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Published in: BMC Geriatrics 1/2016

Open Access 01-12-2016 | Research article

Association between eating alone and depressive symptom in elders: a cross-sectional study

Authors: Xinyi Wang, Wei Shen, Chunmei Wang, Xiaoyi Zhang, Yuanyuan Xiao, Fan He, Yujia Zhai, Fudong Li, Xiaopeng Shang, Junfen Lin

Published in: BMC Geriatrics | Issue 1/2016

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Abstract

Background

Depression is one of the main health concerns in elders which could lead to many negative outcomes. Eating alone is an emerging issue in elders in China and would become more serious along with the fast course of industrialization and urbanization, as well as population aging. However, their relationship was seldom researched.

Methods

Using a two-stage cluster sampling strategy, an investigation was conducted in 2014 among 9,361 permanent residents aged 60 years and above in Zhejiang Province, China. Totally, 7,968 cognitively normal elders were included in our analysis. Multilevel logistic regression was used to explore the association between eating arrangement (number of companions in mealtime) and depressive symptom as well as the association between eating alone and depressive symptom in relation to living alone.

Results

In our sample, 17.1 % of the elders ate alone and 8.7 % had depressive symptom. We observed a distinct inverse association between eating arrangement (number of companions in mealtime) and geriatric depressive symptom (female: OR = 1.12, P = 0.027; aged 60–74 years: OR = 1.16, P = 0.002), after adjustment for demography, socioeconomic status, social relation, health behaviors, underlying conditions and living alone. We then introduced a combined variable of eating alone and living alone and examined its relationship with depressive symptom. We found that compared with elders who ate and lived with others, those who ate alone but lived with others had a significant increased odds of depressive symptom (female: OR = 1.62, P = 0.027; aged 60–74 years: OR = 1.59, P = 0.025).

