Mediating role of coping style between personal and social environmental factors with depression among older persons at Xi’an, China

Introduction: China has the world’s largest population and the most significant number of older persons. Similar to other countries, a rapidly ageing process brings along various health implications to the older community in China, including the increasing prevalence of mental health problems, particularly depression. Objective: By employing the social cognitive theory, this study aimed to determine the mediating role of coping style between personal factors, social environmental factor with depression among the older persons living in Xi'an city. Methodology: This is a cross-sectional study involving older persons aged 60 years old and older in the six urban districts of the Xi’an city. Data was collected by face-to-face interviews using a validated and pre-tested questionnaire. Convenient sampling was used to recruit 300 older persons who fulfilled the pre-determined inclusion criteria. Data were analysed using the IBM SPSS version 26 for descriptive and bivariate analysis, whereas the relationship between variables were identified through path analysis using the Lavvan package of R software. Results: A total of 300 older persons aged 60 years old and older participated in this study, with 31.7% were identified to have major depression. Higher mean score was observed for respondents with positive coping style (23.03±0.43). Only four paths produced significant relationships between personal factors, social environmental factor, and behaviour factor with depression. Significant direct relationships were observed between the presence of chronic disease (β=-0.083, p<0.05) and coping style (β=-0.432, p<0.05) with depression, as well as social support and coping style (β=0.132, p<0.001). Coping style was only found to significantly mediate the relationship between social support and depression (β=-0.061, p<0.001). Conclusion: This study highlighted the high prevalence of depression among the older persons aged above 60 years in Xi’an City, which were dominated with those with major depression. Coping style was only found to significantly mediate the association between social support and depression.

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