Abstract
BACKGROUND: Self-neglect is common among older adults and may have devastating health consequences. OBJECTIVE: This study aims to examine the relationships between self-neglect and depression, social networks, and health literacy (HL) in older adults. METHODS: The cross-sectional study was conducted between March and May 2024 at four family health centres located in a district of Istanbul, Turkey. A total of 370 older adults, aged 65 years and above, were selected by simple random sampling from among those who visited the family health centres during the study period. A Sociodemographic Information Form, the Revised Turkish version of Mini Mental State Examination, the Istanbul Medical School Elder Self-Neglect Questionnaire, the Lubben Social Network Scale, the Geriatric Depression Scale-Short Form, and the Turkish Health Literacy Scale-32 were used for data collection. Data were analysed using descriptive statistics, Pearson's correlation analysis, hierarchical linear regression analysis, and serial multiple mediation analysis. RESULTS: The mean age of the participants was 71.42 ± 5.54 (65-90) years, and 55.7% were women. The prevalence of self-neglect among the participants was 34.9%, and the prevalence of depressive symptoms was 46.2%. The HL levels of 62.7% of the participants were inadequate, and those of 31.6% were problematic-limited. HL, depression, social networks, gender, education status, and income status were statistically significant predictors of self-neglect (R(2) = 0.508, p < 0.001). Depression had a significant direct effect on self-neglect (effect = -0.148, p < 0.001), as did social networks (effect = 0.107, p < 0.001) and HL (effect = 0.107, p < 0.001). The mediating effect of social networks in the relationship between depression and self-neglect was significant (LLCI = -0.043, ULCI = -0.015), with an effect size of -0.028. The mediating effect of HL in the relationship between depression and self-neglect was also significant (LLCI = -0.121, ULCI = -0.063), with an effect size of -0.089. CONCLUSION: Our findings showed that HL, depression, and social networks play a critical role in predicting self-neglect in older adults, and social networks and HL partially mediate the relationship between depression and self-neglect. Based on these results, efforts to improve HL and strengthen social support systems would be beneficial in mitigating the effects of depression and reducing self-neglect in older adults.