Age-Friendly Environments and Depression among Older Adults in Korea: Social Participation as a Mediator Across Household Types

Background: Depression is a common mental health concern among older adults.This study investigated whether the mediating role of social participation on the relationship between age-friendly environments and depression differs across household typesliving alone, living with a spouse, or living with adult children. Methods:This cross-sectional secondary data analysis included 9,956 community-dwelling adults aged 65 years who participated in the 2020 National Survey of Older Koreans.Household types were categorized as living alone (n=3,137), living with a spouse (n=5,131), or living with children (n=1,688).All the participants completed a questionnaire that assessed demographic characteristics, age-friendly environments, social participation, and depression.Mediation analysis was conducted using Model 4 of the PROCESS Macro with 5,000 bootstrap iterations, adjusting for all control variables.Results: Social participation significantly mediated the relationship between age-friendly environments and depression among older adults living alone (=-0.01;95% confidence interval [CI], -0.02--0.01)and those living with children (=-0.01;95% CI, -0.01--0.00).Conversely, the indirect mediation effect was not significant in older adults living with a spouse (=0.00;95% CI, -0.00-0.00). Conclusion:Strategies to promote social participation among older adults living alone and those living with adult children may alleviate depression.Tailored community interventions that consider the characteristics of each household type are warranted.