Tajik Amirmohammad, Varmaghani Mehdi, Shirazinia Matin, Sharifi Farshad, Honari Sara, Moodi Mitra, Barekati Hassan, Khorashadizadeh Msoumeh, Naderimagham Shohreh
Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
BMJ Open. 2025 Aug 5;15(8):e096145. doi: 10.1136/bmjopen-2024-096145.
To examine the association between individual social capital and depression in older adults in Iran and to test the hypothesis that higher levels of social capital are inversely associated with depressive symptoms.
Cross-sectional study using baseline data from a longitudinal cohort.
Community-based study conducted in primary care settings across urban and rural areas of Birjand County, Eastern Iran.
A total of 1348 community-dwelling individuals aged 60 years and older were recruited through multistage stratified cluster random sampling. Participants who were bedridden or had end-stage disease (life expectancy<6 months) were excluded.
The primary outcome was depression status, measured using the Patient Health Questionnaire 9 items, with a score≥10 indicating depression. The main explanatory variable was social capital, assessed using a validated 69-item questionnaire capturing domains such as collective activity, social trust and network structure. Univariable and multivariable logistic regression analyses were conducted to estimate adjusted ORs and 95% CIs for associations between depression and social capital dimensions. Statistical analyses were performed using Stata V.12.0 RESULTS: Of the total participants, 268 (19.94%) were identified as having depressive symptoms, with a significantly higher prevalence among women (27.44%) compared with men (11.88%). Depression was more prevalent among those in the lowest wealth quintile (32.09%) and individuals with low literacy levels (28.10%). Participation in collective activities was inversely associated with depression in the second (OR=0.62, 95% CI (0.42 to 0.93)), third (OR=0.45, 95% CI (0.29 to 0.71)), fourth (OR=0.59, 95% CI (0.37 to 0.93)) and fifth (OR=0.37, 95% CI (0.22 to 0.61)) quintiles. Social trust was also associated with lower odds of depression in the third (OR=0.62, 95% CI (0.39 to 0.99)) and fourth (OR=0.64, 95% CI (0.42 to 0.97)) quintiles. Furthermore, the second (OR=0.63, 95% CI (0.40 to 0.99)) and fifth (OR=0.38, 95% CI (0.23 to 0.63)) quintiles of social network structure were inversely related to depression. These findings suggest that higher levels of social capital, particularly in terms of collective participation, trust and social networks, are associated with a reduced likelihood of depressive symptoms in older adults.
Higher levels of social capital, particularly collective engagement, interpersonal trust and diverse social networks, are associated with lower odds of depression in older adults. These findings support the need for community-based interventions to strengthen social capital as a strategy for mental health promotion among the elderly in low-income and middle-income settings.
探讨伊朗老年人个体社会资本与抑郁症之间的关联，并检验社会资本水平较高与抑郁症状呈负相关这一假设。
采用纵向队列研究的基线数据进行横断面研究。
在伊朗东部比尔詹德县城乡地区的基层医疗场所开展的基于社区的研究。
通过多阶段分层整群随机抽样招募了1348名60岁及以上的社区居住个体。排除卧床不起或患有终末期疾病（预期寿命<6个月）的参与者。
主要结局是抑郁状态，采用患者健康问卷9项进行测量，得分≥10表明存在抑郁。主要解释变量是社会资本，使用经过验证的69项问卷进行评估，该问卷涵盖集体活动、社会信任和网络结构等领域。进行单变量和多变量逻辑回归分析，以估计抑郁与社会资本维度之间关联的调整后比值比（OR）和95%可信区间（CI）。使用Stata V.12.0进行统计分析。结果：在所有参与者中，268人（19.94%）被确定有抑郁症状，女性患病率（27.44%）显著高于男性（11.88%）。抑郁在最贫困五分位数人群（32.09%）和低识字水平个体（28.10%）中更为普遍。在第二（OR = 0.62，95%CI（0.42至0.93））、第三（OR = 0.45，95%CI（0.29至0.71））、第四（OR = 0.59，95%CI（0.37至0.93））和第五（OR = 0.37，95%CI（0.22至0.61））五分位数中，参与集体活动与抑郁呈负相关。在第三（OR = 0.62，95%CI（0.39至0.99））和第四（OR = 0.64，95%CI（0.42至0.97））五分位数中，社会信任也与较低的抑郁几率相关。此外，社会网络结构的第二（OR = 0.63，95%CI（0.40至0.99））和第五（OR = 0.38，95%CI（0.23至0.63））五分位数与抑郁呈负相关。这些发现表明，较高水平的社会资本，特别是在集体参与、信任和社会网络方面，与老年人抑郁症状发生可能性降低有关。
较高水平的社会资本，特别是集体参与、人际信任和多样化的社会网络，与老年人较低的抑郁几率相关。这些发现支持在低收入和中等收入环境中开展基于社区的干预措施以加强社会资本，作为促进老年人心理健康的一项策略。
