Living Alone and Self-Assessed Depression Among Older Adults in Thailand: A Nationwide Cross-Sectional Analysis Using Propensity Score Matching

Thailand has a higher depression rate among older adults than other Southeast Asian countries, and the proportion of older adults living alone is growing. However, evidence regarding the relationship between living alone and depression among older adults in Thailand is scarce. Thus, this study examined this issue, focusing on two research objectives: (1) to examine the relationship between living alone and self-assessed depression using the matched sample of data acquired by propensity score matching and (2) to explore sociodemographic patterns in self-assessed depression using the full sample of data. This study employed a cross-sectional design with individuals aged 65 or above from the 2019 Health and Welfare Survey dataset ( N = 6,164, including a matched subsample of 2,702 individuals). Ordinal logistic regression analyses were performed using a single-item measurement of self-assessed depression. The results showed that older adults living alone reported higher self-assessed depression than those living with family, suggesting that living alone could independently increase the risk of depression among this group, regardless of sociodemographic factors (objective 1). We also found sociodemographic disparities in self-assessed depression. Specifically, older adults who were low-income, female, unemployed, chronically ill, or living in rural regions reported higher self-assessed depression than their counterparts (objective 2). These findings reveal a need to address the increased risk of depression among older adults living alone, which could be accomplished, for example, by establishing a social support network to supplement the support traditionally provided by older adults’ families in helping them overcome daily life challenges. Such a network could be created by integrating social work professionals into existing community health volunteer programs as a pragmatic approach. Additionally, reinforcing external resources, such as participation in social activities, could reduce sociodemographic disparities in mental health. Thus, the government should continue developing community-based social participation programs for older adults.