Perceived Social Support and Well-Being: Mediation and Buffering of the Stress-Depression Link in Rural Older Adults.

Background/

Objectives

Rural older adults are exposed to multiple chronic stressors that may heighten depressive symptoms, and these effects can be intensified by social disconnection, particularly in resource-constrained settings. This study examined whether global and dimension-specific perceived social support-an indicator of perceived social connection-mediates and/or buffers the association between perceived stress and depressive symptoms in rural older adults from northern Peru.

Methods

A cross-sectional survey was conducted with 166 community-dwelling adults aged ≥60 years in a rural coastal district. Perceived stress (PSS-4), depressive symptoms (GDS-15), and perceived social support (MOS-SSS) were assessed. Regression-based mediation and moderation models with bootstrapped confidence intervals were estimated, adjusting for age, sex, marital status, education, income category, and chronic medical conditions.

Results

Higher perceived stress was associated with greater depressive symptoms. Greater overall social support was associated with lower perceived stress and fewer depressive symptoms. Indirect effects supported a stress-process pathway for overall support, particularly socioemotional dimensions (positive social interaction and affectionate support). No buffering effect was observed for overall support; however, tangible (instrumental) support attenuated the association between stress and depressive symptoms.

Conclusions

Mediation analyses supported an indirect pathway linking perceived stress to depressive symptoms via socioemotional support, whereas tangible (instrumental) support moderated the stress-depression association. Interventions that strengthen social connectedness and practical assistance may help protect mental health in rural older adults.