67.92% of older adults living alone in rural northwest China exhibit symptoms of depression.
Older adults living alone show a higher susceptibility to depression symptoms (β = 2.594, P < 0.05).
Depression rates are 51.84% for those in non-empty nests and 46.80% for those living only with a spouse.
living alone receive less than those living with a spouse or in non-empty arrangements, particularly in terms of subjective social support (β = 0.481, P < 0.05).
Heterogeneity analysis reveals that male older adults and those from non-poor families are particularly vulnerable to depressive symptoms when living alone.
Simplified
BACKGROUND: With the intensification of aging, depression among the older adults has become a significant global health challenge, especially in developing countries where the problem is particularly severe. This study aims to explore the association between living arrangements and depression, with a specific focus on examining the mediating role of in rural northwest China.
METHODS: Data were collected from 501 individuals aged 60 and above in rural Shaanxi Province, northwest China. Living arrangements were assessed based on co-residing family members. Depression was measured using the Geriatric Depression Scale-30, and social support was evaluated with the Social Support Rating Scale. Ordinary Least Squares Regression, Quantile Regression, Generalized Linear Regression, and Ordered Regression analyzed the association between living arrangements and depression. Hierarchical multiple linear regression examined the mediating role of social support. A heterogeneity analysis by gender and socio-economic status was also conducted.
RESULTS: The depression rates were 51.84% for non-empty nests, 67.92% for individuals living alone, and 46.80% for individuals only living with a spouse. The regression analysis did not reveal a significant difference in depressive between empty nests compared to non-empty nests. However, older adults living alone exhibited a higher susceptibility to depression symptoms (β = 2.594, P < 0.05). The mediating analysis showed that living alone experience higher rates of depression due to receiving less social support compared to those living with a spouse or in non-empty nest arrangements, particularly concerning subjective social support (β = 0.481, P < 0.05). Heterogeneity analysis identified specific vulnerable groups among older adults, emphasizing the higher susceptibility to depressive symptoms among those living alone, especially among male older adults or those from non-poor families.
CONCLUSIONS: Our findings emphasize a significant prevalence of depression among older adults in rural areas, particularly highlighting the vulnerability of those living alone. This underscores the urgent need for government attention to address the mental health challenges faced by the older adults. Future interventions should focus on improving social support networks to mitigate the impact of living alone on depression symptoms among this population.
Key numbers
67.92%
Depression Prevalence Living Alone
Percentage of older adults living alone exhibiting depressive symptoms.
46.80%
Depression Prevalence Living with Spouse
Percentage of older adults only living with a spouse exhibiting depressive symptoms.
51.84%
Depression Prevalence Non-Empty Nest
Percentage of older adults in non-empty nests exhibiting depressive symptoms.
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Declarations. Ethics approval and consent to participate: The study was approved by “Ethics Committees of Xi’an Jiaotong University in China (2020 − 1239) and Xi’an Gaoxin Hospital in China” (2019-KY005). Verbal informed consent was obtained from all participants. We certify that the study was performed in accordance with the 1964 declaration of Helsinki and later amendments. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
