{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:44:51Z","timestamp":1790973891614,"version":"4.1.0"},"reference-count":22,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Background: Depression in older adults is a multifactorial condition influenced by health status, functional capacity, and lifestyle factors. This study aimed to investigate the individual and combined associations of these factors with late-life depression. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), this study evaluated the associations of general health, chronic conditions, functioning, and lifestyle behaviors (including physical activity, sleep, diet quality, smoking, and alcohol use) with depressive symptoms among U.S. adults 65 years and older. Weighted logistic regression models, accounting for the complex survey design of NHANES, were used to examine the factors both individually and in combination. Results: Depressive symptoms were more prevalent among individuals with poor self-rated health, physical and cognitive functional limitations, hypertension, obesity, current smoking, physical inactivity, and alcohol abstinence. A clear cumulative risk gradient was observed with increasing numbers of risk factors: older adults with six or more risk factors had at least 20-fold higher likelihood of depressive symptoms compared with those with one or no risk factors. Conclusions: These findings highlight the interdependent influences of health, function, and lifestyle on late-life depressive symptoms and underscore the need for integrative prevention and intervention strategies to promote mental well-being in aging populations.<\/jats:p>","DOI":"10.3390\/geriatrics11010005","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T12:23:44Z","timestamp":1767356624000},"page":"5","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Individual and Cumulative Health and Lifestyle Risk Factors for Depressive Symptoms in Older Adults: Evidence from NHANES"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9929-7697","authenticated-orcid":false,"given":"Chaowalit","family":"Srisoem","sequence":"first","affiliation":[{"name":"Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA"},{"name":"Department of Psychiatric and Mental Health Nursing, Boromarajonani College of Nursing Sunpasitthiprasong, Faculty of Nursing, Praboromarajchanok Institute, Ubon Ratchathani 34000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Haddad","sequence":"additional","affiliation":[{"name":"Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA"},{"name":"Department of Adult and Geriatric Medicine, Massachusetts General Hospital, Boston, MA 02114, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jittima","family":"Panyasarawut","sequence":"additional","affiliation":[{"name":"Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA"},{"name":"Department of Fundamental Nursing, Faculty of Nursing, Mahidol University, Nakhon Pathom 73170, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5831-813X","authenticated-orcid":false,"given":"Ling","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2486","DOI":"10.1080\/13548506.2023.2221446","article-title":"Depression is associated with worse health-related quality of life, lower physical activity levels, and inadequate sleep quality in a Greek elderly population","volume":"28","author":"Christodoulou","year":"2023","journal-title":"Psychol. Health Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"7262390","DOI":"10.1155\/2023\/7262390","article-title":"Effects of physical health status, social support, and depression on quality of life in the Korean community-dwelling elderly","volume":"2023","author":"Chang","year":"2023","journal-title":"Adv. Public Health"},{"key":"ref_3","first-page":"770","article-title":"The role of physical activity and depression on quality of life in community-dwelling older adults: Using propensity score matching approaches","volume":"30","author":"Bae","year":"2022","journal-title":"J. Aging Phys. Act."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/jch.14653","article-title":"Comprehensive effects of lifestyle reform, adherence, and related factors on hypertension control: A review","volume":"25","author":"Ojangba","year":"2023","journal-title":"J. Clin. Hypertens."},{"key":"ref_5","first-page":"e13","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiovascular guidelines task force","volume":"71","author":"Whelton","year":"2018","journal-title":"Hypertension"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1123\/jpah.6.6.790","article-title":"Global physical activity questionnaire (GPAQ): Nine country reliability and validity study","volume":"6","author":"Bull","year":"2009","journal-title":"J. Phys. Act. Health"},{"key":"ref_7","first-page":"e18","article-title":"Life\u2019s Essential 8: Updating and enhancing the American Heart Association\u2019s construct of cardiovascular health: A presidential advisory from the American Heart Association","volume":"146","author":"Allen","year":"2022","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"591","DOI":"10.5664\/jcsm.4758","article-title":"Recommended amount of sleep for a healthy adult: A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society","volume":"11","author":"Watson","year":"2015","journal-title":"J. Clin. Sleep Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1016\/j.jand.2018.05.021","article-title":"Update of the Healthy Eating Index: HEI-2015","volume":"118","author":"Pannucci","year":"2018","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1146\/annurev.clinpsy.032408.153621","article-title":"Depression in older adults","volume":"5","author":"Fiske","year":"2009","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1056\/NEJMcp1402180","article-title":"Clinical practice: Depression in older adults","volume":"371","author":"Taylor","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_12","unstructured":"Chen, T.C., Clark, J., Riddles, M.K., Mohadjer, L.K., and Fakhouri, T.H.I. (2025, November 20). National Health and Nutrition Examination Survey, 2015\u20132018: Sample Design and Estimation Procedures, Available online: https:\/\/stacks.cdc.gov\/view\/cdc\/88305."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1038\/s41371-021-00518-3","article-title":"Association of leisure-time physical activity with perceived general health status among hypertensive people: An analysis of NHANES 2015\u201318","volume":"36","author":"Kibria","year":"2022","journal-title":"J. Hum. Hypertens."},{"key":"ref_15","unstructured":"Johnson, C.L., Paulose-Ram, R., Ogden, C.L., Carroll, M.D., Kruszon-Moran, D., Dohrmann, S.M., and Curtin, L.R. (2013). National health and nutrition examination survey: Analytic guidelines, 1999\u20132010, Vital and Health Statistics. Series 2, Data Evaluation and Methods Research."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/S0895-4356(03)00085-4","article-title":"National Health and Nutrition Examination Survey 1999\u20132000: Effect of observer training and protocol standardization on reducing blood pressure measurement error","volume":"56","author":"Ostchega","year":"2003","journal-title":"J. Clin. Epidemiol."},{"key":"ref_17","unstructured":"Weir, C.B., and Jan, A. (2025, August 27). BMI classification percentile and cut off points, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK541070\/."},{"key":"ref_18","unstructured":"Centers for Disease Control and Prevention (2025, August 27). Behavioral Risk Factor Surveillance System (BRFSS) Cognitive Decline Module, Available online: https:\/\/www.cdc.gov\/healthy-aging-data\/brfss\/cognitive-decline.html."},{"key":"ref_19","unstructured":"Centers for Disease Control and Prevention (2025, August 27). The ICF: An Overview [PDF], Available online: https:\/\/www.cdc.gov\/nchs\/data\/icd\/icfoverview_finalforwho10sept.pdf."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3787","DOI":"10.1038\/s41598-024-54102-z","article-title":"Association of physical functional activity impairment with severity of sarcopenic obesity: Findings from the National Health and Nutrition Examination Survey","volume":"14","author":"Huang","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1001\/jama.2018.14854","article-title":"The Physical Activity Guidelines for Americans","volume":"320","author":"Piercy","year":"2018","journal-title":"J. Am. Med. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Wang, K., Zhao, Y., Nie, J., Xu, H., Yu, C., and Wang, S. (2021). Higher HEI-2015 Score Is Associated with Reduced Risk of Depression: Result from NHANES 2005\u20132016. Nutrients, 13.","DOI":"10.3390\/nu13020348"}],"container-title":["Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3417\/11\/1\/5\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T12:43:48Z","timestamp":1767357828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3417\/11\/1\/5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["geriatrics11010005"],"URL":"https:\/\/doi.org\/10.3390\/geriatrics11010005","relation":{},"ISSN":["2308-3417"],"issn-type":[{"value":"2308-3417","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]}}}