Kim Miri, Chung Soondool
Department of Social Welfare, Korea National University of Transportation, Chungju 27469, Republic of Korea.
Department of Social Welfare, Ewha Womans University, Seoul 03760, Republic of Korea.
Healthcare (Basel). 2025 Apr 10;13(8):870. doi: 10.3390/healthcare13080870.
: This study investigates how individual- and regional-level factors jointly influence depressive symptoms among older adults in South Korea, a rapidly aging society facing growing mental health concerns. : Multilevel structural equation modelling with Monte Carlo confidence interval testing is used to analyze a cross-sectional, secondary dataset of 600 Korean older adults aged 65 years. The data come from the 2020 Ewha Study of Intergenerational Issues (ESoII), which is collected using multistage-quota sampling by age, gender, and region to ensure population representativeness across 14 cities and provinces. : Significant direct and indirect effects are observed at both individual and regional levels. At the individual level, aging anxiety is associated with social isolation (β = 0.208, > 001) and depressive symptoms (β = 0.224, < 0.001); social isolation is also associated with depressive symptoms (β = 0.288, > 0.001), and mediates the relationship between aging anxiety and depression (95% CI = [0.016, 0.065]). At the regional level, age-friendly environments are associated with social isolation (β = -0.287, < 0.05), which in turn is associated with depressive symptoms (β = 0.403, < 0.01). The mediation effect of social isolation in the relationship between age-friendly environments and depressive symptoms is statistically significant (95% CI = [-0.022, -0.004]). : The findings suggest that social isolation is a key mechanism linking both psychological and environmental risk factors to depression in later life. Promoting age-friendly environments may be an effective strategy for reducing social isolation and improving mental health outcomes among older adults. Interventions should consider both individual vulnerabilities and structural supports.
本研究调查了在韩国这个面临日益严重心理健康问题的快速老龄化社会中，个体层面和区域层面的因素如何共同影响老年人的抑郁症状。采用具有蒙特卡洛置信区间检验的多层次结构方程模型，对600名65岁韩国老年人的横断面二手数据集进行分析。数据来自2020年梨花女子大学代际问题研究（ESoII），该研究采用按年龄、性别和地区的多阶段配额抽样收集，以确保在14个城市和省份具有人口代表性。在个体和区域层面均观察到显著的直接和间接影响。在个体层面，衰老焦虑与社会隔离（β = 0.208，p < 0.001）和抑郁症状（β = 0.224，p < 0.001）相关；社会隔离也与抑郁症状（β = 0.288，p > 0.001）相关，并介导衰老焦虑与抑郁之间的关系（95%置信区间 = [0.016, 0.065]）。在区域层面，对老年人友好的环境与社会隔离（β = -0.287，p < 0.05）相关，而社会隔离又与抑郁症状（β = 0.403，p < 0.01）相关。社会隔离在对老年人友好的环境与抑郁症状之间关系中的中介作用具有统计学意义（95%置信区间 = [-0.022, -0.004]）。研究结果表明，社会隔离是将心理和环境风险因素与晚年抑郁联系起来的关键机制。促进对老年人友好的环境可能是减少社会隔离和改善老年人心理健康结果的有效策略。干预措施应同时考虑个体脆弱性和结构性支持。
