Gender-specific development of depressive symptoms in older adults: Contemporaneous and temporal network analyses based on the China health and retirement longitudinal study.
It was found that older men with depressive symptoms were more likely to experience somatic fatigue, while depressive symptoms in older women were associated with social isolation, which may suggest that older men with depressive symptoms were more likely to experience somatic fatigue.
Abstract
Depression is highly prevalent among older adults, and impairs both mental and physical health. However, whether and how gender influences the development of depressive symptoms in older adults is unclear. The current study systematically examined the gender-specific development of depressive symptoms in national data. Participants were 5683 older adults (47.9% older women; Mage= 66.8 years) from the China Health and Retirement Longitudinal Study. Depressive symptoms were assessed by the center for epidemiological studies depression scale in 2015 (T1) and 2018 (T2). Gaussian graphical model (GGM) networks, Bayesian networks and cross-lagged panel networks (CLPNs) were used to examine the association between depressive symptoms from a comprehensive perspective. Cross-sectional networks (i.e., GGM and Bayesian networks) with T1 data suggested strong connections between loneliness and inability to get going for women while a strong relationship between the everything was an effort and feeling depressed for men. In CLPNs, the feeling bothered at T1 was positively associated with feeling depressed at T2 and the loneliness showed a bidirectional longitudinal association with inability to get going across time for women, while the everything was an effort at T1 was related to feeling depressed at T2 and the feeling depressed at T1 was associated with loneliness at T2 for men. These findings may suggest that older men with depressive symptoms were more likely to experience somatic fatigue, while depressive symptoms in older women were associated with social isolation. Recognizing these gender-specific symptom profiles may inform the development of tailored mental health policies and prevention strategies.
Background: Depressive symptoms have become a significant public health issue faced by middle-aged and older adults in China. Although previous studies have primarily focused on demographic and socioeconomic factors, the association between modifiable lifestyle behaviors and depressive symptoms still requires further investigation. Objective: To examine the associations between sleep duration, physical activity, digital participation, social participation, and depressive symptoms as well as life satisfaction among middle-aged and older adults in China. Methods: A cross-sectional analysis was conducted using data from the 2020 China Health and Retirement Longitudinal Survey (CHARLS). Depressive symptoms were defined as CES-D-10 scores ≥10, with 13,576 individuals included in the analysis sample. Adjusted prevalence ratios (aPRs) were estimated using modified Poisson regression, while ordinal logistic regression was employed to analyze life satisfaction. The analysis controlled for covariates such as demographics, socioeconomic status, and health status, and accounted for the complex sampling design. Results: The weighted prevalence of depressive symptoms was 44.5%. Sleep deprivation (<7 h/day) was significantly associated with elevated depressive symptoms (aPR = 1.49, 95% CI: 1.33–1.68); participation in recreational activities was significantly associated with reduced depressive symptoms (aPR = 0.86, 95% CI: 0.77–0.96); adequate physical activity was associated with a higher prevalence of elevated depressive symptoms (aPR = 1.17, 95% CI: 1.04–1.32); watching videos (aPR = 0.87, 95% CI: 0.76–0.99) and playing online games (aPR = 0.65, 95% CI: 0.50–0.83) were significantly associated with reduced depressive symptoms; and overall internet use was correlated with lower life satisfaction (OR = 0.90, 95% CI: 0.81–1.00). Women, rural residents, and low-income groups exhibited higher prevalence of elevated depressive symptoms. Conclusion: Sleep deprivation, as well as different types of social engagement, physical activity, and digital behavior, exhibit distinct associations with depressive symptoms in middle-aged and older adults. Behavioral intervention strategies targeting sleep hygiene, leisure activities, and tailored digital behaviors warrant further attention.
Shu Wang, Y. Shirayama, Ishtiaq Ahmad et al.· Behavioral Science· 0 citations
Background While the positive association between physical exercise and depressive symptoms (as an indicator of mental health) is well-established, existing research lacks a dynamic life-course and socio-generational perspective. It remains unclear how these associations evolve across different ages, historical periods, and birth cohorts, and how they are moderated by structural factors such as the urban–rural divide. Methods Utilizing pooled cross-sectional data from five waves (2010–2017) of the China General Social Survey (CGSS) with 28,618 valid adult samples, this study employs a Hierarchical Age-Period-Cohort Cross-Classified Random Effects Model (HAPC-CCREM) to disentangle age, period, and cohort patterns. Results The advantage associated with regular physical exercise in terms of depressive symptoms exhibits a non-linear age pattern suggestive of a U-shape, being strongest among younger and older adults but attenuated during middle age. Cohort analysis reveals that earlier-born cohorts show a stronger positive association between exercise and fewer depressive symptoms. This positive association declined with socio-economic development but shows a resurgence among the post-1990s cohort, suggesting possible links to socio-economic development and shifting values. Urban–rural disparities significantly moderate this association: urban residents exhibit a stronger positive association and more effective stress-alleviating patterns from exercise, whereas the corresponding association for rural residents is comparatively limited. Conclusion The positive psychological correlates of physical exercise with respect to depressive symptoms are not static but are dynamically shaped by individual life stages and macro-social transformations. In the context of China’s transition towards post-materialist values, the role of exercise may be shifting from a “luxury enhancer” to a “necessary support.” Future public health strategies should adopt a differentiated approach, considering life-course stages, cohort experiences, and urban–rural structural contexts to implement precise mental health promotion strategies (i.e., reducing depressive symptoms).
