Factors associated with depressive symptoms among older Chinese Americans with major depressive disorder

PURPOSE: Older Chinese immigrants experience higher rates of depression. This study aimed to examine the associations between key clinical factors and depressive symptoms among older Chinese Americans with major depressive disorder (MDD). METHODS: A cross-sectional study was conducted with ninety-nine participants (mean 60.69 ± SD 7.62 years old). Dependent variable was depressive symptoms. Key study variables included acculturation, social support, physical activity, frailty, cognitive function, and sleep quality. Nine of participants wore an Actiwatch to assess sleep characteristics over a 7-day period. Descriptive statistics, Spearman correlation, Chisquare tests, and blockwise multiple linear regressions were used to analyze the data. RESULTS: Participants with more depressive symptoms had lower levels of social support (r = -0.325, p < .01), reduced engagement in total physical activity (r = -0.222, p < .05), higher levels of frailty (r = 0.425, p < .01), greater cognitive impairment (r = - 0.313, p < .01), and poor subject sleep quality (r = 0.330, p < .001). After controlling confounding factors, social support (p < .01), cognitive function (p < .01), and sleep quality (p < .05) were significant predictors of depressive symptoms. All participants were poor sleepers. However, the discrepancy of sleep onset and sleep efficiency were found between subjective and objective sleep measures. CONCLUSION/IMPLICATIONS: Incorporating clinical assessments of social support, cognitive function, and sleep quality into depression care for this underserved population is warranted. Future studies with larger sample sizes are needed to examine the discrepancy of subjective and objective sleep measures in this population.