Predicting the gender difference in depressive symptoms in older adults

Objectives: The gender difference in depressive symptoms in older adults is well-established, with women exhibiting approximately twice as many depressive symptoms as men across the life span. However, almost no studies have explored why we see this pattern in older adults.Method: In this study, moderation, mediation and reverse mediation analyses were used to learn how gender differences in psychosocial and health variables contribute to the gender difference in depressive symptoms in 60-74 year old participants in the baseline sample of the ORANJ BOWL study (n = 3008).Results: Moderation analyses show that functional ability, health, social support, and living alone interact with gender to predict depressive symptoms. Mediation analyses demonstrate that gender differences in financial comfort, social support, health, functional ability and living alone help explain the gender difference in depression. Reverse mediation analyses show that depressive symptoms also predict the gender difference in psychosocial and health variables.Conclusion: While the moderation analyses show multiple points of entry for clinical implications, they do not provide clarity that explains the gender difference in depressive symptoms. Mediation analyses highlight the roles of functional ability, financial comfort, health and living alone in explaining the gender difference. Reverse mediation analyses suggest a negative feedback loop between depressive symptoms and the predictor variables, with gender differences in functional ability, financial comfort, health and living alone at least partially explained by gender differences in depression. The findings highlight opportunities for targeted depression screening and to identify the gender inequities that need attention in order to reduce disadvantages for women.