Lifestyle

Socioeconomic standing and depressive signs amongst older adults in China: The mediating position of cognitive perform, life-style and social participation

- by fooshya

This web page was created programmatically, to learn the article in its unique location you’ll be able to go to the hyperlink bellow:
https://journals.plos.org/plosone/article%3Fid%3D10.1371/journal.pone.0341370
and if you wish to take away this text from our web site please contact us


Abstract

Citation: Qin Y, Liu X, Wang N, Liu H, Zhou Q, Chen J, et al. (2026) Socioeconomic standing and depressive signs amongst older adults in China: The mediating position of cognitive perform, life-style and social participation. PLoS One 21(2):
e0341370.

https://doi.org/10.1371/journal.pone.0341370

Editor: Madson Alan Maximiano-Barreto, University of Sao Paulo, BRAZIL

Received: July 13, 2025; Accepted: January 5, 2026; Published: February 10, 2026

Copyright: © 2026 Qin et al. This is an open entry article distributed underneath the phrases of the Creative Commons Attribution License, which allows unrestricted use, distribution, and copy in any medium, offered the unique writer and supply are credited.

Data Availability: The knowledge on this examine can be found from the Chinese Longitudinal Health Survey (https://doi.org/10.18170/DVN/WBO7LK).

Funding: This work was supported by Henan Provincial Educational Science Planning Project (2025YB0006) and the Henan Provincial Philosophy and Social Sciences Education Enhancement Project (2025JYQS0194). The funders had no position in examine design, knowledge assortment or evaluation, resolution to publish, or manuscript preparation.

Competing pursuits: The authors have declared that no competing pursuits exist.

Introduction

Population getting older would be the fundamental nationwide situation of China for a very long time sooner or later. It can be an irreversible financial and social regular phenomenon, which is altering the inhabitants foundation of nationwide growth. According to the information of the seventh nationwide inhabitants census, the variety of aged individuals aged 65 and above in China has reached 191 million, accounting for 13.5% of the full inhabitants. This represents a rise of 4.63 p.c in contrast with the sixth census [1]. By 2050, China’s aged inhabitants is predicted to exceed 300 million, accounting for about 30 p.c of the full inhabitants [2]. With the acceleration of inhabitants getting older, the issue of “aging before health care” has turn into more and more distinguished. Depression is without doubt one of the frequent psychological well being issues in older adults. The World Health Organization reported that despair impacts about 7% of older individuals worldwide [3]. In China, the pooled general prevalence of depressive signs amongst older adults is 20.0% [4]. Depression, as a medical dysfunction, is characterised by persistent disappointment, self-blame, lack of curiosity in every day actions, and different unfavorable feelings, and it has well-documented antagonistic results on each bodily and psychological well being outcomes [5,6]. However, in epidemiological research, it’s typically not possible to depend on medical diagnoses; as a substitute, depressive signs—observable manifestations of low temper, anhedonia, and associated emotions—are assessed by means of validated scales. In older adults, these depressive signs can speed up the development of current illnesses, elevate the chance of suicide, and impose a substantial burden on households and society [7].

Depression in older adults is usually brought on by many elements, together with multifactorial correlates of organic, psychosocial, and environmental elements. Socioeconomic standing (SES) is a crucial indicator of social construction. It displays the place of a person or group inside a class-based society. SES can be a complete measure that includes training, revenue, occupation, wealth, and residential space. Due to the variations in financial growth and medical useful resource allocation between city and rural areas and between japanese and western areas in China, the aged inhabitants has apparent variations in bodily well being, psychological well being, common life expectancy and loss of life threat. It is carefully associated to depressive signs in older adults, and additionally it is one of many essential elements affecting depressive signs in older adults. Many earlier research have proven that there’s an inverse affiliation between SES and depressive signs in older adults [8,9]. Compared with individuals with excessive SES, individuals with low SES have decrease management over their work and life, face antagonistic occasions or challenges extra continuously, and usually tend to expertise unfavorable occasions, which can result in potential psychosocial and behavioral hurt. Long-term publicity to such social stressors could contribute to the event of depressive signs [10,11].

