Depressive symptoms in older adult couples: Associations with dyadic physical health, social engagement, and close friends

Objective

The objective of this study was to examine associations between level of depressive symptoms in older adult spouse/partner couples and their physical health and social factors (social activity and number of close friends).

Methods

Using data from 116 community-dwelling couples (age 76.2 ± 8.5), we simultaneously analyzed associations between depressive symptoms (Geriatric Depression Scale, range 0-11) and dyadic physical health, engagement in social activities, and connectedness with close friends.

Results

Greater engagement in social activities was associated with fewer depressive symptoms in men, whereas more close friendships were associated with fewer depressive symptoms in women, controlling for partner effects, age, education, and cognitive function, with good model fit. Additionally, more disparate physical health within the couple (latent incongruence score) was associated with greater depressive symptoms in men.

Discussion

Less social activity and fewer close friends were associated with depressive symptoms in older adult couples, but may be distinctly influential depending on gender and in the context of the older adult couple's physical health.

The Association of Dyadic Symptom Appraisal With Physical and Mental Health Over Time in Care Dyads Living With Lung Cancer

The study examined the association between changes in dyadic symptom appraisal with changes in physical and mental health of 109 family care dyads living with lung cancer over 12 months. Multilevel modeling was used to analyze both aggregate and time-varying associations of dyadic symptom appraisal with dyadic health. Patients had significantly worse physical health compared with their care partner; care partners had significantly worse mental health compared with patients. In general, greater incongruent symptom appraisals were significantly associated with worse physical health for both patients and care partners. Importantly, increases in magnitude of incongruence regarding the patient's pain interference were significantly associated with declines in patient physical health over time. Direction of the incongruence was associated with mental health. Findings highlight the need for both a longitudinal and dyadic perspective of symptom appraisal to move toward theoretically driven interventions that will optimize the health of both patients and their care partners.

The Theory of Dyadic Illness Management

Despite the importance of both members of the adult patient-care partner dyad, a majority of research on illness management is focused on the patient or the care partner. The basic principle of the Theory of Dyadic Illness Management is that illness management is a dyadic phenomenon; the theory focuses extensively on the dyad as an interdependent team. The way dyads appraise illness as a unit influences the ways in which they engage in behaviors to manage illness together in a recursive fashion that influences dyadic health. Optimizing the health of both members of the dyad is a goal of the theory. In turn, the health of the dyad can feedback to influence how they appraise and manage illness together. Finally, dyadic illness management is an inherently variable process that is influenced by several contextual factors. Supportive evidence and implications for practice and future research are presented.