Mediating Effect of Social Support on the Association between Functional Disability and Psychological Distress in Older Adults in Rural China: Does Age Make a Difference?

This study aimed to determine the prevalence of psychological distress among elderly people in rural China. Moreover, the mediating effect of social support on the association between functional disability and psychological distress and whether this effect varies with age would be examined. A total of 741 elderly people aged 60-89 years from a rural area of Shandong Province, China participated in a cross-sectional survey. Their psychological distress, perceived social support, enacted social support, and functional disability were assessed through questionnaires. A total of 217 (29.3%) rural elderly people had psychological distress. The functional disability of people ≥75 years old had smaller total effects (0.18) on their psychological distress than in people <75 years old (0.30). Moreover, most of the effects of functional disability on psychological distress among the people ≥75 years old were indirect (0.12; 66.67% of total effects) through the mediating effect of social support especially perceived support, while the direct effect of functional disability was insignificant. In contrast, most of the effects of functional disability on psychological distress among the people <75 years old were direct (0.29; 96.67% of total effects), while the mediating effect of social support was insignificant. In conclusion, the total effect of functional disability, especially the direct effect, on psychological distress decreases sharply with age. The mediating effect of social support on the association between functional disability and psychological distress varies with age and is only found in people ≥75 years.