Conclusions

Our results suggested that a lack of companionship in mealtime might be independently associated with geriatric depressive symptom for females and those aged 60–74 years. What’s more, eating alone might be a stronger factor associated with depressive symptom than living alone. We recommend interventions to be performed in encouraging elders especially females and those aged 60–74 years to eat with others. Longitudinal studies in different populations which focus on this topic are required to better understand this issue.
Literature
1.
go back to reference Luppa M, Sikorski C, Luck T, Ehreke L, Konnopka A, Wiese B, et al. Age- and gender-specific prevalence of depression in latest-life--systematic review and meta-analysis. J Affect Disord. 2012;136(3):212–21.PubMedCrossRef Luppa M, Sikorski C, Luck T, Ehreke L, Konnopka A, Wiese B, et al. Age- and gender-specific prevalence of depression in latest-life--systematic review and meta-analysis. J Affect Disord. 2012;136(3):212–21.PubMedCrossRef
2.
go back to reference Assil SM, Zeidan ZA. Prevalence of depression and associated factors among elderly sudanese: a household survey in Khartoum State. East Mediterr Health J. 2013;19(5):435–40.PubMed Assil SM, Zeidan ZA. Prevalence of depression and associated factors among elderly sudanese: a household survey in Khartoum State. East Mediterr Health J. 2013;19(5):435–40.PubMed
3.
go back to reference Ng CW, Tan WS, Gunapal PP, Wong LY, Heng BH. Association of Socioeconomic Status (SES) and Social Support with Depressive Symptoms among the Elderly in Singapore. Ann Acad Med Singap. 2014;43(12):576–87.PubMed Ng CW, Tan WS, Gunapal PP, Wong LY, Heng BH. Association of Socioeconomic Status (SES) and Social Support with Depressive Symptoms among the Elderly in Singapore. Ann Acad Med Singap. 2014;43(12):576–87.PubMed
4.
go back to reference Fukunaga R, Abe Y, Nakagawa Y, Koyama A, Fujise N, Ikeda M. Living alone is associated with depression among the elderly in a rural community in Japan. Psychogeriatrics. 2012;12(3):179–85.PubMedCrossRef Fukunaga R, Abe Y, Nakagawa Y, Koyama A, Fujise N, Ikeda M. Living alone is associated with depression among the elderly in a rural community in Japan. Psychogeriatrics. 2012;12(3):179–85.PubMedCrossRef
5.
go back to reference Charlson FJ, Moran AE, Freedman G, Norman RE, Stapelberg NJ, Baxter AJ, et al. The contribution of major depression to the global burden of ischemic heart disease: a comparative risk assessment. BMC Medicine. 2013;11:250.PubMedPubMedCentralCrossRef Charlson FJ, Moran AE, Freedman G, Norman RE, Stapelberg NJ, Baxter AJ, et al. The contribution of major depression to the global burden of ischemic heart disease: a comparative risk assessment. BMC Medicine. 2013;11:250.PubMedPubMedCentralCrossRef
6.
go back to reference Blazer DG. Depression in late life: review and commentary. J Gerontol Ser A Biol Med Sci. 2003;58(3):249–65.CrossRef Blazer DG. Depression in late life: review and commentary. J Gerontol Ser A Biol Med Sci. 2003;58(3):249–65.CrossRef
7.
go back to reference Luppa M, Heinrich S, Angermeyer MC, Konig HH, Riedel-Heller SG. Cost-of-illness studies of depression: a systematic review. J Affect Disord. 2007;98(1-2):29–43.PubMedCrossRef Luppa M, Heinrich S, Angermeyer MC, Konig HH, Riedel-Heller SG. Cost-of-illness studies of depression: a systematic review. J Affect Disord. 2007;98(1-2):29–43.PubMedCrossRef
8.
go back to reference Sengupta P, Benjamin AI. Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana. Indian J Public Health. 2015;59(1):3–8.PubMedCrossRef Sengupta P, Benjamin AI. Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana. Indian J Public Health. 2015;59(1):3–8.PubMedCrossRef
9.
go back to reference Chan A, Malhotra C, Malhotra R, Ostbye T. Living arrangements, social networks and depressive symptoms among older men and women in Singapore. Int J Geriatr Psychiatry. 2011;26(6):630–9.PubMedCrossRef Chan A, Malhotra C, Malhotra R, Ostbye T. Living arrangements, social networks and depressive symptoms among older men and women in Singapore. Int J Geriatr Psychiatry. 2011;26(6):630–9.PubMedCrossRef
10.
go back to reference Aylaz R, Akturk U, Erci B, Ozturk H, Aslan H. Relationship between depression and loneliness in elderly and examination of influential factors. Arch Gerontol Geriatr. 2012;55(3):548–54.PubMedCrossRef Aylaz R, Akturk U, Erci B, Ozturk H, Aslan H. Relationship between depression and loneliness in elderly and examination of influential factors. Arch Gerontol Geriatr. 2012;55(3):548–54.PubMedCrossRef
11.
go back to reference Chao SF. Assessing social support and depressive symptoms in older Chinese adults: a longitudinal perspective. Aging Mental Health. 2011;15(6):765–74.PubMedCrossRef Chao SF. Assessing social support and depressive symptoms in older Chinese adults: a longitudinal perspective. Aging Mental Health. 2011;15(6):765–74.PubMedCrossRef
