# Individual and Cumulative Health and Lifestyle Risk Factors for Depressive Symptoms in Older Adults: Evidence from NHANES

## TL;DR

This study shows that multiple health and lifestyle factors together strongly increase the risk of depression in older adults.

## Contribution

The study reveals a 20-fold increased risk of depressive symptoms with six or more cumulative risk factors in older adults.

## Key findings

- Depressive symptoms were more common in individuals with poor health, functional limitations, and unhealthy lifestyles.
- Older adults with six or more risk factors had a 20-fold higher likelihood of depressive symptoms.
- The study highlights the need for integrative strategies to address mental health in aging populations.

## Abstract

Background: Depression in older adults is a multifactorial condition influenced by health status, functional capacity, and lifestyle factors. This study aimed to investigate the individual and combined associations of these factors with late-life depression. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), this study evaluated the associations of general health, chronic conditions, functioning, and lifestyle behaviors (including physical activity, sleep, diet quality, smoking, and alcohol use) with depressive symptoms among U.S. adults 65 years and older. Weighted logistic regression models, accounting for the complex survey design of NHANES, were used to examine the factors both individually and in combination. Results: Depressive symptoms were more prevalent among individuals with poor self-rated health, physical and cognitive functional limitations, hypertension, obesity, current smoking, physical inactivity, and alcohol abstinence. A clear cumulative risk gradient was observed with increasing numbers of risk factors: older adults with six or more risk factors had at least 20-fold higher likelihood of depressive symptoms compared with those with one or no risk factors. Conclusions: These findings highlight the interdependent influences of health, function, and lifestyle on late-life depressive symptoms and underscore the need for integrative prevention and intervention strategies to promote mental well-being in aging populations.