Restricted Social Engagement Is Associated With Depressive Symptoms in Older Chinese Adults: A Nationwide Cross-Sectional Study.

Abstract

BACKGROUND AND AIMS: Social isolation has been linked to depressive symptoms in older adults. Previous studies have shown that greater engagement in social activities is associated with better mental health. However, it remains unclear whether restricted social engagement is related to poorer mental health outcomes. This study examined the association between reduced social activities/networking and the presence of depressive symptoms among community-dwelling older Chinese adults. METHODS: During the COVID-19 pandemic, people chose to minimize going out to reduce the risk of infection, creating a natural setting that mimicked a passive intervention of restricted social engagement for community-based individuals. Data were drawn from 7288 participants aged ≥ 65 years from the fifth wave (2019-2020) wave of the China Health and Retirement Longitudinal Study. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale. Social activities/networking changes due to COVID-19 were self-reported. Multivariable logistic regression examined associations between activity changes and depressive symptoms, adjusting for demographics and anxiety/fear levels. RESULTS: Among 7288 participants (49.8% female;mean age 73.1, SD = 6.6), 41.4% exhibited depressive symptoms. The prevalence of depressive symptoms was higher among females (50.3%) than males (32.7%). Higher education levels were associated with a lower prevalence of depressive symptoms. Participants reporting anxiety or fear were more likely to exhibit depressive symptoms. After adjusting for potential confounders, including social demographics and other mental problems, multivariate logistic regression analysis revealed reduced contact with other people was a significant risk factor for depression, whereas reduced participation in social gatherings was unexpectedly associated with a lower risk of depressive symptoms. CONCLUSIONS: Reduced social engagement and related health behaviors were associated with an increased likelihood of depressive symptoms among Chinese older adults during the COVID-19 pandemic. Interventions that promote social participation and healthy lifestyles may help protect mental health in this vulnerable population.