The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety
Abstract Background With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (li...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-04161-0 |
| _version_ | 1797451560421163008 |
|---|---|
| author | Mina Huang Kun Liu Chunguang Liang Yongzhu Wang Zhanpeng Guo |
| author_facet | Mina Huang Kun Liu Chunguang Liang Yongzhu Wang Zhanpeng Guo |
| author_sort | Mina Huang |
| collection | DOAJ |
| description | Abstract Background With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms. Methods This cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms. Results Compared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively). Conclusions Sleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms. |
| first_indexed | 2024-03-09T14:56:23Z |
| format | Article |
| id | doaj.art-a398043dbe1546aaa0959fad411950df |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-09T14:56:23Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-a398043dbe1546aaa0959fad411950df2023-11-26T14:11:25ZengBMCBMC Geriatrics1471-23182023-08-0123111110.1186/s12877-023-04161-0The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxietyMina Huang0Kun Liu1Chunguang Liang2Yongzhu Wang3Zhanpeng Guo4Department of Nursing, The Jinzhou Medical UniversityDepartment of Medical College, The Jinzhou Medical UniversityDepartment of Nursing, The Jinzhou Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Jinzhou Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Jinzhou Medical UniversityAbstract Background With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms. Methods This cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms. Results Compared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively). Conclusions Sleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms.https://doi.org/10.1186/s12877-023-04161-0Living aloneDepressive symptomsSleep qualityAnxietyOlder adultsLiving arrangements |
| spellingShingle | Mina Huang Kun Liu Chunguang Liang Yongzhu Wang Zhanpeng Guo The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety BMC Geriatrics Living alone Depressive symptoms Sleep quality Anxiety Older adults Living arrangements |
| title | The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety |
| title_full | The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety |
| title_fullStr | The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety |
| title_full_unstemmed | The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety |
| title_short | The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety |
| title_sort | relationship between living alone or not and depressive symptoms in older adults a parallel mediation effect of sleep quality and anxiety |
| topic | Living alone Depressive symptoms Sleep quality Anxiety Older adults Living arrangements |
| url | https://doi.org/10.1186/s12877-023-04161-0 |
| work_keys_str_mv | AT minahuang therelationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety AT kunliu therelationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety AT chunguangliang therelationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety AT yongzhuwang therelationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety AT zhanpengguo therelationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety AT minahuang relationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety AT kunliu relationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety AT chunguangliang relationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety AT yongzhuwang relationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety AT zhanpengguo relationshipbetweenlivingaloneornotanddepressivesymptomsinolderadultsaparallelmediationeffectofsleepqualityandanxiety |