Abstract
BackgroundLittle is known regarding the role of gender as a possible modulator in determining the associations between lifestyle risk factors and depression in older adults.ObjectivesThis study examined whether gender modulates the relationship between depression and lifestyle risk factors in Korean adults aged 65 years and older (n = 3700).MethodsData were obtained from the 2016 and 2018 Korea National Health and Examination Survey. The primary outcome was depression, assessed with the patient health questionnaire-9. As exposures, smoking habits, at-risk alcohol consumption, and physical inactivity were assessed with a standardized questionnaire. In addition, mean adequacy ratio (MAR) as an indicator of overall nutritional inadequacy was assessed with dietary intakes of macro- and micronutrients.ResultsIn men only, either two or three and more risk factors were significantly associated with higher depression risk (OR (95% confidence interval, CI) = 2.886 (1.003–8.299) and OR (95% CI) = 3.109 (1.064–9.097), respectively). In women only, either two or three and more risk factors were also significantly associated with higher depression risk (OR (95% CI) = 1.505 (1.067–2.124) and OR (95% CI) = 2.828 (1.527–5.239), respectively). In particular, the presence of smoking habits and MAR were the major determinants of depression (OR (95% CI) = 1.835 (1.09–3.10) and OR (95% CI) = 1.585 (1.125–2.233), respectively) in women only. Finally, a moderation analysis with the Hayes PROCESS Macro showed a significant moderating effect of gender (β (95% CI) = 0.633 (0.206 ~ 1.060)) on the relationship between risk factors and depression. In addition, the slope of the relationship was much steeper in women than in men.ConclusionCurrent findings suggest that lifestyle risk factors are more closely associated with depression risk in women than in men.
Highlights
Depression is a common mental disorder resulting in serious physical and mental health problems worldwide [1, 2]
Current findings suggest that lifestyle risk factors are more closely associated with depression risk in women than in men
Overall nutritional inadequacy was associated with greater odds of depression (OR = 1.559 (1.170–2.078)) even after adjustments for age, gender, Body mass index (BMI), income, education, marital status, residence area, and number of comorbidities
Summary
Depression is a common mental disorder resulting in serious physical and mental health problems worldwide [1, 2]. It is well established that depression is significantly associated with various lifestyle risk factors, including smoking [8], heavy alcohol consumption [9], physical inactivity [10], and unhealthy diet [11]. The relationships between lifestyle risk factors and the prevalence and incidence of depression have been demonstrated in previous studies. In an international cohort study of patients with muscle sclerosis, Taylor et al [17] showed that healthy lifestyles, including moderate alcohol intake, being a non-smoker, diet quality, no meat or dairy intake, vitamin D supplementation, omega 3 supplement use, regular exercise, and meditation at baseline, were associated with lower incidences of depression. Little is known regarding the role of gender as a possible modulator in determining the associations between lifestyle risk factors and depression in older adults
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