Factors of the changes in depressive symptoms among retirees: a 3-year follow-up study in Taiwan

BACKGROUND: Depression is a critical mental problem for middle-aged and older adults. In addition, retirement and its adjustment may further affect their physical and psychological health. Hence, this study aims to explore the risk and protective factors associated with the changes in depressive symptoms among retirees. METHODS: A 3-year follow-up study was designed to examine the factors affecting the changes in depressive symptoms in retired people. A total of 2,379 participants aged 50 to 74 years were recruited from the Taiwan Health and Retirement Study during 2015-2019 (two waves). Three types of study variables were included: (i) sociodemographic factors: 9 items, (ii) health-related variables: 7 items, and (iii) psychosocial factors: 6 items. The changes in the 10-item CESD score after three years were measured as the outcome variable. The score change was divided into three groups: maintenance, deterioration, and improvement. Multinomial logistic regressions were used to analyze risk and protective factors related to changes in depressive symptoms in retirees. RESULTS: After adjusting for all covariates, this study found that retirement time ≥ 10 years, unskilled occupation before retirement, and having stressful life events after retirement may worsen depression scores three years later. Instead, getting a good night's sleep prevented worsening depression scores after three years. For the improvement group, the results showed that being a volunteer could improve the depression score; however, living alone and having poor health may hinder improving depression scores after three years. Furthermore, we found that factors associated with changes in depressive symptoms showed gender differences. CONCLUSIONS: Future interventions to prevent depression should consider the diverse needs of different risk and protective factors and gender differences. KEY MESSAGES: • Retirees over ten years, with unskilled occupations and recent stressful events, were at high risk for depression. However, good sleep quality can help prevent depression. • For male retirees, regular physical activity was an enabling factor for improving depression, whereas women benefited from social connections.