Living arrangements, social networks and depressive symptoms among older men and women in Singapore.
OBJECTIVE
To examine the association of living arrangements and social networks outside the household with depressive symptoms among older men and women, ascertain if these relationships differ between older men and women, and investigate whether the association of living arrangements with depressive symptoms varies by strength of social networks.


METHODS
Data for 4489 community-dwelling Singaporeans, aged 60 years and older, from a recent nationally representative survey were analyzed. Depressive symptoms were assessed using the 11-item CES-D (Center for Epidemiologic Studies) scale, social networks through Lubben's revised social network scale, and living arrangements through household composition. Analysis was stratified by gender, and descriptive and multivariate statistics were used to assess the risk of depressive symptoms by living arrangements and social networks, adjusting for age, ethnic group, education, housing type, functional status, number of chronic diseases and involvement in social activities.


RESULTS
Women had higher depressive symptom scores than men. Living alone and living with at least 1 child (no spouse) (relative to living with spouse and children), and weak social networks outside the household were associated with higher depressive symptom scores among both men and women. Men living alone with weak social networks outside the household had higher depressive symptom scores than those with strong networks.


CONCLUSIONS
The findings have implications regarding the importance of strengthening non-familial social networks of older adults, particularly for those living alone.
Chan
Angelique
A
Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore. socchana@nus.edu.sg
Malhotra
Chetna
C
Malhotra
Rahul
R
Ostbye
Truls
T
D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D003863:Depression / Q000209:etiology*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012737:Sex Factors; D012846:Singapore; D012931:Social Environment; D012944:Social Support