Mediating Role of Depressive Symptoms on the Association Between Neighborhood Social Cohesion and Quality of Life in Individuals with Type 2 Diabetes Mellitus

Abstract

Purpose Few studies have explored the association between neighborhood social cohesion (NSC), a type of social capital, and the quality of life of patients with type 2 diabetes mellitus (T2DM). In addition, the potential mechanism for this association remains unclear. The current study examined the mediation effect of depressive symptoms on the relationship between NSC and quality of life among diabetes patients in China. Patients and Methods A cross-sectional study of 1747 T2DM patients was conducted. The specific quality of life (DSQL), Center for Epidemiological Survey Depression (CES-D), and social capital scales were administered using a face-to-face survey. Partial correlation analysis and a linear regression model were employed to explore the relationship between NSC, depressive symptoms, and quality of life. Bootstrap analysis using PROCESS was used to test the mediation model. Results After controlling for covariates, NSC was negatively correlated with depressive symptoms (r=−0.24, P<0.01) and DSQL score (r=−0.20, P<0.01) while depressive symptoms were positively correlated with DSQL score (r=0.46, P<0.01). Linear regression analysis also found that NSC was negatively associated with the DSQL score, while depressive symptoms were positively associated with the DSQL score. Depressive symptoms mediated the relationship between NSC and quality of life in T2DM patients (explaining 50.7% of the total variance). Conclusion NSC was positively associated with improved quality of life among Chinese T2DM patients in this study, and depressive symptoms were likely to partially explain this relationship. These findings may be used to help maintain a good quality of life among at-risk individuals. Additional prospective studies are needed to confirm these findings.

The effect of neighborhood social cohesion on life satisfaction in type 2 diabetes mellitus patients: the chain mediating role of depressive symptoms and sleep quality

“…Our findings indicate that NSC is a significant predictor of life satisfaction among T2DM patients (β = 0.03, p < 0.001), aligning with previous research suggesting that enhancing well-being and life satisfaction can be achieved through NSC or social capital (35,36). Moreover, a previous study has demonstrated a positive correlation between high levels of NSC and improved quality of life in T2DM patients (16). Additionally, our study reveals a negative association between depressive symptoms and life satisfaction (β = −0.01, p < 0.001).…”

“…(18). Our previous study indicated a strong correlation between NSC and depressive symptoms in T2DM patients (16). Worth noting, depressive symptoms were highly associated with life satisfaction in a nationwide sample of healthy Finnish adults (N = 9,679) (19), but not reported in diabetes patients.…”

“…NSC in others was associated with a wide range of health and well-being outcomes, including self-rated health (14), mental health (15), quality of life (16), subjective well-being (17), etc. Despite increasing attention that addresses the significance of NSC on health, very few studies have examined life satisfaction among T2DM patients.…”

Depression, anxiety, and health-related quality of life in normal weight, overweight and obese individuals with diabetes: a representative study in Germany

“…Our data provide further support of a mediating effect of the BMI and HRQOL on the association between diabetes and depressive symptoms. But it must be considered that there may be a chicken-egg problem with HRQOL and depressive symptoms, because depressive symptoms can also be considered as a mediator between diabetes and HRQOL [ 42 , 43 ].…”