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Regional Differences in the Effects of Social Relations on Depression Among Korean Elderly and the Moderating Effect of Living Alone

  • Kim, Chanki (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Chang, Eun Jee (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Kim, Chang-yup (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University)
  • 투고 : 2021.06.16
  • 심사 : 2021.10.08
  • 발행 : 2021.11.30

초록

Objectives: Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area. Methods: We defined social relations as "meetings with neighbors" (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in. Results: MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas. Conclusions: The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.

키워드

참고문헌

  1. World Health Organization. Closing the gap in a generation: health equity through action on the social determinants of health - final report of the commission on social determinants of health; 2008 [cited 2021 Jul 6]. Available from: https://www.who.int/publications/i/item/WHO-IER-CSDH-08.1.
  2. Vink D, Aartsen MJ, Schoevers RA. Risk factors for anxiety and depression in the elderly: a review. J Affect Disord 2008;106(1-2):29-44. https://doi.org/10.1016/j.jad.2007.06.005
  3. Berkman LF, Kawachi I, Glymour MM. Social epidemiology. 2nd ed. New York: Oxford University Press; 2014, p. 234-289, 290-319.
  4. Santini ZI, Koyanagi A, Tyrovolas S, Mason C, Haro JM. The association between social relationships and depression: a systematic review. J Affect Disord 2015;175:53-65. https://doi.org/10.1016/j.jad.2014.12.049
  5. Tengku Mohd TA, Yunus RM, Hairi F, Hairi NN, Choo WY. Social support and depression among community dwelling older adults in Asia: a systematic review. BMJ Open 2019;9(7):e026667. https://doi.org/10.1136/bmjopen-2018-026667
  6. Park K, Park YR, Son D. The relationship between social connectedness and depressive symptom: a comparison between the rural and urban elderly. J Korea Contents Assoc 2020;20(2):667-677 (Korean). https://doi.org/10.5392/JKCA.2020.20.02.667
  7. Son YJ. The effect of social capital on depression between urban and rural older adults: focusing on adult children network and social network. GRI Rev 2010;12(3):311-339 (Korean).
  8. Lee SY, Kim EJ. The social support patterns and depression among the elderly living alone and their friends and neighbors. J Welf Aged 2012;56:137-164 (Korean).
  9. Kim E. Comparison of the factors related to depression of the female elderly living alone by region. Korean J Hum Ecol 2015;24(6):811-827 (Korean). https://doi.org/10.5934/kjhe.2015.24.6.811
  10. Lee Y, Jang K, Lockhart NC. Impact of social integration and living arrangements on Korean older adults' depression: a moderation model. Int J Aging Hum Dev 2018;86(3):306-321. https://doi.org/10.1177/0091415017720887
  11. Chae C, Lee S, Park CS, Kim BJ, Lee CS, Lee SJ, et al. Effects of social support and chronic medical conditions on depressive symptoms in elderly people living alone in a rural community. J Korean Soc Biol Ther Psychiatry 2018;24(3):184-193 (Korean). https://doi.org/10.22802/JKSBTP.2018.24.3.184
  12. Kim HO, Choi YS, Lee JH, Seo AR, Park KS. The association between hopelessness, social support and community integration and depression among elderly living alone. J Agric Med Community Health 2016;41(4):195-204 (Korean). https://doi.org/10.5393/JAMCH.2016.41.4.195
  13. Park YR, Park KS. Social support network and welfare of the elderly in Korea: research trends and future tasks. Korean J Gerontol Soc Welf 2013;60:323-352 (Korean). https://doi.org/10.21194/kjgsw..60.201306.323
  14. Korean Statistical Information Service. Proportion of elderly households living alone (sido/si/gun/gu); 2021 [cited 2021 May 30]. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1YL12701 (Korean).
  15. Kang E, Lee M. Identifying the effect of living alone on life in later adulthood: comparison between living alone and those living with others with a propensity score matching analysis. Health Soc Welf Rev 2018;38(4):196-226 (Korean). https://doi.org/10.15709/hswr.2018.38.4.196
  16. Oh DH, Park JH, Lee HY, Kim SA, Choi BY, Nam JH. Association between living arrangements and depressive symptoms among older women and men in South Korea. Soc Psychiatry Psychiatr Epidemiol 2015;50(1):133-141. https://doi.org/10.1007/s00127-014-0904-2
  17. Kim JM, Shin IS, Yoon JS, Stewart R. Prevalence and correlates of late-life depression compared between urban and rural populations in Korea. Int J Geriatr Psychiatry 2002;17(5):409-415. https://doi.org/10.1002/gps.622
  18. Park NS, Jang Y, Chiriboga DA, Chung S. The role of social networks on depressive symptoms: a comparison of older Koreans in three geographic areas. Int J Aging Hum Dev 2021;92(3):364-382. https://doi.org/10.1177/0091415020905553
  19. Korea Employment Information Service. KLoSA survey overview [cited 2021 May 17]. Available from: https://survey.keis.or.kr/klosa/klosa01.jsp (Korean).
  20. Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med 1999;159(15):1701-1704. https://doi.org/10.1001/archinte.159.15.1701
  21. Bae SW, Kim YY, Doh M, Kim H, Park BS. Testing factor structure and measurement invariance of 10-item versions of the CES-D scale: focusing on Andersenform and Boston form of the CES-D-10. Ment Health Soc Work 2020;48(1):33-55 (Korean).
  22. Shor E, Roelfs DJ. Social contact frequency and all-cause mortality: a meta-analysis and meta-regression. Soc Sci Med 2015;128:76-86. https://doi.org/10.1016/j.socscimed.2015.01.010
  23. World Health Organization. Mental health of older adults; 2017 [cited 2021 May 17]. Available from: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults.
  24. Min IS, Choi PS. Advanced panel data analysis. Seoul: Jiphil Media; 2012, p. 112-121 (Korean).
  25. Gardiner JC, Luo Z, Roman LA. Fixed effects, random effects and GEE: what are the differences? Stat Med 2009;28(2):221-239. https://doi.org/10.1002/sim.3478
  26. Jeong K, Kang E, Kim K, Oh Y, Oh M, Lee Y, et al. Analysis of the survey of living conditions and welfare needs of older Koreans 2017. Sejong: Korea Institute for Health and Social Affairs; 2017 (Korean).
  27. Park EA. Current states of mental health promotion programs and suggestions for improvements: focused on depression. Seoul: Korea Health Promotion Institute; 2017 (Korean).
  28. Ha SK, Park KD. Influencing factors in social capital and regeneration of residential communities: comparative study on housing estates in Seoul and rural village in Yeoju. Korean Local Gov Rev 2011;12(4):133-153 (Korean).
  29. Chan A, Malhotra C, Malhotra R, Ostbye T. Living arrangements, social networks and depressive symptoms among older men and women in Singapore. Int J Geriatr Psychiatry 2011;26(6):630-639. https://doi.org/10.1002/gps.2574
  30. Chao SF. Assessing social support and depressive symptoms in older Chinese adults: a longitudinal perspective. Aging Ment Health 2011;15(6):765-774. https://doi.org/10.1080/13607863.2011.562182
  31. Kim EJ, Lee SY. The informal social support patterns and depression in rural elders: compared to urban elder. Soc Sci Res Rev 2012;28(2):149-176 (Korean).
  32. Lee JH, Park KS, Kim RB, Kim BJ, Chun JH. The influence of individual-level social capital on depression. J Agric Med Community Health 2011;36(2):73-86 (Korean). https://doi.org/10.5393/JAMCH.2011.36.2.073