The importance of social activity to risk of major depression in older adults

Abstract

Background Several social determinants of health (SDoH) have been associated with the onset of major depressive disorder (MDD). However, prior studies largely focused on individual SDoH and thus less is known about the relative importance (RI) of SDoH variables, especially in older adults. Given that risk factors for MDD may differ across the lifespan, we aimed to identify the SDoH that was most strongly related to newly diagnosed MDD in a cohort of older adults. Methods We used self-reported health-related survey data from 41 174 older adults (50–89 years, median age = 67 years) who participated in the Mayo Clinic Biobank, and linked ICD codes for MDD in the participants' electronic health records. Participants with a history of clinically documented or self-reported MDD prior to survey completion were excluded from analysis (N = 10 938, 27%). We used Cox proportional hazards models with a gradient boosting machine approach to quantify the RI of 30 pre-selected SDoH variables on the risk of future MDD diagnosis. Results Following biobank enrollment, 2073 older participants were diagnosed with MDD during the follow-up period (median duration = 6.7 years). The most influential SDoH was perceived level of social activity (RI = 0.17). Lower level of social activity was associated with a higher risk of MDD [hazard ratio = 2.27 (95% CI 2.00–2.50) for highest v. lowest level]. Conclusion Across a range of SDoH variables, perceived level of social activity is most strongly related to MDD in older adults. Monitoring changes in the level of social activity may help identify older adults at an increased risk of MDD.

Social relationship satisfaction and accumulation of chronic conditions and multimorbidity: a national cohort of Australian women

“…No previous study has examined these associations using longitudinal data. However, our findings on the associations between some types of social relationship satisfaction and individual chronic conditions (eg, depression, hypertension, cardiovascular disease and cancer) are similar to those observed in previous research 10–12 21 32 33. Further research is needed to explore other dimension-specific effects of social relationships on multimorbidity, such as the qualitative dimension (eg, intimacy), structure dimension (eg, quantity) and function dimension (eg, emotional and practical support), which were not addressed in this study.…”

“…6 The associations between the structural (eg, social network size and marital status) and functional (eg, received and perceived social support and loneliness) aspects of social relationships and cognitive performance, morbidity and mortality have been estimated in many studies and populations 6 7 15 ; however, the role of qualitative indicators (eg, subjective rating of satisfaction or quality) is largely unknown. Furthermore, most previous studies have examined only individual types of social relationship satisfaction or quality (eg, satisfaction with the partner, family members, friends, work and social activities), [16][17][18][19][20][21] not considering the relative importance and combined effects of these types in relation to the development of individual chronic conditions and accumulation of multimorbidity. To examine the relative importance of each social relationship type, it is important to compare the associations between individual relationship types and the development of multimorbidity using the same analytical model.…”

Profiles of activity engagement and depression trajectories as COVID-19 restrictions were relaxed.

“…In doing so, each indicator is more distinctly represented. Further, in contrast to the conventional variable-centered approach that assumes relations among predictor variables (e.g., types of activities) and between predictor and outcome variables (e.g., depression) to be uniform within a given population (e.g., Isaac et al, 2009; Ryu et al, 2023), the person-centered approach operates with the assumption that subgroups exist and relations among these variables may differ across subgroups (Bauer, 2022; Daljeet et al, 2017; Korhonen et al, 2014). In other words, the person-centered approach complements traditional variable-centered approaches by identifying how a multidimensional construct may be configured differently across subgroups (different magnitudes of strength along distinct construct dimensions) and relate differently to outcome variables of interest (e.g., high group activity and low religious activity vs. low group activity and high religious activity on depression; Daljeet et al, 2017).…”

“…However, despite these promising results, several issues in the activity engagement literature require clarification. To wit, although the nature of activity engagement is multidimensional, it is often operationalized as a unidimensional construct (e.g., Ryu et al, 2023). Even when assessed on multiple dimensions, an activity engagement index is sometimes derived by aggregating scores across distinct domains of activities (e.g., Isaac et al, 2009; Merema, 2014).…”

Psychometric properties of a Turkish version of the social activities scale for community‐dwelling older people requiring support

“…Social activities not only promote mental health but also provide opportunities for older people to socialise and interact with others, enhancing their overall quality of life (Adams et al., 2011). Conversely, studies have shown that a lack of social activities is associated with an increased risk of depression among older people (Ryu et al., 2021).…”