Associations of one-to-one peer support service and intervention outcomes among older adults with depressive symptoms: Evidence from a community-based stepped care programme for late-life depression in Hong Kong.

OBJECTIVE

Evidence on the outcomes of peer support for late-life depression is limited. This study examined whether the presence of a peer supporter alongside intervention improves older adults' mental health outcomes and the differential impacts of different peer support types and contents.

METHOD: From January 2024 to July 2025, depressive symptoms (Patient Health Questionnaire-9), generalised anxiety symptoms (Generalised Anxiety Disorder-7), and loneliness (3-item UCLA Loneliness Scale) of service users in the community-based mental health programme were collected at pre- and post-intervention. Linear mixed models examined the interaction effects between time and the presence of a peer supporter, service type, content, year of peer support experience, adjusting for sociodemographic variables, on mental health outcomes.

RESULT: Among 1124 older adults, 591 received peer support. Those with peer support showed a greater reduction in depressive symptoms (b = -0.42, CI = -0.80 - -0.05) compared to those without. Home visits (b = -1.27, CI = -1.97 - -0.57) and sharing personal recovery stories and life experiences (b = -1.07, CI = -1.87 - -0.26) were associated with a greater reduction in depressive symptoms than those who did not receive any peer support service. Service users with a more experienced peer supporter had a greater reduction in anxiety symptoms (b = -0.29, CI = -0.47 - -0.11) and loneliness (b = -0.14, CI = -0.24 - -0.03) following treatment.

CONCLUSION

Employing older adults as peer supporters may be a promising approach to improve service outcomes and promote productive ageing.