The Relationship Between Perceived Social Support and Ego Strength with Depression in Older Adults: The Mediating Role of Cultural Intelligence

Abstract
Background: Population aging is an imminent and pervasive social and demographic challenge in developing countries, including Iran. Therefore, the present study aimed to investigate the relationship of perceived social support and ego strength with depression in older adults, emphasizing the mediating role of cultural intelligence.
Method: The research employed a descriptive-correlational design utilizing path analysis. The statistical population comprised all older adults residing in Maragheh in 2024. Due to the lack of precise demographic data regarding the exact number of older adults in Maragheh, a sample of 220 individuals (105 men and 115 women) was selected using convenience sampling. Data were collected using the Multidimensional Scale of Perceived Social Support (Zimet et al.), Psychosocial Inventory of Ego Strengths (Markstrom et al.), Beck Depression Inventory (BDI), and the Cultural Intelligence Scale (Ang et al.). Data analysis was conducted using the Pearson correlation coefficient, bootstrapping, and the Sobel test via SPSS and AMOS (version 26).
Results: The results of the path analysis indicated that the proposed research model had a favorable fit, and 17% of the variance in depression among older adults was explained by the research variables. Furthermore, the analysis revealed that cultural intelligence played a significant mediating role in the relationship of both perceived social support and ego strength with depression (p<.01).
Conclusion: Based on these findings, therapists utilizing this model can focus on enhancing perceived social support and ego strength while leveraging cultural intelligence to reduce depression in older adulthood, thereby taking effective steps toward promoting the mental health of this population.
EXTENDED ABSTRACT
 Introduction
Given the growing population of older adults and the challenges and problems associated with this stage of life, efforts toward planning and policymaking to support the mental health of older adults are of essential importance. Despite numerous studies on depression and quality of life in older adults, there remains a significant gap in examining the complex relationships among these variables, particularly regarding the pathways and the mediating roles of variables such as cultural intelligence and social support in reducing depression among this population. This research can contribute to a better understanding of the relationships between these variables and provide new evidence for psychological and health interventions. Recognizing these relationships can be effective not only in the clinical management of depression in older adults but also in designing preventive interventions. In this regard, considering the increasing trend of the aging population in Iran and the importance of this demographic’s mental health, investigating these variables—especially in older adult and vulnerable communities—is of particular importance. This will provide researchers with clearer data, thereby enabling more effective steps toward resolving the psychological problems of this segment of society. Therefore, the present study was conducted to investigate the relationship of perceived social support and ego strength with depression in older adults through the mediating role of cultural intelligence. The study hypotheses were: (1) cultural intelligence mediates the relationship between perceived social support and depression in older adults, and (2) cultural intelligence mediates the relationship between ego strength and depression in older adults.
Method
The present research was applied in terms of its objective and utilized a descriptive-correlational design using path analysis. The statistical population of this study comprised all older adults over the age of 60 residing in Maragheh, Iran in 2024. A sample of 220 older adults in Maragheh was selected using convenience sampling. The inclusion criteria were: (1) age over 60 years, (2) basic literacy (reading and writing skills), and (3) willingness to participate in the study. The exclusion criteria included: (1) diagnosis of Alzheimer’s disease or other memory disorders, (2) use of psychiatric medications, and (3) unwillingness to participate. Following the issuance of permits and coordination with relevant authorities, sampling began among older adults across the city and in recreational areas such as parks. Prior to completing the questionnaires, the purpose of the research was explained to the participants, and they were asked to complete the questionnaires if they were willing. To observe ethical principles, informed consent was obtained from the participating older adults, and they were assured that the collected data would remain confidential. Data were collected using the Multidimensional Scale of Perceived Social Support (Zimet et al.), Psychosocial Inventory of Ego Strengths (Markstrom et al.), Beck Depression Inventory (BDI), and the Cultural Intelligence Scale (Ang et al.). After collecting the questionnaires, the data were analyzed using SPSS version 26 for descriptive statistics (means and standard deviations) and Pearson correlation analyses. Path analysis was performed using AMOS version 26.
Results
To examine the assumption of normal data distribution for the research variables, skewness and kurtosis tests were utilized. The calculated values for both skewness and kurtosis fell between the range of −1 and 1, indicating that the data distribution was normal. Furthermore, the results indicated a significant negative relationship between perceived social support and depression. A significant negative relationship was also observed between ego strength and depression (r=−0.279, p<.01). Additionally, a significant negative relationship existed between cultural intelligence and depression.
The findings demonstrated that ego strength and social support, interacting with the mediating role of cultural intelligence, played a role in explaining depression in older adults. This was supported by the values of the Goodness of Fit Index (GFI), Adjusted Goodness of Fit Index (AGFI), Incremental Fit Index (IFI), and Comparative Fit Index (CFI), which were all greater than 0.9 in the model. Moreover, in appropriate models, the ratio of Chi-square to degrees of freedom (χ2/df) should be in the range of 1 to 3; in this model, the χ2/df ratio fell between this acceptable range of 1 to 3. Additionally, the Root Mean Square Error of Approximation (RMSEA) should be less than 0.09; in this model, it was calculated at 0.05, indicating that the validity of the model was favorable.
Based on the results of path analysis modeling, the bootstrapping test was used to examine the significance of mediating relationships in the model. The results indicated that perceived social support and ego strength, interacting with the mediating role of cultural intelligence, played a role in explaining the depression in older adults, collectively accounting for 17% of the variance in depression among this population. The direct effects of perceived social support, ego strength, and cultural intelligence on depression in older adults were significant (p<.01). Finally, the results of the Sobel test showed that the indirect effects of social support and ego strength, mediated by cultural intelligence, were significant in explaining depression in older adults (p<.01).
Conclusion
The present study aimed to investigate the impact of perceived social support, ego strength, and cultural intelligence on depression in older adults. The findings emphasize that individuals with a higher sense of ego strength, owing to traits such as resilience and adaptability, are capable of engaging in broader interactions with people from other cultures if they possess high cultural intelligence. Upon successful adaptation, they experience a sense of satisfaction and self-worth, which in turn enhances their self-confidence and reduces isolation. Individuals with high cultural intelligence demonstrate better adjustment to social and cultural challenges; this fosters their social interactions and increases their engagement in social environments. Consequently, they perceive greater social support, which leads to a reduction in feelings of loneliness and depression. Furthermore, people with high cultural intelligence are better equipped to understand the needs and emotions of others and improve their interpersonal relationships. This strengthens their social networks, thereby preventing feelings of loneliness and isolation, and ultimately mitigating depression. Additionally, high cultural intelligence helps individuals adapt to diverse cultural settings and situations; this adaptability can elevate feelings of competence and self-confidence, ultimately preventing the onset of depressive symptoms.
Ethical Consideration
Ethical Code
The research was approved by the Research Deputy of the University of Maragheh.
Funding
This study received no external funding.
Financial Support
This study did not receive financial support.
Authors’ Contributions

H: Conceptualization, Methodology, Validation, Project administration, supervision; M. M: Data curation; I.H; Writing-Review & Editing; T. SH: Software, Formal analysis, writing-original draft, Writing - Review & Editing

Conflict of Interest
The authors declare that there is no conflict of interest regarding the publication of this article.
Acknowledgments
The authors would like to express their gratitude to the Research Deputy of the University of Maragheh and all the individuals who sincerely cooperated in the execution of this study.
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