Previous research have proven that there’s a constructive correlation between SES and cognitive perform in older adults, and older adults with low socioeconomic standing have decrease cognitive perform [12,13]. According to the lively cognitive reserve idea, individuals with greater training have higher cognitive perform, and this phenomenon will proceed with age, thereby slowing the development of dementia [14]. At the identical time, there’s a advanced relationship between cognitive perform and despair in older adults. Elderly sufferers with despair are accompanied by cognitive impairment, and sufferers with cognitive dysfunction are sometimes accompanied by despair [15]. Therefore, it may be speculated that cognitive perform is without doubt one of the intermediate hyperlinks between SES and despair in older adults. Similarly, life-style and social participation can also play a job within the affiliation between SES and despair in older adults. Previous research have identified that folks with greater SES are likely to have a good life-style [16], whereas unhealthy existence corresponding to smoking and extreme consuming are threat elements for despair in older adults [17]. Zhang discovered that social participation mitigated the antagonistic well being results of deprived SES on older adults [18]. Therefore, the next hypotheses had been proposed on this examine: (1) SES impacts despair in older adults by influencing their cognitive perform; (2) SES impacts despair in older adults by influencing their life-style; (3) SES impacts despair in older adults by influencing their social participation.

Few earlier research have explored the impact of SES on despair from each physiological and behavioral elements within the aged. Moreover, earlier research principally explored the position of single variable between SES and despair. Therefore, this examine aimed to look at the affiliation between SES and depressive signs in older adults. It additional explored the mediating position of cognitive perform, life-style and social participation on this affiliation through the use of population-based knowledge of aged Chinese individuals. We imagine our examine can present a scientific foundation for lowering the incidence of depressive signs in older adults, bettering the psychological well being of older adults, and selling wholesome getting older.

Materials and strategies

Samples

The knowledge for this examine had been obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) [19]. CLHLS collected longitudinal knowledge coordinated by the Center for Healthy Aging and Development Studies of National School of Development at Peking University. The CLHLS goals to analyze elements influencing wholesome getting older in China, with baseline knowledge collected in 1998 and follow-up surveys carried out each 2–3 years. The 2017–2018 wave included members from 23 provinces, protecting roughly half of the counties and concrete districts in every province, with a stratified random sampling design guaranteeing nationwide representativeness.

The questionnaire knowledge collected gives info on household construction, residing preparations and proximity to kids, actions of every day residing (ADL), the capability of bodily efficiency, self-rated well being, self-evaluation of life satisfaction, cognitive functioning, power illness prevalence, care wants and prices, social actions, food regimen, smoking and consuming behaviors, psychological traits, financial sources, and caregiving and household assist amongst aged respondents and their relations [20]. All the survey knowledge are publicly accessible. The unique 2017–2018 CLHLS dataset included 15,874 members. For the current examine, we utilized the next inclusion standards: (1) aged ≥65 years; (2) full knowledge on key variables (SES, depressive signs, cognitive perform, life-style, social participation); and (3) no logical inconsistencies in responses. Exclusion standards included: (1) duplicate data; (2) lacking knowledge on ≥1 key variable; and (3) outliers (outlined as values ±3 normal deviations from the imply for steady variables). A complete of seven,595 members had been included within the last evaluation. The choice technique of analysis objects is proven in Fig 1. The samples had been effectively consultant.

