Association Between Unmet Healthcare Needs and Depression in Older Adults: Evidence from the Korean National Health and Nutrition Examination Survey

<b>Background:</b> Studies on the relationship between unmet healthcare needs and depression in older adults are limited in Asia. This study aimed to investigate the relationship between unmet healthcare needs and the risk of depression in older adults aged ≥65 years in Korea. <b>Methods:</b> This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey in 2014, 2016, and 2018. Three models were constructed using a weighted multivariate logistic regression analysis to account for the complex survey design. Model 1 is adjusted for sex and age. Model 2 was further adjusted for household income, education level, marital status, and private health insurance. Model 3 was further adjusted for alcohol use, cigarette use, weekly walking activity, hypertension, dyslipidemia, and diabetes mellitus. Subgroup analyses were performed to assess the stability and robustness of the association between unmet healthcare needs and depression. <b>Results:</b> In total, this study included 4062 participants aged ≥65 years, with 3749 and 313 individuals in the non-depression and depression groups, respectively. In the unadjusted models, individuals with unmet healthcare needs had a greater likelihood of depression than those without unmet needs. This association remained significant across all three sequentially adjusted models. Subgroup analyses supported these findings. <b>Conclusions:</b> Unmet healthcare needs are significantly associated with depressive symptoms in older adults. Therefore, a multidimensional approach is required when addressing mental health issues in this population, and addressing unmet healthcare needs may be crucial for promoting mental health.