Fuxiang Yu, Long Niu, Boyang He et al.· Frontiers in Public Health· 0 citations
Depressive symptoms among older adults in Turkey reflect the combined influence of health decline, functional limitations, negative psychosocial perceptions of ageing, and barriers to healthcare access.
BACKGROUND
The global demographic transition indicates a rapid shift toward an aging population structure. Good mental health in advanced ages is critical for a healthy aging. Problems such as depression reduce life expectancy and impose a societal burden. This study aims to examine, through a multidimensional approach, the sociodemographic, economic, health-related, functional, and psychosocial factors affecting depression levels among individuals aged 65 and over in Türkiye.
METHOD
In this study, microdata from the Türkiye Older Adult Profile Survey conducted by Turkish Statistical Institute (TurkStat) in 2023 was utilized. The analysis included a total of 10,348 individuals aged 65 and over who personally responded to perception-related questions. The dependent variable, depression level, was categorized as "not depressed," "mild," and "severe" according to Geriatric Depression Scale scores. In the analysis of the data, a generalized ordered logit model and marginal effects were employed due to the violation of the parallel lines assumption.
FINDINGS
Depression was common among older adults, with 46.71% exhibiting mild depressive symptoms. Specifically, 34.26% were mildly depressed and 12.45% were severely depressed, while 53.29% were classified as non-depressed. According to the analysis results, female gender, living alone, low-income level, and experiencing financial hardship significantly increase the risk of depression. In terms of health status, poor self-rated general health, sensory impairments (vision/hearing difficulties), history of falls, and the need for home care are the main factors increasing the likelihood of depression. An increase in functional independence (KATZ index) and maintaining a physically active lifestyle exhibit protective effects. Additionally, strong neighbor support, a higher number of support people, and a sense of autonomy in decision-making processes significantly reduce the level of depression.
CONCLUSION
Geriatric depression in Türkiye is a multidimensional phenomenon with complex socioeconomic and environmental determinants, in addition to biological factors. In particular, older women, individuals living alone, and economically disadvantaged groups are at high risk. The findings indicate that, to support healthy aging, clinical interventions alone are insufficient; strengthening social support networks, enhancing urban accessibility, and urgently developing inclusive public health policies that promote older adults'autonomy are required.
Kübranur Çebi̇ Karaaslan, Esra Bayrakçeken, Ö. Alkan et al.· BMC Geriatrics· 0 citations
Background: Chronic liver disease (CLD) imposes a heavy global burden, particularly among middle-aged and elderly adults. Prospective evidence on whether depressive symptoms independently predict new-onset CLD remains scarce. Methods: This prospective cohort study used CHARLS (2011–2020) data and enrolled 9549 participants without baseline CLD. Depressive symptoms were assessed using the CES-D-10 and categorized into four severity levels. Multivariable Cox regression, Kaplan–Meier analysis, and ROC curves were used. Subgroup analyses were conducted across demographic and behavioral strata to assess consistency. Results: During a mean follow-up of 8.77 years, 746 (7.8%) participants developed new-onset CLD. Higher baseline depression severity was associated with increased CLD risk. In the fully adjusted model, compared with the non-depressed group, the HR for mild depression was 1.34 (95% CI: 1.12–1.59, p = 0.001), for moderate depression 1.65 (95% CI: 1.34–2.04, p < 0.001), and for severe depression 2.16 (95% CI: 1.26–3.72, p = 0.005). Cumulative incidence increased with depression severity, with group differences widening over time (log-rank p < 0.0001). Subgroup analyses showed consistent associations across different demographic and behavioral strata. Conclusions: Across the total population, the analyses consistently demonstrate an independent, graded association between baseline depressive symptom severity and incident CLD that persists after multivariable adjustment. The stratified analyses further reveal that this association is primarily driven by female participants and middle-aged adults (45–60 years), highlighting these subgroups as priority populations for depression-informed CLD prevention and screening strategies.