The role of social support in enhancing mental health among the elderly

Background

In the coming decades, India is expected to undergo an unprecedented demographic transition, and by the years 2048-2050, the number of elderly people is anticipated to reach nearly 300 million. This rapid demographic transition will pose a considerable public health challenge in terms of the mental wellbeing of older adults in their later years. Psychological distress, social disconnection, and economic dependency of older adults are primary sources of vulnerability. Traditional family caregiving structures are also eroding due to fragmentation, migration, and declining fertility. The pressures of urbanization, rapidly changing marital patterns (marriages can no longer be arranged by family), and the different models of work and families shape how families will care for fragile elderly relatives. This study aimed to assess how social support – emotional, instrumental, perceived and received social support is associated with mental health and quality of life perceptions in elderly people in Telangana.

Methods

A cross-sectional survey was applied to 209 elderly people from rural and urban districts, Warangal, using stratified purposive cluster sampling to achieve a socio-demographically diverse sample. Elderly people's mental health was assessed using standardized instruments: SF-12 Health Survey (for Physical and Mental Component Scores), Geriatric Depression Scale (GDS-15), and quality of life measures; Multidimensional Scale of Perceived Social Support (MSPSS), Received Social Support Scale (RSSS), and Perceived Burden Scale (PBS). The method of analyses included t-test, ANOVA, correlations, and regression models, to understand and establish associations for the dimensions of social support against mental health outcomes, while controlling for gender, marital status and socio-economic measures.

Results

The results indicated the emotional support dimension was a more substantial predictor of psychological well-being and social function than structural indicators of caregiving (such as the number of children, co-residing or not, etc). Findings also indicated that being elderly women or men perceived aspects of social support differently, whereby elderly women reported needing more emotional support as well as practical support and older men reported being more psychologically vulnerable in relation to losing a spouse or being financially insecure. Notably, the stress buffering hypothesis was not supported, as the findings highlighted that emotional support is an independent predictor of mental health. We also found that perceived health status had a moderate relationship with levels of physical functioning and energy levels, as well as differences in how elderly people perceived received social support (or not).

Conclusions

The findings suggest we need to re-conceptualize elder care policy and practice in India from a structural family model to a model that priorities emotional connectedness, gender-based services, and community-based interventions. Improving civic networks and strengthening community networks to support older people, and integrating psychosocial support into older person’s healthcare or response systems as well as addressing economic vulnerabilities, should both promote independent and healthy aging. The present findings directly relate to addiction medicine, mental health and psychiatry, as they highlighted the protective impacts of social support in reducing psychological distress and improving quality of life for vulnerable people who may experience various inequities on a number of domains of life.

Dr. Shoeb Ahmed Ilyas is a distinguished physician-administrator, academic researcher, and public health scholar with over 15 years of diverse experience in healthcare management, quality improvement, and patient safety. His academic background spans multiple disciplines like Dentistry, Hospital & Health Systems Management, Industrial Psychology, Sociology, and Medical Law & Ethics underscoring his multidisciplinary approach to healthcare innovation and leadership.

Dr. Ilyas has made substantial scholarly contributions in the fields of mental health, psychiatry, and addiction medicine, with a particular focus on stressors, social support, geriatric mental health, the psychological impact of COVID-19, and the role of psychologists in patient empowerment and decision-making. His research has been widely published in peer-reviewed journals and has advanced the understanding of how mental health intersects with healthcare systems, patient safety, and human behavior. He is a researcher at Centre for Economic and Social Studies, Hyderabad, Telangana, India.