Variables and devices

Statistical evaluation

Stata 16.0 software program was used to wash the 2017–2018 CLHLS knowledge, and SPSS 21.0 was used for statistical evaluation. Pearson’s χ2 take a look at was used to check categorical variables between members with and with out depressive signs. The SPSS macro program (PROCESS) developed by Hayes [31] was used for mediating impact evaluation to discover the mediating impact. The biasing corrected percentile Bootstrap methodology (repeated sampling 5000 instances) and 95% Confidence Interval (95percentCI) had been used to deduce the importance of the mediating impact. If the 95percentCI didn’t embrace 0, the mediating impact was vital. We carried out mediation analyses individually utilizing “cognitive function”, “lifestyle”, and “social participation” as mediating variables. In addition, “cognitive function-lifestyle”, “cognitive function-social participation”, and “cognitive function-life-style -social participation” had been used because the chain mediators for the mediation evaluation. To confirm the robustness of our findings, we carried out sensitivity analyses. Considering the numerous urban-rural twin construction and the variations between women and men, we carried out stratified analyses to check whether or not the mediation fashions remained constant. Statistical significance was set at P < 0.05.

Results

Characteristics of the examine pattern

Participants’ traits are proven in Table 1. Among the 7595 members, the imply age was 82.2 years previous (16.2% aged 100 and above), and males accounted for about 46.2%. 58.4% of the members lived in cities and 50.0% had spouses. 15.0% of the members had impaired actions of every day residing. The proportion of members with good, honest and poor self-rated well being standing was 48.9%, 38.6% and 12.5%, respectively. Participants with listening to difficulties accounted for 68.9%. In the previous two years, 72.5% of them suffered from extreme sickness.

Among the members, 42.1% had illiterate training, 46.8% had major or junior highschool training, and 11.1% had senior highschool training or above. 70.1% of the members had been peculiar practitioners, 16.2% had been intermediate practitioners, and 13.7% had been senior practitioners. 9.7%, 70.2% and 20.2% of the members rated their financial standing as poor, honest and good, respectively. SES composite scores on this examine ranged from −1.46 to 2.59. Cognitive perform scores ranged from 0 to 30, with a median rating of 26.2 ± 5.1. The rating of existence was between 0 and 6, with a median rating of three. 9 ± 1.2. The rating of social participation ranged from 11 to 55, with a median rating of 23.1 ± 7.2.

The imply CES-D-10 rating of all of the members was 9.6 ± 5.4. Using ≥10 because the cut-off rating, depressive signs had been recognized in 41.1% of the members. The chi-square take a look at outcomes revealed that age, gender, residence, marital standing, actions of every day residing, self-rated well being standing, listening to standing, critical sickness up to now two years, training degree, occupation, and financial standing had been every related to variations within the prevalence of depressive signs (P < 0.001).

Correlation evaluation

Pearson correlation was used to investigate the correlations between CES-D rating, socioeconomic standing, cognitive perform rating, life-style rating, and social participation rating (Table 2). The outcomes confirmed that CES-D rating was negatively correlated with socioeconomic standing (r = −0.216, P < 0.001), cognitive perform rating (r = −0.202, P < 0.001), life-style rating (r = −0.203, P < 0.001), and social participation rating (r = −0.198, P < 0.001). Socioeconomic standing was positively correlated with cognitive perform rating (r = 0.289, P < 0.001), life-style rating (r = 0.276, P < 0.001) and social participation rating (r = 0.335, P < 0.001). In addition, cognitive perform rating, life-style rating and social participation rating had been positively correlated, and the correlation coefficient was between 0.160 and 0.436 (P < 0.001).

The mediating position of cognitive perform, life-style and social participation within the impact of SES on depressive signs

The outcomes of the mediation mannequin evaluation (Table 3) confirmed that SES negatively affected despair in older adults (β = −0.887, P < 0.001) after controlling for sociodemographic variables and well being standing variables (Model Ⅰ), and SES nonetheless negatively affected despair in older adults (β = −0.541, P < 0.001) after including cognitive perform, life-style and social participation as mediating variables (Model Ⅴ). Moreover, SES positively affected cognitive perform (β = 0.835, P < 0.001), life-style (β = 0.345, P < 0.001), and social participation (β = 1.359, P < 0.001) amongst older adults (Models Ⅱ-Ⅳ). Cognitive perform (β = −0.085, P < 0.001), life-style (β = −0.512, P < 0.001) and social participation (β = −0.050, P < 0.001) negatively affected despair in older adults (Model Ⅴ). Cognitive perform positively affected life-style (β = 0.020, P < 0.001) and social participation (β = 0.225, P < 0.001) in older adults (Models Ⅲ-Ⅳ).

