The relationship between lifestyle risk factors and depression in Korean older adults: a moderating effect of gender

Abstract

Background Little is known regarding the role of gender as a possible modulator in determining the associations between lifestyle risk factors and depression in older adults. Objectives This study examined whether gender modulates the relationship between depression and lifestyle risk factors in Korean adults aged 65 years and older (n = 3700). Methods Data were obtained from the 2016 and 2018 Korea National Health and Examination Survey. The primary outcome was depression, assessed with the patient health questionnaire-9. As exposures, smoking habits, at-risk alcohol consumption, and physical inactivity were assessed with a standardized questionnaire. In addition, mean adequacy ratio (MAR) as an indicator of overall nutritional inadequacy was assessed with dietary intakes of macro- and micronutrients. Results In men only, either two or three and more risk factors were significantly associated with higher depression risk (OR (95% confidence interval, CI) = 2.886 (1.003–8.299) and OR (95% CI) = 3.109 (1.064–9.097), respectively). In women only, either two or three and more risk factors were also significantly associated with higher depression risk (OR (95% CI) = 1.505 (1.067–2.124) and OR (95% CI) = 2.828 (1.527–5.239), respectively). In particular, the presence of smoking habits and MAR were the major determinants of depression (OR (95% CI) = 1.835 (1.09–3.10) and OR (95% CI) = 1.585 (1.125–2.233), respectively) in women only. Finally, a moderation analysis with the Hayes PROCESS Macro showed a significant moderating effect of gender (β (95% CI) = 0.633 (0.206 ~ 1.060)) on the relationship between risk factors and depression. In addition, the slope of the relationship was much steeper in women than in men. Conclusion Current findings suggest that lifestyle risk factors are more closely associated with depression risk in women than in men.

Structured assessment of modifiable lifestyle habits among patients with mental illnesses in primary care

“…In older adults it has been revealed that lifestyle habits such as smoking or low levels of physical activity can indicate mental illness such as depression 19 . The accumulation of several bad habits, smoking, high alcohol consumption, inactivity and poor nutrition, increases the risk of depression.…”

Dietary Intake and Associated Factors Among Elderly Persons Receiving Social Assistance Grant for Empowerment (SAGE) in Northern Uganda

“…This positive relationship implies that a reduction in household size by one improves the MAR of SAGE bene ciaries by 0.078. This is not surprising because an increase in household size is often associated with a greater incidence of household food insecurity, as evidenced by previous studies (Mojela et al;Mazenda et al;2022). Therefore, the money obtained from SAGE increases their chances of being food secure and eating quality diets.…”

“…This nding implies that the wellbeing of elderly people is dependent on access to good dietary quality and adequate intake of nutrients. For instance, a study conducted in Korean older adults showed that the MAR was the major determinant of depression (Kim, 2022). Most of these adults also presented such challenges, which could have affected their nutrient intake by reducing their appetite for food, further reducing the MAR (Kim, 2022).…”

Gender Differences in Major Depressive Disorder and Relevant Interventions

“…A health study on depression showed a clear association of gender in the accumulation of these elements. What's more, smoking and overall undernutrition are main determinants of depression risk in women [10]. Smoking is often done to alleviate the distress caused by real-life problems.…”