12.
go back to reference Locher JL, Robinson CO, Roth DL, Ritchie CS, Burgio KL. The effect of the presence of others on caloric intake in homebound older adults. J Gerontol Ser A Biol Med Sci. 2005;60(11):1475–8.CrossRef Locher JL, Robinson CO, Roth DL, Ritchie CS, Burgio KL. The effect of the presence of others on caloric intake in homebound older adults. J Gerontol Ser A Biol Med Sci. 2005;60(11):1475–8.CrossRef
13.
go back to reference Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics. 2011;127(6):e1565–1574.PubMedPubMedCentralCrossRef Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics. 2011;127(6):e1565–1574.PubMedPubMedCentralCrossRef
14.
go back to reference Kimura Y, Wada T, Okumiya K, Ishimoto Y, Fukutomi E, Kasahara Y, et al. Eating alone among community-dwelling Japanese elderly: association with depression and food diversity. J Nutr Health Aging. 2012;16(8):728–31.PubMedCrossRef Kimura Y, Wada T, Okumiya K, Ishimoto Y, Fukutomi E, Kasahara Y, et al. Eating alone among community-dwelling Japanese elderly: association with depression and food diversity. J Nutr Health Aging. 2012;16(8):728–31.PubMedCrossRef
15.
go back to reference Kuroda A, Tanaka T, Hirano H, Ohara Y, Kikutani T, Furuya H, et al. Eating Alone as Social Disengagement is Strongly Associated With Depressive Symptoms in Japanese Community-Dwelling Older Adults. J Am Med Dir Assoc. 2015;16:578–85.PubMedCrossRef Kuroda A, Tanaka T, Hirano H, Ohara Y, Kikutani T, Furuya H, et al. Eating Alone as Social Disengagement is Strongly Associated With Depressive Symptoms in Japanese Community-Dwelling Older Adults. J Am Med Dir Assoc. 2015;16:578–85.PubMedCrossRef
16.
go back to reference Zeng G. Aging of brain and Alzheimer disease (in Chinese). Shanghai: Shanghai Scientific and Technological Literature Press; 1995. Zeng G. Aging of brain and Alzheimer disease (in Chinese). Shanghai: Shanghai Scientific and Technological Literature Press; 1995.
17.
go back to reference Association AP: Severity Measure for Depression—Adult (Patient Health Questionnaire [PHQ-9]). In: American Psychiatric Association. Association AP: Severity Measure for Depression—Adult (Patient Health Questionnaire [PHQ-9]). In: American Psychiatric Association.
18.
go back to reference Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999;282(18):1737–44.PubMedCrossRef Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999;282(18):1737–44.PubMedCrossRef
19.
go back to reference Glaesmer H, Riedel-Heller S, Braehler E, Spangenberg L, Luppa M. Age- and gender-specific prevalence and risk factors for depressive symptoms in the elderly: a population-based study. Int Psychogeriatr. 2011;23(8):1294–300.PubMedCrossRef Glaesmer H, Riedel-Heller S, Braehler E, Spangenberg L, Luppa M. Age- and gender-specific prevalence and risk factors for depressive symptoms in the elderly: a population-based study. Int Psychogeriatr. 2011;23(8):1294–300.PubMedCrossRef
20.
go back to reference Djernes JK. Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatr Scand. 2006;113(5):372–87.PubMedCrossRef Djernes JK. Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatr Scand. 2006;113(5):372–87.PubMedCrossRef
21.
go back to reference Margaretten M, Barton J, Julian L, Katz P, Trupin L, Tonner C, et al. Socioeconomic determinants of disability and depression in patients with rheumatoid arthritis. Arthritis Care Res. 2011;63(2):240–6.CrossRef Margaretten M, Barton J, Julian L, Katz P, Trupin L, Tonner C, et al. Socioeconomic determinants of disability and depression in patients with rheumatoid arthritis. Arthritis Care Res. 2011;63(2):240–6.CrossRef
23.
go back to reference Lai DW. Depression among elderly Chinese-Canadian immigrants from Mainland China. Chin Med J. 2004;117(5):677–83.PubMed Lai DW. Depression among elderly Chinese-Canadian immigrants from Mainland China. Chin Med J. 2004;117(5):677–83.PubMed
24.
go back to reference Imai H, Chen WL, Fukutomi E, Okumiya K, Wada T, Sakamoto R, et al. Depression and subjective economy among elderly people in Asian communities: Japan, Taiwan, and Korea. Arch Gerontol Geriatr. 2015;60(2):322–7.PubMedCrossRef Imai H, Chen WL, Fukutomi E, Okumiya K, Wada T, Sakamoto R, et al. Depression and subjective economy among elderly people in Asian communities: Japan, Taiwan, and Korea. Arch Gerontol Geriatr. 2015;60(2):322–7.PubMedCrossRef
25.
go back to reference Hovaldt HB, Andersen I, Sandager M, Sperling C, Frederiksen K, Bidstrup PE, et al. The role of social position in anxiety and depressive symptoms among Danish cancer survivors. Acta Oncol. 2015;54(5):693–703.PubMedCrossRef Hovaldt HB, Andersen I, Sandager M, Sperling C, Frederiksen K, Bidstrup PE, et al. The role of social position in anxiety and depressive symptoms among Danish cancer survivors. Acta Oncol. 2015;54(5):693–703.PubMedCrossRef