Mediation take a look at outcomes (Table 4) confirmed that the full oblique impact of SES on despair in older adults by means of cognitive perform, life-style and social participation was vital (relative mediating impact = 39.0%, β = −0.346, 95percentCI: −0.398 ~ −0.294), and the direct impact was additionally vital (relative mediating impact = 61.0%, β = −0.541, 95percentCI: −0.670 ~ −0.412). In the oblique impact, SES has a big mediating impact on despair in older adults by means of “cognitive function” (relative mediating impact = 8.0%, β = −0.071, 95percentCI: −0.095 ~ −0.048), “lifestyle” (relative mediating impact = 19.9%, β = −0.177, 95percentCI: −0.213 ~ −0.140) and “social participation” (relative mediating impact = 7.6%, β = −0.068, 95percentCI: −0.095 ~ −0.042), respectively. Moreover, the affect of SES on despair was additionally considerably mediated by “cognitive function → lifestyle” (relative mediating impact = 1.0%, β = −0.009, 95percentCI: −0.012 ~ −0.006), “cognitive function → social participation” (relative mediating impact = 1.0%, β = −0.009, 95percentCI: −0.014 ~ −0.006), “lifestyle → social participation” (relative mediating impact = 1.4%, β = −0.012, 95percentCI: −0.018 ~ −0.007) and “cognitive function → lifestyle →social participation” (relative mediating impact = 0.1%, β = −0.001, 95percentCI: −0.001 ~ −0.001) respectively. Fig 2 exhibits the trail evaluation of SES influencing despair in older adults.

This examine conducts some sturdy assessments to verify the accuracy of the estimation outcomes, together with the stratified evaluation by residence and gender. The outcomes indicating that the mediating results of cognitive perform, life-style, and social participation are constant throughout completely different residing environments and populations. Tables 5– current the inspection findings.

Discussion

The current examine demonstrates that 41.1% of older adults reported depressive signs, with decrease socioeconomic standing (SES) considerably growing the probability of despair. Cognitive perform, life-style, and social participation had been recognized as partial mediators, with life-style exerting probably the most pronounced impact. These findings underscore each the direct affect of SES and the oblique mechanisms by means of which cognitive, behavioral, and social elements contribute to depressive signs in later life.

These findings recommend that the psychological well being standing of older adults in China stays a vital concern [32]. The excessive prevalence of depressive signs noticed on this examine could also be partly attributable to speedy socioeconomic transformations, together with the weakening of conventional household buildings and the growing variety of “empty-nest” aged, each of which can exacerbate psychological vulnerability in later life [33].

Our findings verify an inverse affiliation between SES and depressive signs in older adults, according to prior analysis. Ng et al. reported greater odds of depressive signs amongst low-SES older adults in Singapore [34]. Lei et al. recognized a powerful SES gradient in depressive signs amongst Chinese older adults [35]. This discovering can be according to the affiliation between different well being outcomes (corresponding to bodily well being and cognitive perform) and SES [36], highlighting these socioeconomic inequalities contribute to well being disparities, significantly in psychological well being. According to emotion cognition idea, subjective deprivation is the cognitive hyperlink between social setting and psychological issues, stemming from perceived relative revenue disparities [37]. Subjective deprivation on account of perceived relative revenue disparity amongst low-income teams seems to be a key contributor to depressive signs. Low-SES older adults could expertise better stress and unfavorable feelings, growing their vulnerability to psychological well being points. In addition, restricted entry to enough healthcare companies and decrease high quality of routine care could exacerbate sickness burden and depressive signs [38]. Therefore, acceptable insurance policies and interventions needs to be carried out to scale back the SES associated inequalities in depressive signs amongst older adults.

