Abstract

Objectives: The gender difference in depressive symptoms in older adults is well-established, with women exhibiting approximately twice as many depressive symptoms as men across the life span. However, almost no studies have explored why we see this pattern in older adults.

Method: In this study, moderation, mediation and reverse mediation analyses were used to learn how gender differences in psychosocial and health variables contribute to the gender difference in depressive symptoms in 60–74 year old participants in the baseline sample of the ORANJ BOWL study (n = 3008).

Results: Moderation analyses show that functional ability, health, social support, and living alone interact with gender to predict depressive symptoms. Mediation analyses demonstrate that gender differences in financial comfort, social support, health, functional ability and living alone help explain the gender difference in depression. Reverse mediation analyses show that depressive symptoms also predict the gender difference in psychosocial and health variables.

Conclusion: While the moderation analyses show multiple points of entry for clinical implications, they do not provide clarity that explains the gender difference in depressive symptoms. Mediation analyses highlight the roles of functional ability, financial comfort, health and living alone in explaining the gender difference. Reverse mediation analyses suggest a negative feedback loop between depressive symptoms and the predictor variables, with gender differences in functional ability, financial comfort, health and living alone at least partially explained by gender differences in depression. The findings highlight opportunities for targeted depression screening and to identify the gender inequities that need attention in order to reduce disadvantages for women.

摘要

目标：老年人抑郁症状的性别差异是明确的，女性在一生中表现出的抑郁症状大约是男性的两倍。然而，几乎没有研究探讨为什么我们会在老年人中看到这种模式。

方法：在本研究中，采用调节、中介和反向中介分析来了解 ORANJ BOWL 研究基线样本中 60-74 岁参与者的心理社会和健康变量中的性别差异如何影响抑郁症状的性别差异（n  = 3008）。

结果：调节分析表明，功能能力、健康、社会支持和独居与性别相互作用，可预测抑郁症状。中介分析表明，经济舒适度、社会支持、健康、功能能力和独居方面的性别差异有助于解释抑郁症的性别差异。反向中介分析表明，抑郁症状还可以预测心理社会和健康变量的性别差异。

结论：虽然调节分析显示了临床意义的多个切入点，但它们并没有明确解释抑郁症状的性别差异。中介分析强调了功能能力、经济舒适度、健康和独居在解释性别差异方面的作用。反向中介分析表明抑郁症状和预测变量之间存在负反馈循环，功能能力、经济舒适度、健康状况和独居方面的性别差异至少部分可以通过抑郁症的性别差异来解释。研究结果强调了有针对性的抑郁症筛查和确定需要关注的性别不平等的机会，以减少女性的不利地位。