# Depressive symptoms of older adults with chronic diseases: the mediating roles of activities of daily living and economic burden of diseases

## TL;DR

This study examines how daily living activities and financial strain from chronic diseases affect depression in older adults.

## Contribution

The study identifies both individual and chain mediating effects of ADL and economic burden on depressive symptoms in older adults with chronic diseases.

## Key findings

- ADL and economic burden individually mediate the relationship between chronic diseases and depressive symptoms.
- ADL and economic burden also have a chain mediating effect, contributing to 0.759% of the total effect.
- The study recommends improving ADL and reducing financial strain to alleviate depression in older adults with chronic diseases.

## Abstract

To explore the mediating roles of activities of daily living (ADL) and economic burden of diseases in the relationship between chronic diseases and depressive symptoms of older adults.

The data were sourced from China Health and Retirement Longitudinal Study (CHARLS). The number of chronic diseases, ADL, out-of-pocket medical expenses and the Center for Epidemiological Studies Depression Scale (CES-D) were selected as measuring indexes. Mediation analysis was conducted to explore the potential mediating roles of ADL and economic burden of diseases in the association between chronic diseases and depressive symptoms.

The number of chronic diseases, ADL, economic burden of diseases and depressive symptoms of older adults were significantly correlated with each other. ADL and economic burden of diseases individually mediated the relationship between the number of chronic diseases and depressive symptoms, accounting for 31.460% and 5.471% of the total effect, respectively. Additionally, ADL and economic burden of diseases demonstrated a chain mediating effect in this relationship, contributing to 0.759% of the total effect.

The chain-mediated model effectively elucidated the mediating roles of ADL and economic burden of diseases in the association between chronic diseases and depressive symptoms among older adults. The study underscores the need for policymakers to focus attentively on the mental health of older adults with chronic diseases. Enhancing the capacity for ADL and strengthening social security to mitigate the economic burden of diseases are recommended strategies to alleviate depressive symptoms in older adults.