Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators
Abstract Background While functional and mobility impairments (FMIs) have garnered the attention of health researchers in low and middle-income countries (LMICs), including India, research has yet to explore whether and to what extent the perception of one’s social status is associated with FMIs. We...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-04380-5 |
| _version_ | 1827633218418900992 |
|---|---|
| author | Manacy Pai T. Muhammad |
| author_facet | Manacy Pai T. Muhammad |
| author_sort | Manacy Pai |
| collection | DOAJ |
| description | Abstract Background While functional and mobility impairments (FMIs) have garnered the attention of health researchers in low and middle-income countries (LMICs), including India, research has yet to explore whether and to what extent the perception of one’s social status is associated with FMIs. We fill this gap in the literature by examining (1) the association between subjective social status (SSS) and FMIs among older adults in India and (2) whether this association between SSS and FMIs is mediated and moderated by life satisfaction and depression. Methods Data come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults aged 60 years and above. FMIs were assessed using established scales on impairments in activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility. SSS was assessed using the Macarthur scale. Life satisfaction was measured using responses to five statements gauging respondent’s overall satisfaction with life. Depression was calculated using the shortened version of the Composite International Diagnostic Interview (CIDI-SF). Multivariable regression was employed to examine the association between variables, and the interaction terms and Karlson-Holm-Breen (KHB) method were used separately to test the mediation and moderation effects. Results 39.11% of the sample had a low SSS, 8.26% were depressed, and 32.07% reported low life satisfaction. A total of 8.74%, 10.91%, and 8.45% of the study population reported at least one impairment in ADL, IADL, and mobility, respectively. Older adults in the higher SSS group were less likely to have ADL impairment (beta: -0.017, CI: -0.030, -0.0032) and mobility impairment (beta: -0.044, CI: -0.076, -0.013). Depression moderated the association between SSS and mobility impairment (p-value: 0.025), and life satisfaction moderated the association between SSS and ADL impairments (p-value: 0.041) and SSS and IADL impairments (p-value: 0.037). Depression mediated 20.28%, 31.88%, and 18.39% of the associations of SSS with ADL, IADL, and mobility impairments, respectively. Similarly, life satisfaction mediated 23.24%, 52.69%, and 27.22% of the associations of SSS with ADL, IADL, and mobility impairments. Conclusions That SSS is associated with FMIs among older Indians, even after considering their objective socioeconomic status (SES), suggests that the use of SSS is relevant to the study of health inequalities in India. The finding that life satisfaction and depression mediate and moderate this association is crucial in pinpointing those older Indians at risk of the functional and mobility-related repercussions of lower SSS. |
| first_indexed | 2024-03-09T14:56:28Z |
| format | Article |
| id | doaj.art-b9cf9e5753e04f3ba5f8d898a98a5394 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-09T14:56:28Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-b9cf9e5753e04f3ba5f8d898a98a53942023-11-26T14:10:47ZengBMCBMC Geriatrics1471-23182023-10-0123111710.1186/s12877-023-04380-5Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderatorsManacy Pai0T. Muhammad1Department of Sociology and Criminology, Kent State UniversityDepartment of Family & Generations, International Institute for Population SciencesAbstract Background While functional and mobility impairments (FMIs) have garnered the attention of health researchers in low and middle-income countries (LMICs), including India, research has yet to explore whether and to what extent the perception of one’s social status is associated with FMIs. We fill this gap in the literature by examining (1) the association between subjective social status (SSS) and FMIs among older adults in India and (2) whether this association between SSS and FMIs is mediated and moderated by life satisfaction and depression. Methods Data come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults aged 60 years and above. FMIs were assessed using established scales on impairments in activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility. SSS was assessed using the Macarthur scale. Life satisfaction was measured using responses to five statements gauging respondent’s overall satisfaction with life. Depression was calculated using the shortened version of the Composite International Diagnostic Interview (CIDI-SF). Multivariable regression was employed to examine the association between variables, and the interaction terms and Karlson-Holm-Breen (KHB) method were used separately to test the mediation and moderation effects. Results 39.11% of the sample had a low SSS, 8.26% were depressed, and 32.07% reported low life satisfaction. A total of 8.74%, 10.91%, and 8.45% of the study population reported at least one impairment in ADL, IADL, and mobility, respectively. Older adults in the higher SSS group were less likely to have ADL impairment (beta: -0.017, CI: -0.030, -0.0032) and mobility impairment (beta: -0.044, CI: -0.076, -0.013). Depression moderated the association between SSS and mobility impairment (p-value: 0.025), and life satisfaction moderated the association between SSS and ADL impairments (p-value: 0.041) and SSS and IADL impairments (p-value: 0.037). Depression mediated 20.28%, 31.88%, and 18.39% of the associations of SSS with ADL, IADL, and mobility impairments, respectively. Similarly, life satisfaction mediated 23.24%, 52.69%, and 27.22% of the associations of SSS with ADL, IADL, and mobility impairments. Conclusions That SSS is associated with FMIs among older Indians, even after considering their objective socioeconomic status (SES), suggests that the use of SSS is relevant to the study of health inequalities in India. The finding that life satisfaction and depression mediate and moderate this association is crucial in pinpointing those older Indians at risk of the functional and mobility-related repercussions of lower SSS.https://doi.org/10.1186/s12877-023-04380-5Subjective social statusFunctional and mobility impairmentOlder adults |
| spellingShingle | Manacy Pai T. Muhammad Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators BMC Geriatrics Subjective social status Functional and mobility impairment Older adults |
| title | Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators |
| title_full | Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators |
| title_fullStr | Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators |
| title_full_unstemmed | Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators |
| title_short | Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators |
| title_sort | subjective social status and functional and mobility impairments among older adults life satisfaction and depression as mediators and moderators |
| topic | Subjective social status Functional and mobility impairment Older adults |
| url | https://doi.org/10.1186/s12877-023-04380-5 |
| work_keys_str_mv | AT manacypai subjectivesocialstatusandfunctionalandmobilityimpairmentsamongolderadultslifesatisfactionanddepressionasmediatorsandmoderators AT tmuhammad subjectivesocialstatusandfunctionalandmobilityimpairmentsamongolderadultslifesatisfactionanddepressionasmediatorsandmoderators |