The Association Between Living Alone and Depressive Symptoms in Older Adults Population: Evidence from the China Health and Retirement Longitudinal Study

Overview

Journal Front Public Health

Specialty Public Health

Date 2024 Oct 24

PMID 39444967

Authors

Hui Fang

Yingxin Duan

Yinxin Hou

HaoRan Chang

Shanju Hu

Ruyi Huang

Affiliations

Soon will be listed here.

Abstract

Objective: The goal of this research was to reveal the association between living alone and depressive symptoms in older adults. It also aims to explore the mediating role of social activity and adult children's relationship satisfaction. Ultimately, the study seeks to add to the body of knowledge for lowering the risk of depression among older people and promoting positive aging.

Methods: Based on information from the 2020 China Health and Retirement Longitudinal Study, the ordinary least square (OLS) regression model and propensity score matching (PSM) were used to investigate the association between living alone and depressive symptoms in older adults and to explore possible heterogeneity in different groups. Utilizing the SPSS PROCESS macro application, the mediation model was constructed. The significance of the mediation effect was investigated using the Bootstrap technique.

Results: The average level of depressive symptoms of older people living alone (10.55 ± 6.962) was higher than that of older people who do not live alone (8.80 ± 6.363). The baseline regression analysis revealed a significant connection between living alone and the depressive symptoms of older people ( = 0.842, < 0.001). The association between living alone and the level of depressive symptoms was significantly higher in those aged 60-74 years ( = 1.698, < 0.001) than in those aged 75 and older ( = 0.953, < 0.05). The association between living alone and depressive symptoms was significantly higher in rural older adults ( = 1.512, < 0.001) than in urban older adults ( = 1.141, < 0.001). Between living alone and the level of depressive symptoms experienced by older people, there was a substantial mediation impact on social engagement and adult children's relationship satisfaction, which contributed to 2.91 and 13.62% of the overall effect.

Conclusion: For older age groups, living alone is associated with higher levels of depressive symptoms. This effect is stronger in older adults aged 60-74 or rural areas. In older age groups, the association between living alone and depressive symptoms is mediated by social activity and adult children's relationship satisfaction.

Citing Articles

A network analysis of depression and anxiety symptoms among Chinese elderly living alone: based on the 2017-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS).

Chang Z, Zhang Y, Liang X, Chen Y, Guo C, Chi X BMC Psychiatry. 2025; 25(1):28.

PMID: 39780094 PMC: 11716466. DOI: 10.1186/s12888-024-06443-2.

References

Silverstein M, Bengtson V . Do close parent-child relations reduce the mortality risk of older parents?. J Health Soc Behav. 1991; 32(4):382-95. View

Ang S . Social Participation and Mortality Among Older Adults in Singapore: Does Ethnicity Explain Gender Differences?. J Gerontol B Psychol Sci Soc Sci. 2016; 73(8):1470-1479. DOI: 10.1093/geronb/gbw078. View

Oshio T, Kan M . Which is riskier for mental health, living alone or not participating in any social activity? Evidence from a population-based eleven-year survey in Japan. Soc Sci Med. 2019; 233:57-63. DOI: 10.1016/j.socscimed.2019.05.049. View

Cui L, Ding D, Chen J, Wang M, He F, Yu S . Factors affecting the evolution of Chinese elderly depression: a cross-sectional study. BMC Geriatr. 2022; 22(1):109. PMC: 8822727. DOI: 10.1186/s12877-021-02675-z. View

Wu B, Xiong G, Zhang P, Ma X . Effects of tai chi, ba duan jin, and walking on the mental health status of urban older people living alone: the mediating role of social participation and the moderating role of the exercise environment. Front Public Health. 2024; 12:1294019. PMC: 10881673. DOI: 10.3389/fpubh.2024.1294019. View

Collins A . Health ecology and environmental management in Mozambique. Health Place. 2002; 8(4):263-72. DOI: 10.1016/s1353-8292(02)00005-9. View

Zhang J, Nazroo J, Zhang N . Gender differences in rural-urban migration and its impact on depression in later life. Health Place. 2022; 77:102890. DOI: 10.1016/j.healthplace.2022.102890. View

Gu D, Feng Q, Yeung W . Reciprocal Dynamics of Solo-Living and Health Among Older Adults in Contemporary China. J Gerontol B Psychol Sci Soc Sci. 2018; 74(8):1441-1452. DOI: 10.1093/geronb/gby140. View

Li L, Zhang J, Liang J . Health among the oldest-old in China: which living arrangements make a difference?. Soc Sci Med. 2008; 68(2):220-7. PMC: 4912352. DOI: 10.1016/j.socscimed.2008.10.013. View

10.

Gong J, Wang G, Wang Y, Zhao Y . Consumption and poverty of older Chinese: 2011-2020. J Econ Ageing. 2023; 23. PMC: 10205791. DOI: 10.1016/j.jeoa.2022.100410. View

11.

Andresen E, Malmgren J, Carter W, Patrick D . Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994; 10(2):77-84. View

12.

Nakagomi A, Shiba K, Kondo K, Kawachi I . Can Online Communication Prevent Depression Among Older People? A Longitudinal Analysis. J Appl Gerontol. 2020; 41(1):167-175. DOI: 10.1177/0733464820982147. View

13.

Russell D, Taylor J . Living alone and depressive symptoms: the influence of gender, physical disability, and social support among Hispanic and non-Hispanic older adults. J Gerontol B Psychol Sci Soc Sci. 2009; 64(1):95-104. PMC: 2654980. DOI: 10.1093/geronb/gbn002. View

14.

Malhi G, Mann J . Depression. Lancet. 2018; 392(10161):2299-2312. DOI: 10.1016/S0140-6736(18)31948-2. View

15.

Lee C, Yeh C, Lee M, Lin H, Chen V, Hsieh M . Social support and mobility limitation as modifiable predictors of improvement in depressive symptoms in the elderly: results of a national longitudinal study. Arch Gerontol Geriatr. 2012; 55(3):530-8. DOI: 10.1016/j.archger.2012.03.002. View

16.

Barrenetxea J, Yang Y, Pan A, Feng Q, Koh W . Social Disconnection and Living Arrangements among Older Adults: The Singapore Chinese Health Study. Gerontology. 2021; 68(3):330-338. DOI: 10.1159/000516626. View

17.

Thapa D, Visentin D, Kornhaber R, Cleary M . Migration of adult children and mental health of older parents 'left behind': An integrative review. PLoS One. 2018; 13(10):e0205665. PMC: 6197646. DOI: 10.1371/journal.pone.0205665. View

18.

Jacob L, Haro J, Koyanagi A . Relationship between living alone and common mental disorders in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. PLoS One. 2019; 14(5):e0215182. PMC: 6493731. DOI: 10.1371/journal.pone.0215182. View

19.

Sukontamarn P, Asadullah M, Photphisutthiphong N, Nguyen Y . Happiness in Old Age: The Daughter Connection. J Happiness Stud. 2023; 24(5):1729-1757. PMC: 10139918. DOI: 10.1007/s10902-023-00655-1. View

20.

McElroy E, Herrett E, Patel K, Piehlmaier D, Di Gessa G, Huggins C . Living alone and mental health: parallel analyses in UK longitudinal population surveys and electronic health records prior to and during the COVID-19 pandemic. BMJ Ment Health. 2023; 26(1). PMC: 10577768. DOI: 10.1136/bmjment-2023-300842. View