Full Text:   <2021>

Summary:  <1505>

CLC number: R181.3

On-line Access: 2019-10-09

Received: 2019-04-18

Revision Accepted: 2019-09-15

Crosschecked: 2019-09-21

Cited: 0

Clicked: 3478

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
Open peer comments

Journal of Zhejiang University SCIENCE B 2019 Vol.20 No.11 P.910-919


Association between social health status and depressive symptoms among community-dwelling elderly adults in Zhejiang Province, China

Author(s):  Hong-Lei Dai, Zhe-Bin Yu, Liu-Qing You, Min-Hua Fan, Hong-Wei Zhu, Dan-Jie Jiang, Meng-Yin Wu, Shu-Juan Lin, Xiao-Cong Zhang, Kun Chen

Affiliation(s):  Department of Family Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; more

Corresponding email(s):   ck@zju.edu.cn

Key Words:  Depressive symptom, Social health, Elderly adult

Hong-Lei Dai, Zhe-Bin Yu, Liu-Qing You, Min-Hua Fan, Hong-Wei Zhu, Dan-Jie Jiang, Meng-Yin Wu, Shu-Juan Lin, Xiao-Cong Zhang, Kun Chen. Association between social health status and depressive symptoms among community-dwelling elderly adults in Zhejiang Province, China[J]. Journal of Zhejiang University Science B, 2019, 20(11): 910-919.

@article{title="Association between social health status and depressive symptoms among community-dwelling elderly adults in Zhejiang Province, China",
author="Hong-Lei Dai, Zhe-Bin Yu, Liu-Qing You, Min-Hua Fan, Hong-Wei Zhu, Dan-Jie Jiang, Meng-Yin Wu, Shu-Juan Lin, Xiao-Cong Zhang, Kun Chen",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Association between social health status and depressive symptoms among community-dwelling elderly adults in Zhejiang Province, China
%A Hong-Lei Dai
%A Zhe-Bin Yu
%A Liu-Qing You
%A Min-Hua Fan
%A Hong-Wei Zhu
%A Dan-Jie Jiang
%A Meng-Yin Wu
%A Shu-Juan Lin
%A Xiao-Cong Zhang
%A Kun Chen
%J Journal of Zhejiang University SCIENCE B
%V 20
%N 11
%P 910-919
%@ 1673-1581
%D 2019
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1900207

T1 - Association between social health status and depressive symptoms among community-dwelling elderly adults in Zhejiang Province, China
A1 - Hong-Lei Dai
A1 - Zhe-Bin Yu
A1 - Liu-Qing You
A1 - Min-Hua Fan
A1 - Hong-Wei Zhu
A1 - Dan-Jie Jiang
A1 - Meng-Yin Wu
A1 - Shu-Juan Lin
A1 - Xiao-Cong Zhang
A1 - Kun Chen
J0 - Journal of Zhejiang University Science B
VL - 20
IS - 11
SP - 910
EP - 919
%@ 1673-1581
Y1 - 2019
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1900207

Objective: Mental disorders of the elderly population in China deserve attention. social health is significantly associated with depression. This study aimed to evaluate the rate of depressive symptoms and to test the relationships between social health and depressive symptoms among a large sample of community-dwelling elderly adults. Methods: We conducted a cross-sectional study among community-dwelling adults aged 60 years or above in Zhejiang Province, China. Face-to-face interviews were used to complete a structured questionnaire for all participants. We used the social health Scale for the Elderly (SHSE) to evaluate social health status and used the short form of the Geriatric Depression Scale to evaluate depressive symptoms. Multivariate logistic regression was used to evaluate the association between social health status and depressive symptoms. Results: Of the total of 3757 participants included, 1887 (50.23%) were female, and the mean±standard deviation (SD) age was (70.0±8.3) years. The rate of depressive symptoms was 25.92%. The social health score was higher in non-depressed participants than in depressed participants (raw score 50.7 vs. 48.3, P<0.001). Participants with “moderate” or “good” social health had a significantly lower risk of depressive symptoms than those with “poor” social health (odds ratio (OR)=0.55, 95% confidence interval (CI): 0.46–0.66 for moderate social health; OR=0.45, 95% CI: 0.35–0.60 for good social health). The association between social health and depressive symptoms was consistent across several subgroups. Conclusions: social health is significantly inversely associated with depressive symptoms. The SHSE may serve as an efficient screener to identify those elderly adults with social health deficits, but systematic assessment to guide intervention merits further investigation.




Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


[1]Alexopoulos GS, 2005. Depression in the elderly. Lancet, 365(9475):1961-1970.

[2]Andrea SB, Siegel SAR, Teo AR, 2016. Social support and health service use in depressed adults: findings from the national health and nutrition examination survey. Gen Hosp Psychiatry, 39:73-79.

[3]Baiyewu O, Yusuf AJ, Ogundele A, 2015. Depression in elderly people living in rural Nigeria and its association with perceived health, poverty, and social network. Int Psychogeriatr, 27(12):2009-2015.

[4]Balsamo M, Cataldi F, Carlucci L, et al., 2018. Assessment of late-life depression via self-report measures: a review. Clin Interv Aging, 13:2021-2044.

[5]Bao CZ, Yu ZB, Yin XF, et al., 2018. The development of the social health scale for the elderly. Health Qual Life Outcomes, 16:67.

[6]Cao WM, Li L, Zhou XD, et al., 2015. Social capital and depression: evidence from urban elderly in China. Aging Ment Health, 19(5):418-429.

[7]Carlson JA, Sarkin AJ, Levack AE, et al., 2011. Evaluating a measure of social health derived from two mental health recovery measures: the California Quality of Life (CA-QOL) and Mental Health Statistics Improvement Program Consumer Survey (MHSIP). Community Ment Health J, 47(4):454-462.

[8]Chen YY, Wong GHY, Lum TY, et al., 2016. Neighborhood support network, perceived proximity to community facilities and depressive symptoms among low socioeconomic status Chinese elders. Aging Ment Health, 20(4): 423-431.

[9]Chi I, Yip PSF, Chiu HFK, et al., 2005. Prevalence of depression and its correlates in Hong Kong’s Chinese older adults. Am J Geriatr Psychiatry, 13(5):409-416.

[10]Chiu HC, Chen CM, Huang CJ, et al., 2005. Depressive symptoms, chronic medical conditions and functional status: a comparison of urban and rural elders in Taiwan. Int J Geriatr Psychiatry, 20(7):635-644.

[11]Chou KL, Chi I, 2002. Chronic illness and depressive symptoms among Chinese older adults: a longitudinal study. Int J Aging Hum Dev, 54(2):159-171.

[12]Colman RW, 1986. Platelet activation: role of an ADP receptor. Semin Hematol, 23(2):119-128.

[13]Djernes JK, 2006. Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatr Scand, 113(5):372-387.

[14]Domènech-Abella J, Lara E, Rubio-Valera M, et al., 2017. Loneliness and depression in the elderly: the role of social network. Soc Psychiatry Psychiatr Epidemiol, 52(4):381-390.

[15]Forlani C, Morri M, Ferrari B, et al., 2014. Prevalence and gender differences in late-life depression: a population-based study. Am J Geriatr Psychiatry, 22(4):370-380.

[16]Gariépy G, Honkaniemi H, Quesnel-Vallée A, 2016. Social support and protection from depression: systematic review of current findings in Western countries. Br J Psychiatry, 209(4):284-293.

[17]George PP, Heng BH, Wong LY, et al., 2014. Determinants of health-related quality of life among community dwelling elderly. Ann Acad Med Singapore, 43(1):3-10.

[18]Heok KE, Ho R, 2008. The many faces of geriatric depression. Curr Opin Psychiatry, 21(6):540-545.

[19]Ho RCM, Ho ECL, Tai BC, et al., 2014. Elderly suicide with and without a history of suicidal behavior: implications for suicide prevention and management. Arch Suicide Res, 18(4):363-375.

[20]Ho RCM, Chua AC, Tran BX, et al., 2018. Factors associated with the risk of developing coronary artery disease in medicated patients with major depressive disorder. Int J Environ Res Public Health, 15(10):2073.

[21]Holmquist S, Mattsson S, Schele I, et al., 2017. Low physical activity as a key differentiating factor in the potential high-risk profile for depressive symptoms in older adults. Depress Anxiety, 34(9):817-825.

[22]International Health Conference, 2002. Constitution of the World Health Organization. 1946. Bull World Health Organ, 80(12):983-984.

[23]Kuehner C, 2017. Why is depression more common among women than among men? Lancet Psychiatry, 4(2):146-158.

