Wang Zhenjie, Jin Yongai, Tian Wanning, Zhou Xun
Institute of Population Research, Peking University, Beijing, People's Republic of China.
Center for Population and Development Studies, School of Population and Health, Renmin University of China, Beijing, People's Republic of China.
PLoS One. 2025 Jun 6;20(6):e0325595. doi: 10.1371/journal.pone.0325595. eCollection 2025.
The aim of the current study is to assess various effect of social isolation on depression risk among older adults during COVID-19 in China.
Data was obtained from the China Longitudinal Ageing Social Survey (CLASS) conducted in 2020. A total of 9883 participants were included. Depression status was assessed by 9-item Center for Epidemiological Studies Depression Scale (CES-D). Social isolation was assessed by Lubben Social Network Scale-6 (LSNS-6). The odds ratios of depression risk according to LSNS-6 categories were obtained using a logistic regression model with adjustment for potential confounding variables.
The prevalence of depression was 31.2%, and the presence of social isolation was 37.9% during the COVID-19 among older population. A decrease in depression risk was observed with reduced isolation. The odds ratio for the lowest versus highest was 0.75 (95% confidence interval: 0.63, 0.89; Ptrend = 0.012). Friend support reduced depression risk more significantly than family support. The association between LSNS-6 friend subscale and depression risk was differentiated by LSNS-6 family subscale. In men, LSNS-6 friend subscale tended to be associated with depression risk inversely when their LSNS-6 family subscale was less than 6 (interaction P = 0.041). Similar associations and stratified modifications were observed among those who lived in rural areas (interaction P = 0.002), married (interaction P = 0.003), Han (interaction P = 0.01), lived with others (interaction P = 0.001), and so on.
Most depression cases were found to be strongly associated with social isolation during the pandemic. Our findings have provided empirical evidence for researchers to understand the association between social isolation and depression, which could help them evaluate and manage depression promptly. Because of the cross-sectional design, we cannot establish causal relationships between depression and isolation.
本研究旨在评估中国新冠疫情期间社会隔离对老年人抑郁风险的多种影响。
数据来自2020年进行的中国老年社会追踪调查（CLASS）。共纳入9883名参与者。抑郁状态通过9项流行病学研究中心抑郁量表（CES-D）进行评估。社会隔离通过鲁本社会网络量表-6（LSNS-6）进行评估。根据LSNS-6类别得出抑郁风险的比值比，使用逻辑回归模型并对潜在混杂变量进行调整。
在老年人群中，新冠疫情期间抑郁患病率为31.2%，社会隔离发生率为37.9%。随着隔离程度降低，抑郁风险有所下降。最低隔离水平与最高隔离水平的比值比为0.75（95%置信区间：0.63，0.89；P趋势=0.012）。朋友支持比家庭支持更显著地降低抑郁风险。LSNS-6朋友子量表与抑郁风险之间的关联因LSNS-6家庭子量表而异。在男性中，当他们的LSNS-6家庭子量表小于6时，LSNS-6朋友子量表往往与抑郁风险呈负相关（交互作用P=0.041）。在农村地区居住者（交互作用P=0.002）、已婚者（交互作用P=0.003）、汉族（交互作用P=0.01）、与他人同住者（交互作用P=0.001）等人群中也观察到类似的关联和分层差异。
在疫情期间，大多数抑郁病例被发现与社会隔离密切相关。我们的研究结果为研究人员理解社会隔离与抑郁之间的关联提供了实证证据，这有助于他们及时评估和管理抑郁。由于采用横断面设计，我们无法确定抑郁与隔离之间的因果关系。
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