{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:52:29Z","timestamp":1776185549710,"version":"3.50.1"},"reference-count":80,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The rapid ageing of the European population presents growing challenges for mental health, highlighting the need to identify factors that can prevent or delay psychological decline and promote a higher quality of life in later life. This study aims to provide an updated and comprehensive overview of mental health among older adults in Europe by examining the prevalence of depressive symptoms and identifying key associated factors. Methods: We analysed data from individuals (n = 45,601) aged 65 years and older across 27 European countries and Israel who participated in Wave 9 of the Survey of Health, Ageing and Retirement in Europe (SHARE). This study assessed the prevalence of depressive symptoms, which were evaluated using the EURO-D scale (score range: 0\u201312), with a cut-off of \u22654 indicating clinically relevant symptoms. It also explored associations with sociodemographic characteristics, physical health, behavioural factors, social participation, internet skills and living conditions. Results: Our findings confirm that depressive symptoms remain highly prevalent among older adults in Europe, with 35.1% of women and 21.5% of men affected, reflecting persistent gender disparities in mental health. Depression in later life was significantly associated with poor physical health, loneliness and lower quality of life. Conversely, moderate involvement in grandchild care and in social participation emerged as potential protective factors. Conclusions: Late-life depression has substantial implications for both mental and physical well-being. Our findings suggest that social integration, gender related factors and physical health are closely associated with depressive symptoms in older adults. These associations highlight the importance of considering these domains when designing interventions and policies aimed at promoting mental health in ageing populations.<\/jats:p>","DOI":"10.3390\/jcm14155340","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T09:31:45Z","timestamp":1753781505000},"page":"5340","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prevalence and Determinants of Depressive Symptoms in Older Adults Across Europe: Evidence from SHARE Wave 9"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5121-2853","authenticated-orcid":false,"given":"Daniela","family":"Melo","sequence":"first","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1981-2554","authenticated-orcid":false,"given":"Lu\u00eds","family":"Mid\u00e3o","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3573-7232","authenticated-orcid":false,"given":"In\u00eas","family":"Mimoso","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"given":"Leovaldo","family":"Alc\u00e2ntara","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0183-000X","authenticated-orcid":false,"given":"Teodora","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5897-1155","authenticated-orcid":false,"given":"Joana","family":"Carrilho","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1158-1480","authenticated-orcid":false,"given":"El\u00edsio","family":"Costa","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"ref_1","unstructured":"GBD 2021 Europe Life Expectancy Collaborators (2025). Changing life expectancy in European countries 1990\u20132021: A subanalysis of causes and risk factors from the Global Burden of Disease Study 2021. Lancet Public Health, 10, e172\u2013e188."},{"key":"ref_2","first-page":"7014","article-title":"\u2018Inclusive\u2019 health systems increase healthy life expectancy","volume":"22","author":"Athanasakis","year":"2022","journal-title":"Rural. Remote Health"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Choi, M., Sempungu, J.K., Lee, E.H., and Lee, Y.H. (2024). Living longer but in poor health: Healthcare system responses to ageing populations in industrialised countries based on the Findings from the Global Burden of Disease Study 2019. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-18049-0"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e551","DOI":"10.1016\/S2468-2667(20)30190-0","article-title":"The burden of neurological diseases in Europe: An analysis for the Global Burden of Disease Study 2017","volume":"5","author":"Deuschl","year":"2020","journal-title":"Lancet Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S0140-6736(14)61347-7","article-title":"The burden of disease in older people and implications for health policy and practice","volume":"385","author":"Prince","year":"2015","journal-title":"Lancet"},{"key":"ref_6","unstructured":"World Health Organization (2025, May 06). World Mental Health Report: Transforming Mental Health for All, Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240049338."