This examine additional demonstrates that SES influences depressive signs by means of cognitive perform, life-style, and social participation. Nutakor et al. discovered that greater training and revenue are related to higher cognitive perform [39]. There are two attainable explanations for the affiliation between SES and cognitive perform: the Brain Reserve Capacity Theory (greater training enhances mind reserve) [40]and the behavioral regulatory position of training (selling wholesome existence that assist cognitive perform) [41].The advanced interaction between cognitive perform and despair is well-documented, and the prevalence of main despair in sufferers with Alzheimer’s illness is about 17% [42], and it’s even greater in sufferers with subcortical dementia [7]. The medical manifestations of despair intersect with dementia in older adults, and they’re tough to tell apart from one another. The outcomes of this examine present that cognitive perform can negatively predict despair in older adults, that’s, older adults with higher cognitive perform are much less prone to be depressed, which additionally partially confirms the constructive affiliation between cognitive perform and despair in older adults.

Studies in developed nations such because the United States have proven that teams with greater SES have more healthy existence [43]. Lower SES teams could face disadvantages in threat notion, studying efficacy, and social capital, resulting in much less wholesome behaviors. Unhealthy existence corresponding to low food regimen high quality, smoking, extreme alcohol consumption, lack of train and insomnia are related to depressive signs in older adults [44–46]. The underlying physiological mechanism could also be that unhealthy life-style (poor consuming habits, inadequate sleep, and publicity to chemical compounds and pollution) could probably disturb the hypothalamic-pituitary-adrenal axis, enhance cortisol, and trigger low-grade systemic irritation and oxidative stress [47]. Both neuroendocrine issues and irritation have been implicated within the etiology of despair [48].

Previous research have additionally supported the constructive affiliation between SES and social participation [18]. Berkman et al.’s path mode [49]means that social structural elements (e.g., SES) form social community measurement, which in flip facilitates social participation, assist, and useful resource entry. Thus, the upper SES group has a wider social community and their social participation is greater. The Activity Theory [50]emphasizes that common social participation is vital for sustaining shallowness, psychological satisfaction, and bodily well being in older adults, highlighting the psychological well being advantages of lively social engagement.

While our findings assist the pathway from SES to depressive signs by way of cognitive and behavioral mediators, interpretation warrants warning on account of the potential for bidirectional relationships. The ‘Health Selection Hypothesis’ posits that early-onset depressive signs or cognitive decline may result in downward socioeconomic mobility or social withdrawal, thereby inflating the noticed associations. Although we managed for baseline well being standing, the cross-sectional design limits our capacity to utterly rule out reverse causality—as an example, despair itself serves as a barrier to sustaining a wholesome life-style and social participation. Furthermore, potential survival bias should be thought-about. As the CLHLS targets the oldest-old, people with low SES and extreme despair may need had greater mortality charges and had been thus excluded from the pattern. This choice bias implies that our examine may truly underestimate the true antagonistic influence of low SES on despair, because the ‘frailest’ members are lacking. Additionally, not like Western contexts, the protecting impact of SES in China could be moderated by conventional household assist methods, which act as a buffer. Future longitudinal research utilizing cross-lagged panel fashions are wanted to disentangle these advanced temporal dynamics.

Several limitations of this examine needs to be addressed. First, the cross-sectional knowledge used on this examine make it tough to check the inference of causality, we should acknowledge within the dialogue that the affiliation between SES and despair is probably going bidirectional. And CLHLS survey centered on people aged 65 and older. Individuals who died prematurely on account of low SES and associated well being issues (together with extreme despair) weren’t included within the examine pattern. Secondly, the information on this examine are all from questionnaires, which can trigger investigation bias. Thirdly, this examine didn’t embrace different covariates, corresponding to medicine, and extra in-depth analysis needs to be carried out within the subsequent step. Finally, we included life-style and social participation as an entire within the mediation evaluation, and didn’t conduct an in depth evaluation of particular related variables. Therefore, longitudinal research after 2018 needs to be carried out to additional discover the causal affiliation between SES and depressive signs in older adults and different associated mechanisms, together with cognitive decline, unhealthy life-style, and antagonistic childhood experiences.

