Association between depressive symptoms and health-related quality of life among older adults with hypertension living alone

Background Older adults with hypertension who live alone face greater psychological pressure and poorer health outcomes compared with those living with family, yet evidence regarding the interplay of depression and quality of life in this vulnerable group remains insufficient. To determine the factors associated with depression status and health-related quality of life among older adults with hypertension living alone and to provide a reference for improving mental health and health-related quality of life in this population. Methods Data from 278 older adults aged 65 years and older living with hypertension were selected from the “NCLM-Cohort_2023–2024 database.” Depression status was assessed using the Chinese version of the Patient Health Questionnaire Depression Scale (PHQ-9), and quality of life was evaluated using the EuroQol Five-Dimension Five-Level Scale (EQ-5D-5L). Factors related to depression status and quality of life among older adults with hypertension living alone were explored using univariate analysis, binary logistic regression, and multiple linear regression. Results The median EuroQol Visual Analog Scale (EQ-VAS) score was 80.00 (63.75, 83.00) points. Binary logistic regression showed that female sex, sleep duration of 6–8 h or >8 h, alcohol consumption, occasional consumption of fried food, and no or very little consumption of fried food were protective factors for depression, whereas difficulty falling asleep was a risk factor for depression. Multiple linear regression indicated that marital status, occupation, sleep duration, difficulty falling asleep, and frequency of eating pickles and preserved vegetables were influencing factors for EQ-VAS scores. Depressive state significantly moderated the relationship between sleep duration and quality of life. Conclusion Multiple factors are associated with depression symptoms and quality of life among older adults with hypertension living alone. Adjusting sleep duration and dietary habits, improving disease perception, and enhancing social support may help reduce the incidence of depression and improve quality of life.