[24]Lai DL, Tong HM, Zeng Q, et al., 2010. The factor structure of a Chinese Geriatric Depression Scale-SF: use with alone elderly Chinese in Shanghai, China. Int J Geriatr Psychiatry, 25(5):503-510.

[25]Mak KK, Kong WY, Mak A, et al., 2013. Polymorphisms of the serotonin transporter gene and post-stroke depression: a meta-analysis. J Neurol Neurosurg Psychiatry, 84(3): 322-328.

[26]Mechakra-Tahiri S, Zunzunegui MV, Préville M, et al., 2009. Social relationships and depression among people 65 years and over living in rural and urban areas of Quebec. Int J Geriatr Psychiatry, 24(11):1226-1236.

[27]Ng KST, Sia A, Ng MKW, et al., 2018. Effects of horticultural therapy on Asian older adults: a randomized controlled trial. Int J Environ Res Public Health, 15(8):1705.

[28]Niti M, Ng TP, Kua EH, et al., 2007. Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status. Int J Geriatr Psychiatry, 22(11):1087-1094.

[29]Nyunt MS, Fones C, Niti M, et al., 2009. Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging Ment Health, 13(3):376-382.

[30]Russell RD, 1973. Social health: an attempt to clarify this dimension of well-being. Int J Health Educ, 16:74-82.

[31]Sözeri-Varma G, 2012. Depression in the elderly: clinical features and risk factors. Aging Dis, 3(6):465-471.

[32]Stokes JE, Moorman SM, 2018. Influence of the social network on married and unmarried older adults’ mental health. Gerontologist, 58(6):1109-1113.

[33]Su D, Wu XN, Zhang YX, et al., 2012. Depression and social support between China’ rural and urban empty-nest elderly. Arch Gerontol Geriatr, 55(3):564-569.

[34]Tang WK, Lum CM, Ng KY, et al., 2006. Prevalence and correlates of depression in Chinese elderly patients with pneumoconiosis. Aging Ment Health, 10(2):177-181.

[35]Uchmanowicz I, Gobbens RJJ, 2015. The relationship between frailty, anxiety and depression, and health-related quality of life in elderly patients with heart failure. Clin Interv Aging, 10:1595-1600.

[36]Wang JK, Zhao XD, 2012. Family functioning and social support for older patients with depression in an urban area of Shanghai, China. Arch Gerontol Geriatr, 55(3):574-579.

[37]Wang S, Blazer DG, 2015. Depression and cognition in the elderly. Annu Rev Clin Psychol, 11:331-360.

[38]World Health Organization, 2017. Depression and Other Common Mental Disorders: Global Health Estimates. WHO, Geneva.

[39]Xiao YB, Zhang B, Wu YL, 2018. Radiofrequency ablation versus hepatic resection for breast cancer liver metastasis: a systematic review and meta-analysis. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 19(11):829–843.

[40]Yaka E, Keskinoglu P, Ucku R, et al., 2014. Prevalence and risk factors of depression among community dwelling elderly. Arch Gerontol Geriatr, 59(1):150-154.

[41]Yu J, Li J, Cuijpers P, et al., 2012. Prevalence and correlates of depressive symptoms in Chinese older adults: a population-based study. Int J Geriatr Psychiatry, 27(3):305-312.

[42]Zeng W, North N, Kent B, 2013. Family and social aspects associated with depression among older persons in a Chinese context. Int J Older People Nurs, 8(4):299-308.

[43]Zhang CC, Xue YQ, Zhao HN, et al., 2019. Prevalence and related influencing factors of depressive symptoms among empty-nest elderly in Shanxi, China. J Affect Disord, 245:750-756.

[44]Zhang MWB, Ho RCM, 2017. Personalized reminiscence therapy M-health application for patients living with dementia: innovating using open source code repository. Technol Health Care, 25(1):153-156.

[45]Zhang MWB, Chan S, Wynne O, et al., 2016. Conceptualization of an evidence-based smartphone innovation for caregivers and persons living with dementia. Technol Health Care, 24(5):769-773.

[46]Zhu J, Gao RJ, Liu Q, et al., 2017. Metabolic benefits of rivaroxaban in non-valvular atrial fibrillation patients after radiofrequency catheter ablation. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 18(11):946–954.

Open peer comments: Debate/Discuss/Question/Opinion


Please provide your name, email address and a comment

Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE