The Impact Of Social Participation On Depression Among The Older Adults: The Mediating Role Of Physical Multi-Morbidity

Background: Social participation and physical multi-morbidity are common influencing factors of mental health conditions in the older adult population. Understanding the trajectories of these will help implement treatments and interventions. With the increasing attention given to geriatric depression in recent years, this study aims to explore the correlation between social participation and depression, and further to detect the mediating effect of physical multi-morbidity. Methods: : We screened 6,421 subjects that met the inclusion criteria from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS) database. Social participant and depressive symptoms were assessed using the 12-item self-made scale and 10-item Center for Epidemiological Studies Depression Scale (CESD-10), respectively. Logistic regression and mediating effect model were used to identify the association between the main variables. Results: : We found that 13.4% of the elderly are engaged in heavy social participation and 53.38% of them are not engaged in any social participation. In addition, 8.27% of the elderly have depression and 31.38% have depressive symptoms. Female, rural areas, lower education, more negative marital status, poor health status, and more frequent outpatient and inpatient services were associated with higher depression in the Chinese elderly. CESD-10 is negatively correlated with social participation and positively correlated with physical multi-morbidity. Physical multi-morbidity has a mediating effect in the affection of social participation on depression. Conclusions: : This study preliminary prompted severe depressive symptoms associated with worse social participation intense in a Chinese elderly community population. Higher levels of social participation and a low level of physical multi-morbidity should be maintained in this population, and additional educational activities should be organized among seniors on a large scale.