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"103417","DOI":"10.1016\/j.ajp.2022.103417","article-title":"Global prevalence of depression in older adults: A systematic review and meta-analysis of epidemiological surveys","volume":"80","author":"Cai","year":"2023","journal-title":"Asian J. Psychiatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"100618","DOI":"10.1016\/j.lanhl.2024.07.001","article-title":"The associations of socioeconomic status, social activities, and loneliness with depressive symptoms in adults aged 50 years and older across 24 countries: Findings from five prospective cohort studies","volume":"5","author":"Wang","year":"2024","journal-title":"Lancet Healthy Longev."},{"key":"ref_9","unstructured":"World Health Organization (2025, May 06). Comprehensive Mental Health Action Plan 2013\u20132030, Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240031029."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.2174\/1381612821666150130124354","article-title":"Diagnosing and treating depression in older and oldest old","volume":"21","author":"Morichi","year":"2015","journal-title":"Curr. Pharm. Des."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1007\/s127-001-8202-7","article-title":"Prevalence of depression and depression recognition in nursing homes","volume":"36","author":"Teresi","year":"2001","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.psc.2013.08.001","article-title":"What Are the Causes of Late-Life Depression?","volume":"36","author":"Aziz","year":"2013","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1080\/13607860500294266","article-title":"Depression and social support in late life: A clear but not obvious relationship","volume":"9","author":"Blazer","year":"2005","journal-title":"Aging Ment. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jad.2024.01.106","article-title":"Association between social isolation and depression: Evidence from longitudinal and Mendelian randomization analyses","volume":"350","author":"Zhu","year":"2024","journal-title":"J. Affect. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"104980","DOI":"10.1016\/j.archger.2023.104980","article-title":"Loneliness, social isolation, depression and anxiety among the elderly in Shanghai: Findings from a longitudinal study","volume":"110","author":"Zhang","year":"2023","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Liu, J., Rozelle, S., Xu, Q., Yu, N., and Zhou, T. (2019). Social Engagement and Elderly Health in China: Evidence from the China Health and Retirement Longitudinal Survey (CHARLS). Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16020278"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.jamda.2022.11.008","article-title":"Factors Associated with Social Isolation in Older Adults: A Systematic Review and Meta-Analysis","volume":"24","author":"Wen","year":"2023","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1080\/13607863.2023.2172138","article-title":"Early life adversities and discrimination, social activity, and loneliness among older adults in Europe: A moderated mediation analysis","volume":"27","author":"Liu","year":"2023","journal-title":"Aging Ment. Health"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Lin, S.A., Xu, X., Liu, Y., and Ai, B. (2024). Mechanism of the impacts of older adults social participation on their health. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1377305"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1080\/01634372.2021.2019163","article-title":"Are Older People Living Alone Socially Isolated? A Qualitative Study of Their Experiences","volume":"65","author":"Charpentier","year":"2022","journal-title":"J. Gerontol. Soc. Work."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s00127-020-01961-2","article-title":"The moderating role of social network size in the temporal association between formal social participation and mental health: A longitudinal analysis using two consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE)","volume":"56","author":"Santini","year":"2021","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"112906","DOI":"10.1016\/j.socscimed.2020.112906","article-title":"Formal social participation protects physical health through enhanced mental health: A longitudinal mediation analysis using three consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE)","volume":"251","author":"Santini","year":"2020","journal-title":"Soc. Sci. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1093\/geronb\/gbt090","article-title":"Impact of caring for grandchildren on the health of grandparents in Taiwan","volume":"68","author":"Ku","year":"2013","journal-title":"J. Gerontol. B Psycholo Sci. Soc. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.socscimed.2018.05.047","article-title":"Physical and mental health of Chinese grandparents caring for grandchildren and great-grandparents","volume":"229","author":"Xu","year":"2019","journal-title":"Soc. Sci. Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Tsai, F.-J., Motamed, S., and Rougemont, A. (2013). The protective effect of taking care of grandchildren on elders\u2019 mental health? Associations between changing patterns of intergenerational exchanges and the reduction of elders\u2019 loneliness and depression between 1993 and 2007 in Taiwan. