The Impacts of Self-Perception of Aging and Self-Efficacy on Depression among Korean Older Persons

Background and Purpose Depression in later life affects functional limitation, high suicide risk, decreased quality of life, and increased health care cost. Recent comprehensive analysis of brief interventions designed to ameliorate depression among older adults concluded that the effectiveness of these interventions is modest and the capacity of treatment is limited. Therefore, developing prevention strategies might be important as well as improving treatment. The purpose of this study is to examine how older persons' own stereotyping about aging relates to their depression. Studies on effects of self-perception of aging have shown that negative self-perception of aging predicted lowered self-efficacy, decreased cognitive performance, cardiovascular stress, and increased mortality. However, few studies have examined the impacts of older persons' own ageism on depression. Also, self-efficacy is tested as a mediator in the relationship between self-perception of aging and depression. It is hypothesized that self-perception of aging will predict depression and self-efficacy will mediate the relationship between self-perception of aging and depression.

Methods This study used a cross sectional survey design. One hundred and twenty-nine participants were recruited through 16 city councils in Busan, Korea. The data were collected by a continuing education program in Pusan National University, Korea through a mail survey. All participants were age 60 and over (M = 66.3, SD = 5.6). First, the principle component analysis was conducted to identify common factors underlying ageism, self-efficacy, and depression instruments. Second, structural equation model (SEM) was used to determine the structural relationships among latent constructs such as ageism, self-efficacy, and depression. The study used the product of coefficient tests to examine the statistical significance of the mediating variable, self-efficacy.

Results Findings indicated that the hypothesized model fit well with sample data (c² = 26.80, df = 20, p = 0.14, CFI = 0.98, RMSEA = 0.05). The direct relationship between ageism and depression was significant (p < .05). However, when the self-efficacy served as a mediator in the relationship between ageism and depression, the relationship between them was not significant anymore. The test of a specific indirect effect showed that the mediating effect of self-efficacy between ageism and depression was statistically significant (p < .05). The hypothesized model based on the relationships between ageism and self-efficacy accounts for 60% of the variances in depression.

Conclusions and Implications The results indicate that self-perception of aging predicted depression and self-efficacy mediates this relationship. That is, older adults who have a positive self-perception of aging were more likely to have a higher self-efficacy and to be less depressed. Self-perception of aging and self-efficacy might be important pathways which impact Korean older persons' mental health. Interventions to help older persons release their own ageism might be effective to prevent and alleviate depression. Self-perception of aging and self-efficacy should be considered when developing strategies to prevent and treat depression in older persons.