Living Arrangements and Depression among Elderly Persons in China: A National Cross-sectional Study

Background: While the positive effect of living alone on depression among elderly persons has been demonstrated by multiple studies in China, evidence regarding other types of living arrangements, specifically considering family size, is scarce. This study assessed the effect of living arrangements, as measured by family size, on depression among elderly persons. Methods: A cross-sectional analysis of 6,678 adults aged 60+ from the 2020 China Health and Retirement Longitudinal Study was conducted using descriptive and binary logistic regression analyses. Results: Of the analyzed elderly persons, 35.43% (n=2,366) exhibited depression. Elderly persons living alone exhibited higher levels of depression than those living with two or more family members. Depression levels were not significantly different between those living with one family member and those living with two or more family members. This result highlights the importance of co-residence with family regarding depression among Chinese elderly persons and suggests that simply living with family, regardless of the number of family members, can alleviate the risk of depression. Apart from living arrangements, the results reveal social inequalities in depression, particularly in socioeconomic status and health status. Conclusion: The government should consider establishing a social network similar to existing ‘buddy programs’ that can supplement the role of family to assist elderly persons living alone in overcoming life’s daily challenges. Furthermore, targeted interventions should be implemented to aid the abovementioned high-risk groups for depression, thereby alleviating the social inequalities found in this study. Keywords: Depressive symptoms, Living arrangements, Living alone, Social convoy model