Acknowledgments

We wish to thank the CLHLS analysis workforce for accumulating prime quality, nationally consultant knowledge and for making the information public.

References

  1. 1.
    Bulletin of the seventh nationwide inhabitants Census. [https://www.gov.cn/guoqing/2021-05/13/content_5606149.htm]
  2. 2.
    World report on ageing and well being. Geneva: World Health Organization. 2015.
  3. 3.
    Who: Mental well being of older adults. 2017.
  4. 4.
    Tang T, Jiang J, Tang X. Prevalence of depressive signs amongst older adults in mainland China: A scientific evaluation and meta-analysis. J Affect Disord. 2021;293:379–90. pmid:34246000
  5. 5.
    Andrade-Gómez E, Martínez-Gómez D, Rodríguez-Artalejo F, García-Esquinas E. Sedentary behaviors, bodily exercise, and adjustments in despair and psychological misery signs in older adults. Depress Anxiety. 2018;35(9):884–97. pmid:30040170
  6. 6.
    Ouyang P, Sun W. The affiliation between depressive signs and fall accidents amongst middle-aged and aged individuals in China. Environ Health Prev Med. 2018;23(1):42. pmid:30185143
  7. 7.
    Alexopoulos GS. Depression within the aged. Lancet. 2005;365(9475):1961–70. pmid:15936426
  8. 8.
    Back JH, Lee Y. Gender variations within the affiliation between socioeconomic standing (SES) and depressive signs in older adults. Arch Gerontol Geriatr. 2011;52(3):e140-4. pmid:20947184
  9. 9.
    Xu Y, Yang J, Gao J, Zhou Z, Zhang T, Ren J, et al. Decomposing socioeconomic inequalities in depressive signs among the many aged in China. BMC Public Health. 2016;16(1):1214. pmid:27905918
  10. 10.
    Zhou S, Gao L, Liu F, Tian W, Jin Y, Zheng Z-J. Socioeconomic standing and depressive signs in older individuals with the mediation position of social assist: A population-based longitudinal examine. Int J Methods Psychiatr Res. 2021;30(4):e1894. pmid:34591341
  11. 11.
    Marmot M. The affect of revenue on well being: Views of an epidemiologist. Health Aff (Millwood). 2002;21(2):31–46. pmid:11900185
  12. 12.
    Marengoni A, Fratiglioni L, Bandinelli S, Ferrucci L. Socioeconomic standing throughout lifetime and cognitive impairment no-dementia in late life: The population-based getting older within the Chianti Area (InCHIANTI) Study. J Alzheimers Dis. 2011;24(3):559–68. pmid:21297261
  13. 13.
    Marden JR, Tchetgen Tchetgen EJ, Kawachi I, Glymour MM. Contribution of Socioeconomic Status at 3 Life-Course Periods to Late-Life Memory Function and Decline: Early and Late Predictors of Dementia Risk. Am J Epidemiol. 2017;186(7):805–14. pmid:28541410
  14. 14.
    Yang L, Martikainen P, Silventoinen Ok, Konttinen H. Association of socioeconomic standing and cognitive functioning change amongst aged Chinese individuals. Age Ageing. 2016;45(5):674–80. pmid:27496922
  15. 15.
    Paroni G, Panza F, De Cosmo S, Greco A, Seripa D, Mazzoccoli G. Klotho on the Edge of Alzheimer’s Disease and Senile Depression. Mol Neurobiol. 2019;56(3):1908–20. pmid:29978424
  16. 16.
    Granic A, Davies Ok, Adamson A, Kirkwood T, Hill TR, Siervo M, et al. Dietary patterns and socioeconomic standing within the very previous: The newcastle 85+ examine. PLoS One. 2015;10(10):e0139713. pmid:26488497
  17. 17.
    An R, Xiang X. Smoking, heavy consuming, and despair amongst U.S. middle-aged and older adults. Prev Med. 2015;81:295–302. pmid:26436684
  18. 18.
    Zhang Y, Su D, Chen Y, Tan M, Chen X. Effect of socioeconomic standing on the bodily and psychological well being of the aged: the mediating impact of social participation. BMC Public Health. 2022;22(1):605. pmid:35351078
