Moderating effects of social capital on the relationship between fear of falling and depressive symptoms among community-dwelling older adults

Abstract

BackgroundFear of falling (FoF) and depression substantially affect the health outcomes of older adults. Previous studies have established an association between FoF and depression; however, the moderating role of social capital in this relationship remains underexplored. We aimed to investigate the moderating effect of social capital on the relationship between FoF and depressive symptoms in older adults.MethodsData from 773,861 adults aged >= 65 years who participated in the 2019 Korean Community Health Survey (KCHS) were used for this cross-sectional study. The assessment tools included measures of FoF, the Patient Health Questionnaire-9, and indicators of social capital (neighborhood trust, neighborly reciprocity, neighborhood satisfaction, social networks, and social participation). Data were analyzed using a linear regression model with the complex survey module, which accounts for stratification, clustering, and sampling weights inherent in the KCHS design.ResultsHigher levels of FoF were significantly associated with increased depressive symptoms (B = 0.94, 95% confidence interval [CI] = 0.88, 1.00). Social capital significantly moderated this FoF-depression relationship, with the strongest effects observed for social participation (B = -0.21, 95% CI = -0.26, -0.15) and social networks (B = -0.16, 95% CI = -0.23, -0.10), followed by neighborhood satisfaction (B = -0.12, 95% CI = -0.17, -0.06). These interactions indicate that higher social capital attenuates the positive association between FoF and depressive symptoms.ConclusionsThe critical role of social capital in moderating the relationship between FoF and depressive symptoms in community-dwelling older adults was empirically validated. Using a nationally representative dataset and complex sampling design, the generalizability of the findings was enhanced. The findings underscore the need for social capital enhancement strategies, such as strengthening social networks, expanding social participation opportunities, and developing age-friendly environments, to prevent and manage FoF and depression among community-dwelling older adults.