Abstract
BACKGROUND: Depression among rural empty-nest older adults has emerged as a significant global and Chinese concern in recent years. Studies have identified associations between depression in rural empty-nest older adults and factors such as social alienation, attitudes towards aging, and mental health. However, the intricate mechanisms underlying these relationships remain incompletely understood. Therefore, this study seeks to investigate the intricate connections between social alienation and depression among Chinese rural empty-nest older adults, aiming to shed light on the underlying mechanisms contributing to depression in this demographic. METHODS: The study data were gathered from a sample of rural empty-nest older adults (N = 1025) residing in the cities of Chaoyang, Liaoning Province, China. Depression served as the primary outcome variable, with social alienation as the predictor variable. Attitude towards aging and anxiety symptoms were examined as potential mediators in the relationship between social alienation and depression. Mediation and chained mediation modeling analyses were conducted to analyze the data and explore the proposed relationships. RESULTS: (1) Social alienation positively predicted attitude towards aging (β = 0.109, P < 0.001), anxiety symptoms (β = 0.076, P < 0.001), and depression (β = 0.021, P < 0.001). Attitude towards aging positively predicted anxiety symptoms (β = 0.390, P < 0.001) and depression (β = 0.006, P < 0.001). Anxiety symptoms also positively predicted depression (β = 1.207, P < 0.001). (2) Social alienation mainly affects depression through three indirect effects: (1) Social alienation → attitude towards aging → depression; (2) Social alienation → anxiety symptoms → depression; (3) Social alienation → attitude towards aging → anxiety symptoms → depression. CONCLUSION: Our findings suggest that social alienation impacts depression among Chinese rural empty-nest older adults through the pathways of attitude towards aging and anxiety symptoms. Consequently, efforts aimed at preventing depression rooted in social alienation among this demographic should address both attitudes towards aging and mental health concerns.