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-567"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e28022","DOI":"10.2196\/28022","article-title":"Older Adults\u2019 Loneliness, Social Isolation, and Physical Information and Communication Technology in the Era of Ambient Assisted Living: A Systematic Literature Review","volume":"23","author":"Latikka","year":"2021","journal-title":"J. Med. Internet Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1017\/S0714980821000040","article-title":"Online Social Networking and Mental Health among Older Adults: A Scoping Review","volume":"41","author":"Chen","year":"2022","journal-title":"Can. J. Aging"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e39","DOI":"10.2196\/jmir.2306","article-title":"Impact of internet use on loneliness and contact with others among older adults: Cross-sectional analysis","volume":"15","author":"Cotten","year":"2013","journal-title":"J. Med. Internet Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1111\/jgs.18179","article-title":"Impact of technology on social isolation: Longitudinal analysis from the National Health Aging Trends Study","volume":"71","author":"Umoh","year":"2023","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_30","first-page":"e3573","article-title":"Impact of digital social media on the perception of loneliness and social isolation in older adults","volume":"30","author":"Kusumota","year":"2022","journal-title":"Rev. Lat. Am. Enferm."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Wilson, J., Heinsch, M., Betts, D., Booth, D., and Kay-Lambkin, F. (2021). Barriers and facilitators to the use of e-health by older adults: A scoping review. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-11623-w"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1177\/0733464818807468","article-title":"Older Adult Internet Use and eHealth Literacy","volume":"39","author":"Arcury","year":"2020","journal-title":"J. Appl. Gerontol."},{"key":"ref_33","first-page":"31","article-title":"Computer skills among the community-dwelling 55+ European population based on survey of health, ageing, and retirement in Europe","volume":"11","author":"Pedreiro","year":"2020","journal-title":"IJDLDC"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.gerinurse.2020.11.004","article-title":"Physical activity and predictors of loneliness in community-dwelling older adults: The role of social connectedness","volume":"42","author":"Gyasi","year":"2021","journal-title":"Geriatr. \u00d1urs"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1177\/0194599820910377","article-title":"Hearing Loss, Loneliness, and Social Isolation: A Systematic Review","volume":"162","author":"Shukla","year":"2020","journal-title":"Otolaryngol. Head. Neck Surg."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Hussain, B., Mirza, M., Baines, R., Burns, L., Stevens, S., Asthana, S., and Chatterjee, A. (2023). Loneliness and social networks of older adults in rural communities: A narrative synthesis systematic review. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1113864"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s41256-023-00320-3","article-title":"Mental health around retirement: Evidence of Ashenfelter\u2019s dip","volume":"8","author":"Vo","year":"2023","journal-title":"Glob. Health Res. Policy"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1093\/ije\/dyt088","article-title":"Data Resource Profile: The Survey of Health, Ageing and Retirement in Europe (SHARE)","volume":"42","author":"Brandt","year":"2013","journal-title":"Int. J. Epidemiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1192\/bjp.174.4.330","article-title":"Development of the EURO\u2013D scale\u2014A European Union initiative to compare symptoms of depression in 14 European centres","volume":"174","author":"Prince","year":"1999","journal-title":"Br. J. Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Bonanno, E.G., Figueiredo, T., Mimoso, I.F., Morgado, M.I., Carrilho, J., Mid\u00e3o, L., and Costa, E. (2025). Polypharmacy Prevalence Among Older Adults Based on the Survey of Health, Ageing and Retirement in Europe: An Update. J. Clin. Med., 14.","DOI":"10.3390\/jcm14041330"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1080\/1360786031000101157","article-title":"A measure of quality of life in early old age: The theory, development and properties of a needs satisfaction model (CASP-19)","volume":"7","author":"Hyde","year":"2003","journal-title":"Aging Ment. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1080\/13607863.2014.938605","article-title":"Psychometric properties and confirmatory factor analysis of the CASP-19, a measure of quality of life in early old age: The HAPIEE study","volume":"19","author":"Kim","year":"2015","journal-title":"Aging Ment. Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1177\/0164027504268574","article-title":"A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies","volume":"26","author":"Hughes","year":"2004","journal-title":"Res. Aging"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1207\/s15327752jpa4203_11","article-title":"Developing a Measure of Loneliness","volume":"42","author":"Russell","year":"1978","journal-title":"J. Pers. Assess."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1162\/rest_a_00760","article-title":"Regression Discontinuity Designs Using Covariates","volume":"101","author":"Calonico","year":"2019","journal-title":"Rev. Econ. Stat."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1177\/09622802221114544","article-title":"The benefits of covariate adjustment for adaptive multi-arm designs","volume":"31","author":"Lee","year":"2022","journal-title":"Stat. Methods Med. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"114511","DOI":"10.1016\/j.psychres.2022.114511","article-title":"Prevalence of depression in older adults: A systematic review and meta-analysis","volume":"311","author":"Hu","year":"2022","journal-title":"Psychiatry Res."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"N\u00fa\u00f1ez-Cort\u00e9s, R., Calatayud, J., Andersen, L.L., Villafa\u00f1e, J.H., Suso-Mart\u00ed, L., and L\u00f3pez-Bueno, R. (2025). Trends in depression in the European population aged 50 years and older by geographic region. Am. J. Epidemiol., kwaf027.","DOI":"10.1093\/aje\/kwaf027"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/BF03324754","article-title":"Men: Good health and high mortality","volume":"20","author":"Oksuzyan","year":"2008","journal-title":"Sex. Differ. Health Aging Clin. Exp. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/13607863.2021.2013434","article-title":"Sex differences in quality of life and depressive symptoms among middle-aged and elderly Europeans: Results from the SHARE survey","volume":"27","author":"Olsen","year":"2023","journal-title":"Aging Ment. Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1017\/S0033291701004524","article-title":"The incidence of first-onset depression in a population followed from the age of 70 to 85","volume":"31","author":"Ostling","year":"2001","journal-title":"Psychol. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1017\/S2045796024000295","article-title":"The long-term spatio-temporal trends in burden and attributable risk factors of major depressive disorder at global, regional and national levels during 1990-2019: A systematic analysis for GBD 2019","volume":"33","author":"Mo","year":"2024","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Girgus, J.S., Yang, K., and Ferri, C.V. (2017). The Gender Difference in Depression: Are Elderly Women at Greater Risk for Depression Than Elderly Men?. Geriatrics, 2.","DOI":"10.3390\/geriatrics2040035"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.socscimed.2008.10.016","article-title":"Gender and socio-economic patterning of self-reported sleep problems in Britain","volume":"68","author":"Arber","year":"2009","journal-title":"Soc. Sci. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1176\/ajp.157.1.81","article-title":"Sleep complaints and depression in an aging cohort: A prospective perspective","volume":"157","author":"Roberts","year":"2000","journal-title":"Am. J. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1016\/j.neubiorev.2021.10.041","article-title":"The global prevalence of major depressive disorder among the elderly: A systematic review and meta-analysis","volume":"132","author":"Abdoli","year":"2022","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1093\/geront\/gnab116","article-title":"Socioemotional Selectivity Theory: The Role of Perceived Endings in Human Motivation","volume":"61","author":"Carstensen","year":"2021","journal-title":"Gerontologist"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1037\/pag0000091","article-title":"The happy survivor? Effects of differential mortality on life satisfaction in older age","volume":"31","author":"Segerstrom","year":"2016","journal-title":"Psychol. Aging"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1177\/070674370905400710","article-title":"Marital Status, Partner Satisfaction, and Depressive Symptoms in Older Men and Women","volume":"54","author":"Montgomery","year":"2009","journal-title":"Can. J. Psychiatry"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1177\/070674370605100204","article-title":"Descriptive epidemiology of major depression in Canada","volume":"51","author":"Patten","year":"2006","journal-title":"Can. J. Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1177\/0898264304272794","article-title":"The role of marital quality in physical health during the mature years","volume":"17","author":"Bookwala","year":"2005","journal-title":"J. Aging Health"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.jad.2022.01.010","article-title":"Associations between education levels and prevalence of depressive symptoms: NHANES (2005\u20132018)","volume":"301","author":"Li","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_63","unstructured":"Mirowsky, J., and Ross, C.E. (2003). Education, Social Status, and Health, Routledge. [1st ed.]."