The Relationship between Physical Functioning and Mental Health among Older Adults with Disabilities in Korea - Moderating Effects of Age -

Abstract

Few Korean studies have examined the effects of physical functioning and age on mental health, a condition that is likely to vary according to different age groups. This study examines how functional limitations are related to psychological well-being represented by both depression and anxiety among a sample of the young-old and old-old persons with disabilities in South Korea. The moderating effect of age on the relationship between functional limitation and depression/anxiety among the older adults were also examined.

Research questions of the present study are based on Lazarus and Folkmans (1984) Transactional Model of Stress and Havighursts (1961) Activity Theory. There are three research questions: 1) What are the characteristics of older Koreans with disabilities?

2) How does functional limitation of older Koreans with disabilities affect their mental health?

and 3) Does age moderate the effect of functional limitations on mental health?

Survey responses from a total of 491 older Koreans with disabilities who are age 65 or over were collected from the National Pension Panel in 2009. Multiple regression analyses, path analyses, and the parametric statistical procedures were used to test the hypotheses.

The findings of this study are presented as the following: First, the majority of older Korean adults with disabilities are less educated and highly unemployed. Over 80% of the samples are not financially independent and they consider health/medical issues as important aspects. Also, the study participants consider that the governments support is essential in later life. Second, consistent with the previous study, the current study shows that functional limitations (ADLs and IADLs) have a positive association with depressive and anxiety symptoms. ADL and IADL did not have a different impact on depression and anxiety. Third, there is a significant moderating effect of age

higher functional limitations were significantly related to lower levels of depression and anxiety among the older elderly people compared to their younger counterparts. Surprisingly, despite of the aging process, older age had a buffering effect on the relationship between functional limitations and mental health.

Based on the research outcomes, the present study suggests the future practical work on older adults with disability needs to concentrate on the interrelationship between physical and mental health to promote the healthy later life. To do so, incorporating services and intervention in the field of both gerontology and disability are essential. Moreover, the significant moderating effect of age on physical health and mental health provides insights on developing a health age index every decade expecting the cohort effects. Developing a health age index by each decade will be helpful to group of older adults who are all different by their physical age as well as their chronological age.

The current study is meaningful as it contributes to the aging, disability, and psychological literature by applying the Activity Theory and the Transactional Model. Also, it is the first study that analyzes the relationship between functional health and mental health focused on both depression and anxiety among older Koreans with disabilities using nationally representative data.

However, the present study still has several limitations. First, it is difficult to demonstrate how the functional status correlates with mental health over time as the current study conducted used a cross-sectional design. Also, social and environmental components that affect ones capacity for activities in daily living are not fully reflected in ADL/IADL measures. Third, the study design does not provide a determination of the causal direction of the relationships between functional health and mental health (depression/anxiety). These limitations should be addressed in future studies. No one is immune from becoming disabled and being old. Active researches on older adults with disabilities will provide greater insights, expanding the horizon enhancing understanding of late life that everyone will encounter.