Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study

Zheng, Guangjun; Zhou, Biying; Fang, Zhenger; Jing, Chunxia; Zhu, Sui; Liu, Mingliang; Chen, Xia; Zuo, Lei; Chen, Haiyan; Hao, Guang

doi:10.1186/s12888-023-05370-y

Cited by 4 publications

References 53 publications

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Utilisation Willingness for Institutional Care among Elderly Adults Living Alone in Northwest of China: A Cross-sectional Survey

Lv,

Zeng,

Zhu

et al. 2024

Preprint

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Background: Due to changes in family structures and social environments, an increasing number of elderly adults are living alone. The unique characteristics of their lifestyles and the absence of home-based care have necessitated the provision of special care and amenities for the elderly. The issue of willingness to utilize institutional care is a significant research priority, yet few studies have examined the willingness and factors influencing elderly adults living alone to consider such care. The objective of the study is to examine the variables that influence the decision of elderly individuals living alone to receive institutional care. This study aimed to explore the willingness of elderly adults living alone to choose institutional care and associated factors. Methods: This was a cross-sectional study, involving seven cities in Gansu Province, China. The analysis included 3,726 elderly adults living alone and used univariate analysis and binary logistic regression models to analyze the factors influencing institutional care willingness. To explore key factors, data were analyzed with stratifications on gender, age, and gender. The impact strength of each model was determined using the Anderson model as the theoretical foundation. Results: Of 3,726 elderly adults living alone, only 6.3% have a willingness for institutional care. The binary logistic regression showed that sources of life support, knowledge of the combination with medical care, the number of children, satisfaction with current health services, feeling of solitude, and frequency of medical examinations had a statistically significant impact on the willingness of the elderly adultsliving alone to age in institutions (P < 0.05). The predisposing and enabling factors have a bigger impact on the outcomes, according to the findings of fitting the coefficients using the Anderson model. Conclusions: The results of our study showed that elderly adults living alone were less willing to receive institutional care, but they had a higher demand for medical care and emotional support. Consequently, to address the aging crisis, it is advised that pertinent authorities implement targeted initiatives with an emphasis on the elderly.

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Utilisation Willingness for Institutional Care among Elderly Adults Living Alone in Northwest of China: A Cross-sectional Survey

Lv,

Zeng,

Zhu

et al. 2024

Preprint

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Healthy lifestyle moderates the association between recent negative life events and depressive symptoms: a cross-sectional study

Yang,

Liao,

et al. 2024

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Background Both recent negative life events (RNLEs) and lifestyle factors were associated with depressive symptoms, but it is unclear whether adopting a healthy lifestyle can mitigate the association between RNLEs and depressive symptoms. We aim to explore the modifying role of adopting a healthy lifestyle in the association between RNLEs and depressive symptoms. Method A cross-sectional study was conducted among 4278 participants aged 18–70 years. RNLEs includes 12 common negative life events that have occurred in the past year, and were classified as low RNLEs (0 RNLEs), intermediate RNLEs (1–5 RNLEs), and high RNLEs (6–12 RNLEs). A healthy lifestyle score in adulthood was constructed as the sum of five modifiable lifestyle factors (i.e., smoking status, drinking status, regular physical activity, sleep duration, and living alone), and was classified as unfavorable [0–2 points], intermediate [3 points], and favorable [4–5 points]) groups. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire. A cut-off value of ≥ 5 was used to identify participants with depressive symptoms. Results A total of 1366 (31.9%) participants had depressive symptoms. Individuals with high RNLEs had a higher likelihood of depressive symptoms (odds ratio [OR] = 10.89, 95% confidence interval [95%CI]: 8.59–13.80, P < 0.001) compared to those with low RNLEs. The prevalence of depressive symptoms decreased with the adoption of more favorable lifestyle categories, with the lowest likelihood observed among individuals with a favorable lifestyle (0.30 [0.25–0.37]). Participants with high RNLEs and a favorable lifestyle had an 80% lower association between depressive symptoms and RNLEs (OR = 0.20, 95% CI: 0.14–0.29) compared to those with high RNLEs and an unfavorable lifestyle. Conclusions In this cross-sectional study, adopting a greater number of healthy lifestyles was associated with a lower likelihood of depressive symptoms, and mitigated the association between RNLEs and depressive symptoms.

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The mediating effect of life satisfaction between daily living abilities and depressive symptoms in the Chinese older people: evidence from CHARLS 2020

Liao,

Zhang,

Xie

et al. 2024

Front. Public Health

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BackgroundDepressive symptoms represent a significant public health challenge, impacting the mental well-being of older adults. Despite this, the understanding of how activities of daily living (ADL) abilities correlate with life satisfaction and depressive symptoms among older Chinese adults remains limited.AimsThis study aims to investigate the relationship between ADL and depressive symptoms in older people Chinese individuals, with a specific focus on examining the mediating role of life satisfaction within this context.MethodsThe study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2020. A cohort of 8,343 individuals aged 60 years and above was included. The analysis was conducted using STATA 17.0 and SPSS 26.0, employing descriptive statistics, chi-square tests, Pearson correlations, and mediation analysis using the percentile Bootstrap method with 5,000 resamples to explore the interrelations among ADL, life satisfaction, and depressive symptoms.ResultsADL is positively correlated with life satisfaction (r = 0.129, p < 0.01) and negatively correlated with depressive symptoms (r = −0.313, p < 0.01). Additionally, life satisfaction and depressive symptoms are negatively correlated with each other (r = −0.360, p < 0.01). In the model of the mediating effect, ADL directly, significantly and negatively predicts depressive symptoms in the Chinese older people (β = −0.193, t = −17.827, p < 0.001). After incorporating life satisfaction into the regression equation, the direct predictive effect of ADL on depressive symptoms remains significant (β = −0.177, t = −17.099, p < 0.001); furthermore, ADL has a significant positive predictive effect on life satisfaction (β = 0.007, t = 4.959, p < 0.001) and life satisfaction significantly negatively predicts depressive symptoms (β = −2.235, t = −27.799, p < 0.001). Furthermore, the direct effect of ADL on depressive symptoms (−0.177) and its mediating effect (−0.016) account for 91.71% and 8.29% of the total effect (−0.193), respectively.ConclusionADL is inversely associated with the risk of depressive symptoms among older people Chinese individuals, with life satisfaction serving as a significant mediator in this relationship. Interventions aimed at improving life satisfaction in older people individuals with ADL impairments may effectively reduce or prevent the onset of depressive symptoms.

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Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study

Cited by 4 publications

References 53 publications

Utilisation Willingness for Institutional Care among Elderly Adults Living Alone in Northwest of China: A Cross-sectional Survey

Utilisation Willingness for Institutional Care among Elderly Adults Living Alone in Northwest of China: A Cross-sectional Survey

Healthy lifestyle moderates the association between recent negative life events and depressive symptoms: a cross-sectional study

The mediating effect of life satisfaction between daily living abilities and depressive symptoms in the Chinese older people: evidence from CHARLS 2020

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