Good interpersonal relationships and 42% lower depression risk in older adults: a national cross-sectional study from the China Family Panel Studies (CFPS 2022)

Against the backdrop of increasing social mobility and changing social interaction patterns in China, older adults’ interpersonal interaction patterns and sources of social support are undergoing transformation, and self-rated interpersonal relationships may represent an important psychosocial factor influencing mental health in later life. This study aimed to examine the association between self-rated interpersonal relationships and depressive symptoms among older adults, and to analyze the heterogeneity of this association across subgroups with different characteristics, so as to provide scientific evidence for developing precision prevention and intervention strategies for late-life depression.

Using data from the 2022 China Family Panel Studies (CFPS), we conducted a cross-sectional study including 4609 participants aged ≥60 years with complete data on key variables. Depressive symptoms were assessed with the 8-item Center for Epidemiologic Studies Depression Scale (CES-D8), with a score >16 defined as having depressive symptoms. Self-rated interpersonal relationship score was treated as the independent variable and categorized into low (0 to 5), medium (6 to 7), and high (8 to 10) groups. Chi-square tests and multivariable logistic regression models were used; after controlling for confounders including age, sex, household registration (hukou), marital status, education, insurance, and physical exercise, we analyzed the association between self-rated interpersonal relationships and depressive symptoms, and further performed Spearman correlation and subgroup stratification analyses.

The detection rate of depressive symptoms among older adults in China was 25.86%. The detection rates in the low, medium, and high self-rated interpersonal relationship groups were 33.48%, 27.08%, and 22.14%, respectively. Multivariable logistic regression analysis showed that, after adjusting for confounders, the high-score group had lower likelihood of experiencing depressive symptoms compared with the low-score group (OR=0.58, 95%CI: 0.50 to 0.68, P<0.001), with a dose-response relationship (chi-square test for trend P<0.001). Correlation analysis indicated that self-rated interpersonal relationship score was significantly negatively correlated with the total CES-D8 scores and all item scores (r=-0.12, 95%CI: -0.149 to -0.092, P<0.001); the correlations were stronger for the three items “feeling lonely”, “feeling happy about life” and “feeling sad”. Subgroup analysis revealed that, compared with the low-score group, the high-score group showed a consistent association with lower likelihood of depressive symptoms across all subgroups except those with university education or higher (P<0.05), while the medium-score group showed a protective effect only in the female subgroup (OR=0.748, 95%CI: 0.559 to 0.999, P<0.05).

Good self-rated interpersonal relationships represent an independent protective factor against depressive symptoms among Chinese older adults, showing a dose-effect relationship and playing a prominent role in alleviating core affective symptoms such as loneliness and sadness. This protective effect varies across older adults with different characteristics, suggesting that differentiated strategies should be implemented in interventions for depressive symptoms in older adults.