Gender-specific development of depressive symptoms in older adults: Contemporaneous and temporal network analyses based on the China health and retirement longitudinal study.

Abstract

Depression is highly prevalent among older adults, and impairs both mental and physical health. However, whether and how gender influences the development of depressive symptoms in older adults is unclear. The current study systematically examined the gender-specific development of depressive symptoms in national data. Participants were 5683 older adults (47.9% older women; Mage= 66.8 years) from the China Health and Retirement Longitudinal Study. Depressive symptoms were assessed by the center for epidemiological studies depression scale in 2015 (T1) and 2018 (T2). Gaussian graphical model (GGM) networks, Bayesian networks and cross-lagged panel networks (CLPNs) were used to examine the association between depressive symptoms from a comprehensive perspective. Cross-sectional networks (i.e., GGM and Bayesian networks) with T1 data suggested strong connections between loneliness and inability to get going for women while a strong relationship between the everything was an effort and feeling depressed for men. In CLPNs, the feeling bothered at T1 was positively associated with feeling depressed at T2 and the loneliness showed a bidirectional longitudinal association with inability to get going across time for women, while the everything was an effort at T1 was related to feeling depressed at T2 and the feeling depressed at T1 was associated with loneliness at T2 for men. These findings may suggest that older men with depressive symptoms were more likely to experience somatic fatigue, while depressive symptoms in older women were associated with social isolation. Recognizing these gender-specific symptom profiles may inform the development of tailored mental health policies and prevention strategies.