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1017\/S1041610209008928","article-title":"Influence of education and depressive symptoms on cognitive function in the elderly","volume":"21","author":"Avila","year":"2009","journal-title":"Int. Psychogeriatri"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1503\/cmaj.060235","article-title":"Poverty and health","volume":"174","author":"Murray","year":"2006","journal-title":"CMAJ"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1990","DOI":"10.1080\/13607863.2019.1655706","article-title":"The Longitudinal Associations between Physical Health and Mental Health among Older Adults","volume":"24","author":"Luo","year":"2020","journal-title":"Aging Ment. Health"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Li, D., Su, M., Guo, X., Liu, B., and Zhang, T. (2023). The association between chronic disease and depression in middle-aged and elderly people: The moderating effect of health insurance and health service quality. Front. Public. Health, 11.","DOI":"10.3389\/fpubh.2023.935969"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Liu, H., Ma, Y., Lin, L., Sun, Z., Li, Z., and Jiang, X. (2023). Association between activities of daily living and depressive symptoms among older adults in China: Evidence from the CHARLS. Front. Public. Health, 11.","DOI":"10.3389\/fpubh.2023.1249208"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s41999-023-00835-5","article-title":"Association between pain intensity and depressive symptoms in community-dwelling adults: Longitudinal findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)","volume":"14","author":"Ogliari","year":"2023","journal-title":"Eur. Geriatr. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1146\/annurev-psych-010418-102955","article-title":"Positive Affect and Health: What Do We Know and Where Next Should We Go?","volume":"70","author":"Pressman","year":"2019","journal-title":"Annu. Rev. Psychol."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Ribeiro, O., Teixeira, L., Ara\u00fajo, L., Rodr\u00edguez-Bl\u00e1zquez, C., Calder\u00f3n-Larra\u00f1aga, A., and Forjaz, M.J. (2020). Anxiety, Depression and Quality of Life in Older Adults: Trajectories of Influence across Age. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17239039"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/0898264316673511","article-title":"Social Isolation, Depression, and Psychological Distress Among Older Adults","volume":"30","author":"Taylor","year":"2018","journal-title":"J. Aging Health"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1093\/geronb\/gbz035","article-title":"Social Network Characteristics and Their Associations with Stress in Older Adults: Closure and Balance in a Population-Based Sample","volume":"75","author":"Ellwardt","year":"2020","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1080\/13607863.2012.692766","article-title":"Grandparenting and psychosocial health among older Chileans: A longitudinal analysis","volume":"16","author":"Grundy","year":"2012","journal-title":"Aging Ment. Health"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1111\/j.1475-6773.2004.00312.x","article-title":"Elevated depressive symptoms among caregiving grandparents","volume":"39","author":"Blustein","year":"2004","journal-title":"Health Serv. Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"S108","DOI":"10.1093\/geronb\/62.2.S108","article-title":"All in the family: The impact of caring for grandchildren on grandparents\u2019 health","volume":"62","author":"Hughes","year":"2007","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.ejpsy.2022.03.003","article-title":"Digital divide in elderly: Self-rated computer skills are associated with higher education, better cognitive abilities and increased mental health","volume":"36","author":"Augner","year":"2022","journal-title":"Eur. J. Psychiatry"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1080\/13607863.2024.2367044","article-title":"Prevalence and risk factors of depression among elderly people in nursing homes from 2012 to 2022: A systematic review and meta-analysis","volume":"28","author":"Wang","year":"2024","journal-title":"Aging Ment. Health"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1177\/002214650905000103","article-title":"Social disconnectedness, perceived isolation, and health among older adults","volume":"50","author":"Cornwell","year":"2009","journal-title":"J. Health Soc. Behav."},{"key":"ref_80","first-page":"536","article-title":"The built environment and mental health","volume":"80","author":"Evans","year":"2003","journal-title":"J. Urban."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/15\/5340\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:17:45Z","timestamp":1760033865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/15\/5340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,29]]},"references-count":80,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["jcm14155340"],"URL":"https:\/\/doi.org\/10.3390\/jcm14155340","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,29]]}}}