Physical Health, Economic Status, Social Relations, and Depression among Chinese Older Adults: A Structural Equation Modelling Analysis

Abstract

This study aims to test an integrated model of physical health, economic status, social relations, and geriatric depression, and in particular to examine the stress-buffering role of social relations on the negative psychological effects of declining physical health and worsening economic status. Data from 5,316 older adults (≥60 years) from a nationally representative cross-sectional database in China were used. Social relations were measured by both the intergenerational relationship and the social network beyond family ties. Descriptive analysis, multivariable regression, and structural equation modelling were used in a stepwise fashion. The results showed that poor physical health (identified as more chronic diseases, worse daily living function, and worse sleep quality) and lower economic status (identified as lower income and more debt) were significantly associated with weaker social relations and higher depression scores. Both intergenerational relationship and social network appeared to mediate the effects of physical health and economic status on geriatric depression, but in slightly different ways. Social relations play an important role in buffering the negative psychological effects of declining physical health and worsening economic status on the older group in China. The findings suggest the importance of strengthening health care, compensating for economic disadvantage and improving social relations in protecting the mental health of older adults.