Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study

Guangjun Zheng; Biying Zhou; Zhenger Fang; Chunxia Jing; Sui Zhu; Mingliang Liu; Xia Chen; Lei Zuo; Haiyan Chen; Guang Hao

doi:10.1186/s12888-023-05370-y

Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study

BMC Psychiatry. 2023 Nov 17;23(1):853. doi: 10.1186/s12888-023-05370-y.

Authors

Guangjun Zheng¹, Biying Zhou¹, Zhenger Fang¹, Chunxia Jing^{1

2}, Sui Zhu¹, Mingliang Liu¹, Xia Chen¹, Lei Zuo¹, Haiyan Chen³, Guang Hao⁴

Affiliations

¹ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
² Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, China.
³ Department of Parasitic Disease and Endemic Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
⁴ Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Guangzhou, 510632, Guangdong, China. haoguang2015@hotmail.com.

Abstract

Background: There were a few studies that examined the longitudinal association between living alone and depressive symptoms, and the vast majority of them were conducted in patients with certain diseases, such as heart failure, cancer, and glaucoma. This study aimed to examine the association between living alone and depressive symptoms in a large representative older Chinese population.

Methods: The China Health and Retirement Longitudinal Study (CHARLS) data from 2015 to 2018 were used. Living alone was defined as participants who did not live with others ever or more than 11 months in the past year at baseline. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression Scale (CES-D10). The multivariate logistic regression was used to estimate the relationship between living alone and depressive symptoms.

Results: There were 5,311 and 2,696 participants ≥ 60 years old included in the cross-sectional and cohort analysis, respectively. The risk of depressive symptoms in participants who lived alone was significantly higher than those who lived with others in both cross-sectional (OR:1.33; 95%CI:1.14,1.54) and cohort analysis (OR:1.23; 95%CI:0.97,1.55). There was a significant interaction between financial support and living alone (P_interaction = 0.008) on the risk of depressive symptoms. Stratified analyses showed that, compared to those who lived with others, the risk of depressive symptoms in participants who lived alone increased by 83% (OR:1.83; 95%CI:1.26,2.65) in participants receiving lower financial support. However, we did not find statistically significant associations in participants with medium (OR:1.10; 95%CI: 0.74,1.63) and higher financial support (OR: 0.87; 95%CI: 0.53,1.41).

Conclusion: Living alone was associated with a higher risk of depressive symptoms in the Chinese older population, and this association was moderated by the receipt of financial support. Living alone may be an effective and easy predictor for early identification of high-risk populations of depression in the older population.

Keywords: Depressive symptoms; Financial support; Living alone; Older population.

MeSH terms

China / epidemiology
Cohort Studies
Cross-Sectional Studies
Depression* / complications
Depression* / diagnosis
Depression* / epidemiology
Home Environment
Humans
Longitudinal Studies
Middle Aged
Retirement*