The pattern of support networks among the community dwelling elderly in urban Ireland: variations with mental disorder

Objectives: The changing family and social patterns in modern society are l ikely to influence the availability of informal support for older people. T he aims of this study were to determine the support network distribution of a community dwelling elderly population in Dublin, and of those with menta l disorders (dementia, depression and anxiety). Methods: Interviews with 1,001 community dwelling older people using GMS-AG ECAT. In addition, a support network assessment instrument was administered , which identifies five different support network types. The local integrat ed and wider community focused networks are characterised by extensive comm unity involvement, family dependent networks by close family support, and t he local self contained and private restricted networks by low levels of fa mily and community involvement, Results: Of the elderly population, 83% had support networks characterised by close community and/or family involvement. Subjects with cognitive impai rment had lower levels of informal support from the community as indicated by a lower proportion of local integrated (44% v 63%) and a higher proporti on of private restricted (6% v 12%) networks. Late life depression was also associated with decreased levels of community integration. Conclusions: The elderly in Dublin appear to have high levels of informal s upport. The extensive support may be a factor in the lower rates of depress ion found in Dublin than in London and New York. While the overall level of informal support available to older people with mental disorders in the co mmunity remains high, a proportion have low levels of family and community involvement and consequently their mental health problems may go unrecognis ed.