Does Education Influence Life-Course Depression in Middle-Aged and Elderly in China? Evidence from the China Health and Retirement Longitudinal Study (CHARLS)

Abstract

Mental health problems have become a major public health problem worldwide and are more common among middle-aged and elderly people in China. Research on the effect of education on depression is limited, and whether the relationship between education and depression changes over the life course remains unclear. This study was based on the cross-sectional data of 15,767 middle-aged and elderly individuals in the 2018 tracking survey (Wave 4) of the China Health and Retirement Longitudinal Study (CHARLS) database. Multiple linear regression and bootstrap methods were developed to detect the mediating effect of education on depression. In all samples or different age groups, education was significantly positively associated with depression. Three mediators (economic level, health-related lifestyle, and cognitive level) were significantly positively associated with depression, and cognitive level had a greater effect on depression than economic level and health-related lifestyle. The total, direct, and indirect effects of the whole samples and elderly samples were significant; however, the direct effect of the middle-aged samples was insignificant, and the total and indirect effects of the three mediating pathways were all significant, that is, economic level, health-related lifestyle, and cognitive level should produce complete mediation. The multiple linear regression and bootstrap methods could successfully detect the mediating effect of education on depression. On the basis of the education, economic level, health-related lifestyle, cognitive level, and depression of middle-aged and elderly people, we established and compared the total, direct, and mediating effects of education on depression under the life course. The mediating variables should be further increased, and the measurement methods of depression should be developed to improve the credibility of the research results.

Health-related quality of life and associated factors among people living with HIV/AIDS in Sichuan, China: A cross-sectional study

“…The reason may be that the sample was a general adult PLWH population with higher psychological scores than those reported in other literature ( 84 , 85 ), and fewer people reported anxiety (17%) and depression (11%) among the symptom questionnaires, which indicates a relatively high level of mental health in this study sample. Second, nearly half of the PLWH in this sample had received only primary education and below, and their cognitive level of mental health might not be sufficient ( 86 ). Last, previous studies have shown that disclosure, sexual orientation and other factors have a significant impact on the mental health of PLWH ( 87 ), the level of disclosure in this sample population is higher than that in previous studies ( 21 , 83 ), and the sexual orientation is mostly heterosexual.…”

The relationship between sleep length and depression level in older adults: The masking effect of education level

“…The indirect effect of education level weakened the direct effect of sleep length on depression level, which weakened the total effect, and belonged to a certain degree of masking effect, where education level masked the effect of sleep length on depression level. We believe there may be several reasons for this: First, older adults with higher education levels typically possess more knowledge and cognitive ability to comprehend and manage sleep disorders and depression better, thus reducing the likelihood of negative effects [19] ; Second, older adults with higher education levels are more likely to adopt healthy lifestyles, such as regular rest and relaxation and appropriate amounts of physical activity, which contribute to improved sleep quality and mental health [20] ;Finally, older adults with higher education levels are more likely to have higher mental health awareness and psychological coping skills, to recognize their own sleep problems and depressive symptoms early, and to take proactive steps to seek help and treatment [21] .…”