26.
go back to reference Wang L, Song R, Chen Z, Wang J, Ling F. Prevalence of depressive symptoms and factors associated with it in type 2 diabetic patients: a cross-sectional study in China. BMC Public Health. 2015;15:188.PubMedPubMedCentralCrossRef Wang L, Song R, Chen Z, Wang J, Ling F. Prevalence of depressive symptoms and factors associated with it in type 2 diabetic patients: a cross-sectional study in China. BMC Public Health. 2015;15:188.PubMedPubMedCentralCrossRef
27.
go back to reference Papadopoulos FC, Petridou E, Argyropoulou S, Kontaxakis V, Dessypris N, Anastasiou A, et al. Prevalence and correlates of depression in late life: a population based study from a rural Greek town. Int J Geriatr Psychiatr. 2005;20(4):350–7.CrossRef Papadopoulos FC, Petridou E, Argyropoulou S, Kontaxakis V, Dessypris N, Anastasiou A, et al. Prevalence and correlates of depression in late life: a population based study from a rural Greek town. Int J Geriatr Psychiatr. 2005;20(4):350–7.CrossRef
28.
go back to reference Sapranaviciute-Zabazlajeva L, Reklaitiene R, Tamosiunas A, Baceviciene M, Virviciute D, Peasey A. Correlates of depressive symptoms in urban middle-aged and elderly Lithuanians. Soc Psychiatry Psychiatr Epidemiol. 2014;49(8):1199–207.PubMedPubMedCentralCrossRef Sapranaviciute-Zabazlajeva L, Reklaitiene R, Tamosiunas A, Baceviciene M, Virviciute D, Peasey A. Correlates of depressive symptoms in urban middle-aged and elderly Lithuanians. Soc Psychiatry Psychiatr Epidemiol. 2014;49(8):1199–207.PubMedPubMedCentralCrossRef
29.
go back to reference Ambo H, Meguro K, Ishizaki J, Shimada M, Yamaguchi S, Sekita Y, et al. Depressive symptoms and associated factors in a cognitively normal elderly population: the Tajiri Project. Int J Geriatr Psychiatry. 2001;16(8):780–8.PubMedCrossRef Ambo H, Meguro K, Ishizaki J, Shimada M, Yamaguchi S, Sekita Y, et al. Depressive symptoms and associated factors in a cognitively normal elderly population: the Tajiri Project. Int J Geriatr Psychiatry. 2001;16(8):780–8.PubMedCrossRef
30.
go back to reference Al-Salmani A, Juma T, Al-Noobi A, Al-Farsi Y, Jaafar N, Al-Mamari K, et al. Characterization of depression among patients at urban primary healthcare centers in Oman. Int J Psychiatry Med. 2015;49(1):1–18.PubMedCrossRef Al-Salmani A, Juma T, Al-Noobi A, Al-Farsi Y, Jaafar N, Al-Mamari K, et al. Characterization of depression among patients at urban primary healthcare centers in Oman. Int J Psychiatry Med. 2015;49(1):1–18.PubMedCrossRef
31.
go back to reference Kim SA, Kim E, Morris RG, Park WS. Exploring the non-linear relationship between alcohol consumption and depression in an elderly population in Gangneung: the Gangneung Health Study. Yonsei Med J. 2015;56(2):418–25.PubMedPubMedCentralCrossRef Kim SA, Kim E, Morris RG, Park WS. Exploring the non-linear relationship between alcohol consumption and depression in an elderly population in Gangneung: the Gangneung Health Study. Yonsei Med J. 2015;56(2):418–25.PubMedPubMedCentralCrossRef
32.
go back to reference Davis TM, Hunt K, Bruce DG, Starkstein S, Skinner T, McAullay D, et al. Prevalence of depression and its associations with cardio-metabolic control in Aboriginal and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study Phase II. Diabetes Res Clin Pract. 2015;107(3):384–91.PubMedCrossRef Davis TM, Hunt K, Bruce DG, Starkstein S, Skinner T, McAullay D, et al. Prevalence of depression and its associations with cardio-metabolic control in Aboriginal and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study Phase II. Diabetes Res Clin Pract. 2015;107(3):384–91.PubMedCrossRef
33.
go back to reference Kader Maideen SF, Sidik SM, Rampal L, Mukhtar F. Prevalence, associated factors and predictors of depression among adults in the community of Selangor, Malaysia. PloS ONE. 2014;9(4), e95395.PubMedPubMedCentralCrossRef Kader Maideen SF, Sidik SM, Rampal L, Mukhtar F. Prevalence, associated factors and predictors of depression among adults in the community of Selangor, Malaysia. PloS ONE. 2014;9(4), e95395.PubMedPubMedCentralCrossRef
34.
go back to reference Oh DH, Park JH, Lee HY, Kim SA, Choi BY, Nam JH. Association between living arrangements and depressive symptoms among older women and men in South Korea. Soc Psychiatry Psychiatr Epidemiol. 2015;50(1):133–41.PubMedCrossRef Oh DH, Park JH, Lee HY, Kim SA, Choi BY, Nam JH. Association between living arrangements and depressive symptoms among older women and men in South Korea. Soc Psychiatry Psychiatr Epidemiol. 2015;50(1):133–41.PubMedCrossRef
35.
go back to reference Kim SH, Kim JS, Choi JY, Lee KY, Park TJ, Lee JH. Factors Associated with Depressive Symptom in Chronic Obstructive Pulmonary Disease Based on the Third (2005) and Fourth (2008) Korea National Health and Nutritional Examination Survey (KNHANES III, IV). Korean J Family Med. 2011;32(4):234–42.CrossRef Kim SH, Kim JS, Choi JY, Lee KY, Park TJ, Lee JH. Factors Associated with Depressive Symptom in Chronic Obstructive Pulmonary Disease Based on the Third (2005) and Fourth (2008) Korea National Health and Nutritional Examination Survey (KNHANES III, IV). Korean J Family Med. 2011;32(4):234–42.CrossRef
36.
go back to reference China MoHotPsro. The National Stardard of Basic Public Health Service (2011) (in Chinese). In: National Health and Family Planning Commission of the People's Republic of China. vol. 2014. 2011. p. 54. China MoHotPsro. The National Stardard of Basic Public Health Service (2011) (in Chinese). In: National Health and Family Planning Commission of the People's Republic of China. vol. 2014. 2011. p. 54.
37.
go back to reference Wee LE, Yong YZ, Chng MW, Chew SH, Cheng L, Chua QH, et al. Individual and area-level socioeconomic status and their association with depression amongst community-dwelling elderly in Singapore. Aging Mental Health. 2014;18(5):628–41.PubMedCrossRef Wee LE, Yong YZ, Chng MW, Chew SH, Cheng L, Chua QH, et al. Individual and area-level socioeconomic status and their association with depression amongst community-dwelling elderly in Singapore. Aging Mental Health. 2014;18(5):628–41.PubMedCrossRef
38.
go back to reference Lai DW. Depressive symptoms of elderly Chinese in Guangzhou, Hong Kong, and Taipei. Aging Mental Health. 2009;13(5):725–35.PubMedCrossRef Lai DW. Depressive symptoms of elderly Chinese in Guangzhou, Hong Kong, and Taipei. Aging Mental Health. 2009;13(5):725–35.PubMedCrossRef
39.
40.
go back to reference Victor CR, Yang K. The prevalence of loneliness among adults: a case study of the United Kingdom. J Psychol. 2012;146(1-2):85–104.PubMedCrossRef Victor CR, Yang K. The prevalence of loneliness among adults: a case study of the United Kingdom. J Psychol. 2012;146(1-2):85–104.PubMedCrossRef
41.
go back to reference Gerst-Emerson K, Shovali TE, Markides KS. Loneliness among very old Mexican Americans: findings from the Hispanic Established Populations Epidemiologic Studies of the Elderly. Arch Gerontol Geriatr. 2014;59(1):145–9.PubMedPubMedCentralCrossRef Gerst-Emerson K, Shovali TE, Markides KS. Loneliness among very old Mexican Americans: findings from the Hispanic Established Populations Epidemiologic Studies of the Elderly. Arch Gerontol Geriatr. 2014;59(1):145–9.PubMedPubMedCentralCrossRef
42.
go back to reference Kanner AD, Coyne JC, Schaefer C, Lazarus RS. Comparison of two modes of stress measurement: daily hassles and uplifts versus major life events. J Behav Med. 1981;4(1):1–39.PubMedCrossRef Kanner AD, Coyne JC, Schaefer C, Lazarus RS. Comparison of two modes of stress measurement: daily hassles and uplifts versus major life events. J Behav Med. 1981;4(1):1–39.PubMedCrossRef
43.
go back to reference Tiedt AD. The gender gap in depressive symptoms among Japanese elders: evaluating social support and health as mediating factors. J Cross Cultural Gerontol. 2010;25(3):239–56.CrossRef Tiedt AD. The gender gap in depressive symptoms among Japanese elders: evaluating social support and health as mediating factors. J Cross Cultural Gerontol. 2010;25(3):239–56.CrossRef
44.
go back to reference Christensen H, Jorm AF, Mackinnon AJ, Korten AE, Jacomb PA, Henderson AS, et al. Age differences in depression and anxiety symptoms: a structural equation modelling analysis of data from a general population sample. Psychol Med. 1999;29(2):325–39.PubMedCrossRef Christensen H, Jorm AF, Mackinnon AJ, Korten AE, Jacomb PA, Henderson AS, et al. Age differences in depression and anxiety symptoms: a structural equation modelling analysis of data from a general population sample. Psychol Med. 1999;29(2):325–39.PubMedCrossRef
45.
go back to reference Berry JM, Storandt M, Coyne A. Age and sex differences in somatic complaints associated with depression. J Gerontol. 1984;39(4):465–7.PubMedCrossRef Berry JM, Storandt M, Coyne A. Age and sex differences in somatic complaints associated with depression. J Gerontol. 1984;39(4):465–7.PubMedCrossRef
Metadata
Title
Association between eating alone and depressive symptom in elders: a cross-sectional study
Authors
Xinyi Wang
Wei Shen
Chunmei Wang
Xiaoyi Zhang
Yuanyuan Xiao
Fan He
Yujia Zhai
Fudong Li
Xiaopeng Shang
Junfen Lin
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2016
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-016-0197-2

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