Depression is a persistent mental health condition characterized by sadness, loss of interest, and a range of emotional and physical difficulties.
Living situations can significantly influence depression risk, with factors like social isolation, family conflict, and lack of support potentially worsening symptoms, while positive social interactions and a sense of belonging can have protective effects.
Wang, H., & Sun, B. (2025). Does living alone exacerbate depression in older adults? Frontiers in Psychology, 16, 1553080. https://doi.org/10.3389/fpsyg.2025.1553080
Key Points
- Living alone was associated with lower depression levels in older adults in China compared to living with children.
- The positive effect of living alone on depression was primarily observed in older adults who lived close to their children.
- Living alone was found to be beneficial for depression in rural older adults but not in urban older adults.
- The findings suggest that living alone can be a positive living arrangement for older adults in China, especially in rural areas and when living close to children.
Rationale
The study is justified by the growing trend of older adults living alone in China, a phenomenon that challenges traditional Confucian values emphasizing co-residence with children.
Previous research on the relationship between living arrangements and depression in older adults has yielded mixed results, with some studies suggesting that living alone is detrimental to mental health (Kim and Choi, 2011; Do and Malhotra, 2012; Tiedt, 2013; Xu et al., 2022) while others have found no significant effects or even positive effects (Ren and Treiman, 2015; Gu et al., 2018; Xn et al., 2019).
This study aims to contribute to this debate by using a longitudinal dataset and a fixed-effects model to examine the relationship between living arrangements and depression in China, considering the influence of family culture and urban-rural differences.
The study’s findings have implications for policymakers and practitioners working with older adults in China, as they suggest that living alone can be a positive living arrangement for older adults under certain conditions.
Method
Quantitative analysis of secondary data from the China Health and Retirement Longitudinal Study (CHARLS).
Procedure
- The researchers analyzed data from three waves of the CHARLS survey (2013, 2015, 2018).
- They included individuals aged 60 years and above who had at least one living child.
- The researchers examined the relationship between living arrangements and depression using a fixed-effects model.
- They controlled for various demographic, social, economic, and health factors.
- The researchers also conducted robustness tests to address potential endogeneity and measurement issues.
Sample
- The sample size was 14,739.
- Relevant demographic characteristics included age, gender, marital status, household registration (rural vs. urban), years of education, work status, and number of children.
Measures
- Depression: The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depression levels.
- Living arrangements: Participants were categorized as either living with children or living alone.
- Control variables: Demographic characteristics, social and economic features, health conditions, and social engagement.
Statistical measures
- The researchers used a fixed-effects model to analyze the relationship between living arrangements and depression.
- They conducted Hausman tests to determine the appropriate model.
- Robustness tests were performed using instrumental variables and by addressing potential measurement issues.
- The study also examined urban-rural differences.
Results
- Hypothesis 1: Living alone would be associated with lower depression levels in older adults compared to living with children. This hypothesis was supported.
- Hypothesis 2: The positive effect of living alone on depression would be primarily observed in older adults who lived close to their children. This hypothesis was supported.
- Hypothesis 3: Living alone would be beneficial for depression in rural older adults but not in urban older adults. This hypothesis was supported.
Insight
The study provides valuable insights into the relationship between living arrangements and depression in older adults in China.
The findings challenge the traditional view that co-residence with children is necessary for well-being in old age, suggesting that living alone can be a positive living arrangement, especially in rural areas and when living close to children.
This is particularly informative in the context of China’s changing family culture, where individual independence is increasingly valued.
The study extends previous research by using a longitudinal dataset and a fixed-effects model to address potential endogeneity and measurement issues.
The findings suggest that future research should explore the factors that contribute to the positive effects of living alone on depression in older adults, such as social support, community engagement, and access to services.
Implications
The findings have implications for practitioners and policymakers working with older adults in China.
Practitioners should consider promoting living arrangements that allow older adults to live close to their children while maintaining their independence.
This could involve providing support for older adults who choose to live alone, such as home care services, social activities, and transportation assistance.
Policymakers should consider incentivizing migrant workers to return to their rural hometowns to provide support for their aging parents.
They should also invest in community-based services for older adults, such as senior centers, healthcare facilities, and transportation infrastructure.
The potential benefits of implementing these recommendations include improved mental health and well-being for older adults, reduced healthcare costs, and stronger family relationships.
However, there may also be challenges, such as resistance from traditional families, limited resources, and logistical difficulties in providing services to older adults in rural areas.
Strengths
This study had several methodological strengths, including:
- Longitudinal design
- Use of a fixed-effects model to control for confounding variables
- Robustness tests to address potential endogeneity and measurement issues
- Examination of urban-rural differences
Limitations
This study also had several limitations, including:
- Reliance on self-reported data
- Limited consideration of other potential moderators and mediators
- The study was conducted in China and may not be generalizable to other cultures
Socratic Questions
- How might the findings of this study differ in cultures with different family structures and values?
- What are the potential ethical considerations of promoting living alone for older adults?
- How can practitioners and policymakers balance the need for independence and support for older adults living alone?
- What are the potential long-term consequences of the trend toward living alone among older adults in China?
- How can future research further explore the factors that contribute to the positive effects of living alone on depression in older adults?