  19. 19.
    Studies CfHAaD: The Chinese Longitudinal Healthy Longevity Survey (CLHLS)-Longitudinal Data (1998-2018). In., DRAFT VERSION edn: Peking University Open Research Data Platform; 2020.
  20. 20.
    Studies CFHA: The Chinese Longitudinal Healthy Longevity Survey (CLHLS)-Longitudinal Data (1998-2018). 2020.
  21. 21.
    Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for despair in effectively older adults: analysis of a brief type of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77–84. pmid:8037935
  22. 22.
    Cheng S-T, Chan ACM. The Center for Epidemiologic Studies Depression Scale in older Chinese: thresholds for lengthy and quick kinds. Int J Geriatr Psychiatry. 2005;20(5):465–70. pmid:15852439
  23. 23.
    Bradley RH, Corwyn RF. Socioeconomic standing and youngster growth. Annu Rev Psychol. 2002;53:371–99. pmid:11752490
  24. 24.
    Wang Y, Wang Y, Xu H. Ambient air air pollution and socioeconomic standing in China. Environ Health Perspect. 2022;130(6):67001.
  25. 25.
    An R, Liu GG. Cognitive impairment and mortality among the many oldest-old Chinese. Int J Geriatr Psychiatry. 2016;31(12):1345–53. pmid:26891153
  26. 26.
    Jin X, He W, Zhang Y, Gong E, Niu Z, Ji J, et al. Association of APOE ε4 genotype and life-style with cognitive perform amongst Chinese adults aged 80 years and older: A cross-sectional examine. PLoS Med. 2021;18(6):e1003597. pmid:34061824
  27. 27.
    Bai W, Zhang J, Smith RD. Inter-relationship between cognitive efficiency and depressive signs and their affiliation with high quality of life in older adults: A community evaluation based mostly on the 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS). J Affect Disord. 2023;320:621–7.
  28. 28.
    He X, Song X, Liang J. The affiliation between wholesome life-style trajectory and depressive signs: findings from the Chinese longitudinal wholesome longevity survey (CLHLS). J Affect Disord. 2025;392:120170.
  29. 29.
    Hui Z. On the affect of social participation on loneliness of the aged in China——based mostly on knowledge of CLHLS 2018. Population Development. 2021;27(5):12–23.
  30. 30.
    Zhang N, Zhang Y, Zou Y. The influence of partner well being on social participation of older adults in China: Evidence from the CLHLS. J Affect Disord. 2023;324:46–52.
  31. 31.
    Hayes A. Introduction to mediation, moderation, and conditional course of evaluation. J Educ Measurement. 2013;51(3):335–7.
  32. 32.
    Yu J, Li J, Cuijpers P, Wu S, Wu Z. Prevalence and correlates of depressive signs in Chinese older adults: a population-based examine. Int J Geriatr Psychiatry. 2012;27(3):305–12. pmid:21538538
  33. 33.
    Li D, Zhang D, Shao J, Qi X, Tian L. A meta-analysis of the prevalence of depressive signs in Chinese older adults. Arch Gerontol Geriatr. 2014;58(1):1–9. pmid:24001674
  34. 34.
    Ng CWL, Tan WS, Gunapal PPG, Wong LY, Heng BH. Association of Socioeconomic Status (SES) and Social Support with Depressive Symptoms among the many Elderly in Singapore. Ann Acad Med Singap. 2014;43(12):576–87. pmid:25588916
  35. 35.
    Lei X, Sun X, Strauss J, Zhang P, Zhao Y. Depressive signs and SES among the many mid-aged and aged in China: Evidence from the China Health and Retirement Longitudinal Study nationwide baseline. Soc Sci Med. 2014;120:224–32. pmid:25261616
  36. 36.
