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

Abstract

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.

Assessment of the relationship between living alone and the risk of depression based on longitudinal studies: A systematic review and meta-analysis

“…Numerous previous cross-sectional studies have also discovered that this risk varies by age, gender, and location. Older people living alone are more vulnerable than younger people ( 28 ), men living alone are more vulnerable than women ( 29 ), and rural people living alone are more vulnerable than urban people ( 30 ). Unfortunately, the number of longitudinal studies currently available is insufficient to allow for subgroup analysis in our study.…”

Concerns related to COVID-19 in South Korea : What are associated individual and regional factors?

“…[36-38] Indeed, areas with greater deprivation in South Korea showed higher rates of suicide and mental illness such as depression and anxiety, moderated by a higher proportion of the elderly and poorer economic status. [39,40] Furthermore, those who already had mental illness showed a greater risk of developing its severity. [41] Moreover, those who live in more deprived areas would be more likely to have a lower educational and socio-economical level; thus, they may have less opportunity to acquire appropriate information about COVID-19 in proper time.…”

Global rural health disparities in Alzheimer's disease and related dementias: State of the science

“…Prior studies of cognitive health in rural versus urban environments have focused on the influence of social factors, such as education, but health management is a large driver of the vulnerability to cognitive impairment that exists in rural communities, in part due to the limited access to medical infrastructure. 136 Rural-dwelling individuals have a higher risk for emergency department encounters for preventable visits than urban dwellers, driven by a range of factors, primarily among them the lack of mental health professionals. 14 Among those with ADRD admitted to the hospital, length of stay does not appear to differ across rural and urban settings.…”