Association between chronic diseases and depressive inclinations among rural middle-aged and older adults

This study investigates the association between chronic diseases and depressive inclinations among middle-aged and older adults in rural Northwest China, emphasizing the moderating role of social relationships. Data collected via face-to-face surveys in a cross-sectional design conducted in March 2021, encompassing 395 participants aged 45 and above, were analyzed using Ordinary Least Squares (OLS) regression. The results indicate that, excluding metabolic diseases (such as dyslipidemia and diabetes), other chronic diseases significantly increase depressive inclinations, particularly eye diseases, chronic lung diseases, heart disease, rheumatoid arthritis, and gastrointestinal diseases. Additionally, a greater number of chronic diseases show a positive association with depressive inclinations. Among social relationships, spousal trust and intergenerational relationship satisfaction were associated with a mitigation of the association between chronic diseases and depressive inclinations, whereas skipped generational caregiving exacerbated this association. Other social relationships, including kinship and friendship network size, neighbor relationships, and villager relationships, exhibited no significant moderating associations. These findings underscore the critical role of positive family relationships and robust social support systems in improving the mental health of rural middle-aged and older adults. They provide practical insights for designing targeted policies and interventions to promote healthy aging and mental well-being in resource-limited rural settings.