The Association Of Living Arrangements And Intergenerational Support On Depressive Symptoms Of The Rural Elderly

Objective：To investigate the distribution characteristics of elderly depressive symptoms and itsassociation with living arrangements and intergenerational support in the rural area ofTuanfeng County, Hubei Province, and to provide evidence for prevention and promote theaging health.Methods:The study was conducted in Tuanfeng, Hubei province, in central China，from October2006to April2008. The subjects were selected by a stratified cluster random samplingmethod. We randomly selected5townships form the overall10townships in Tuanfeng, andthen randomly chose22villages form the whole94villages. People aged15years andabove were invited to participate in the survey by trained interviewers using a structuredquestionnaire. Information was collected on depressive symptom scores (measured by theBeck Depression Inventory-II), living arrangements (single-dwelling, lived with spousesonly, skip-generation family, lived with children, lived with others), intergenerationalsupport, demographic characteristics, socio-economic status and self-rated physical healthand so on. In this current analysis, only elderly person aged60years and above wereincluded. All analyses were performed using SAS version9.2. The analysis methodsinclude descriptive analysis, analysis of variance, t test, multiple linear regression andordinal logistic regression.Results:1. The prevalence of elder depression symptoms was26.59%in Tuanfeng County, Hubei. Among them, the mild depression symptom was13.44%, the moderate was8.99%,and the severe was4.15%. Average depressive symptoms score was10.14±8.59.2. Univariate analysis results: Depressive symptoms score among different livingarrangements and different level of intergenerational support are statistically significant (p<0.05). The depressive symptoms score of single dweller is higher than that of the couplegroup. Significant statistics differences of depressive symptoms score are in gender, maritalstatus, years of schooling, economic situation, and self-rated physical health (p <0.05).3. The results of multiple linear regression model were very similar to those of ordinalmodel: intergenerational support had a positive association with depressive symptoms, butthere was no association between living arrangements and depressive symptoms. Thedepressive symptoms score of little support group, moderate support and fully supportgroup was3.2points,4.47points and5.94points lower than that of no support group,respectively. Economic status and physical health are protective factors for depressivesymptoms.Conclusions:1. The prevalence of elderly depressive symptoms was26.59%in the rural area ofTuanfeng County, Hubei Province.2. Living arrangements has no association with depressive symptoms for the elderly.It should be cautious to combine the single-dwelling and those who lived with spouses asempty nesters in view of the significant different depressive symptoms score between thesegroups.3. Intergenerational support is a protective factor for elderly depressive symptoms.With respect to elderly depressive symptoms intervention, intergenerational support may bemore important than living arrangement. Strategic interventions should focus priorities onimproving intergenerational support level and favor the low income and the poor health.