ABSTRACT
Objective:To investigate the status and influencing factors of activities of daily living (ADL), anxiety and depression of the community-dwelling elderly, and to explore the mediating effect of social support and social participation on ADL, anxiety and depression.Methods:A questionnaire survey was conducted from July to October 2022, among 637 residents over 60 years old registered in the Community Health Service Center of Taiyuan Economic and Technological Development Zone selected by simple random sampling method. The general information questionnaire, Activities of Daily Living (ADL) scale, Anxiety Self-assessment Scale, Depression Self-assessment Scale, Social Support Scale, and Social Participation Scale were used in the survey. The dichotomous logistic regression model was used to analyze the influencing factors of disability, anxiety, and depression of the elderly. Structural equation modeling was used to verify the mediating effects of social participation and social support on the ADL and mental health status in the elderly.Results:The disability rate of the elderly in the community was 42.9%(258/602). Age( OR=2.87-4.91), acute disease attack in the last three months( OR=2.03),poor economic status( OR=2.39), impaired social participation ability( OR=4.07, 11.75) and low level of social support( OR=2.37) were risk factors for disability of the elderly in the community. The incidence of anxiety symptoms was 22.7%(137/602). The risk factors of anxiety were having more than one chronic disease ( OR=2.24), poor economic status ( OR=2.27), mild and intermediate impairment of social participation ability( OR=6.97, 180.43)and low level of social support( OR=2.04). The incidence of depressive symptoms was 19.4%(117/602). The risk factors of depression were acute disease attack in the past three months ( OR=1.90), loneliness in the past three months ( OR=2.17), impaired social participation ( OR=4.17) and low level of social support ( OR=3.90). The direct effect of ADL on mental health was 0.204 (Bootstrap 95% CI:0.081-0.330), accounting for 34.58% of the total effect. The mediating effects of social participation and social support on ADL and mental health were 0.343 (Bootstrap 95% CI:0.274-0.418) and 0.042 (Bootstrap 95% CI:0.015-0.075) respectively, accounting for 58.13% and 7.12% of the total effect. Conclusions:Social support and social participation are not only the common influencing factors of ADL, anxiety and depression of the community-dwelling elderly, but also have a mediating effect on ADL and mental health. Promoting the social participation of the community-dwelling elderly and increasing social support can improve both ADL and mental health for them.