moderately to severely disabled older women. The study used a cross-sectional community based sample, enrolled in the Women's Health and Aging Study I, randomly selected from the Centers for Medicare & Medicaid Services enrollment files for women living in the Baltimore, Maryland area. The participants were women aged 65 or older who completed the in-person interview (n = 999). After adjusting for demographics and risk factors, each unit increase in the Short Physical Performance Battery (SPPB) score was associated with a 0.31 point increase in satisfaction with social participation for the non-depressed group, and 2.04 points for the depressed group. Depressive symptoms and lower extremity functioning interact to affect satisfaction with social participation. Among women with high depressive symptoms the gradient of association with social participation increased sharply with better lower extremity function compared with non-depressed women, where the gradient of association was moderate. The findings suggest the potential value of programs that focus on improving lower extremity function among older high risk groups.