    Lei X, Sun X, Strauss J, Zhao Y, Yang G, Hu P, et al. Health outcomes and socio-economic standing among the many mid-aged and aged in China: Evidence from the CHARLS nationwide baseline knowledge. J Econ Ageing. 2014;4:59–73. pmid:31428556
  37. 37.
    Ross CE, Mirowsky J. Neighborhood dysfunction, subjective alienation, and misery. J Health Soc Behav. 2009;50(1):49–64. pmid:19413134
  38. 38.
    Areán PA, Reynolds CF. The influence of psychosocial elements on late-life despair. Biol Psychiatry. 2005;58(4):277–82. pmid:16102545
  39. 39.
    Nutakor JA, Dai B, Zhou J, Larnyo E, Gavu AK, Asare MK. Association between socioeconomic standing and cognitive functioning amongst older adults in Ghana. Int J Geriatr Psychiatry. 2021;36(5):756–65. pmid:33215724
  40. 40.
    Schmand B, Smit JH, Geerlings MI, Lindeboom J. The results of intelligence and training on the event of dementia. A take a look at of the mind reserve speculation. Psychol Med. 1997;27(6):1337–44. pmid:9403905
  41. 41.
    Albert MS. How does training have an effect on cognitive perform?. Ann Epidemiol. 1995;5(1):76–8. pmid:7728289
  42. 42.
    Wragg RE, Jeste DV. Overview of despair and psychosis in Alzheimer’s illness. Am J Psychiatry. 1989;146(5):577–87. pmid:2653053
  43. 43.
    Skalamera J, Hummer RA. Educational attainment and the clustering of health-related habits amongst U.S. younger adults. Prev Med. 2016;84:83–9. pmid:26740348
  44. 44.
    Goh CMJ, Abdin E, Jeyagurunathan A, Shafie S, Sambasivam R, Zhang YJ, et al. Exploring Singapore’s consumption of native fish, greens and fruits, meat and problematic alcohol use as threat elements of despair and subsyndromal despair in older adults. BMC Geriatr. 2019;19(1):161. pmid:31182040
  45. 45.
    Gomes AP, Oliveira Bierhals I, Gonçalves Soares AL, Hellwig N, Tomasi E, Formoso Assunção MC, et al. Interrelatioship between food regimen high quality and depressive signs in aged. J Nutr Health Aging. 2018;22(3):387–92. pmid:29484352
  46. 46.
    Baglioni C, Battagliese G, Feige B, Spiegelhalder Ok, Nissen C, Voderholzer U, et al. Insomnia as a predictor of despair: A meta-analytic analysis of longitudinal epidemiological research. J Affect Disord. 2011;135(1–3):10–9. pmid:21300408
  47. 47.
    Sarris J, O’Neil A, Coulson CE, Schweitzer I, Berk M. Lifestyle medication for despair. BMC Psychiatry. 2014;14:107. pmid:24721040
  48. 48.
    Raison CL, Capuron L, Miller AH. Cytokines sing the blues: Inflammation and the pathogenesis of despair. Trends Immunol. 2006;27(1):24–31. pmid:16316783
  49. 49.
    Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to well being: Durkheim within the new millennium. Soc Sci Med. 2000;51(6):843–57. pmid:10972429
  50. 50.
    Lemon BW, Bengtson VL, Peterson JA. An exploration of the exercise idea of getting older: Activity varieties and life satisfaction amongst in-movers to a retirement neighborhood. J Gerontol. 1972;27(4):511–23. pmid:5075497


This web page was created programmatically, to learn the article in its unique location you’ll be able to go to the hyperlink bellow:
https://journals.plos.org/plosone/article%3Fid%3D10.1371/journal.pone.0341370
and if you wish to take away this text from our web site please contact us

Related Posts

Life-style modifications could make ‘huge impact’ on Alzheimer’s illness

Nearly 40% Of Cancers Can Be Prevented With 3 Life-style Modifications, Study Finds

Horoscope Tomorrow, February 11, 2026: Love and profession collide as the celebs stir robust needs and realisations

About fooshya

View all posts by fooshya →