Abstract
BACKGROUND: Few studies have explored the longitudinal association between eating alone and depressive symptoms, and have focused on the effect of eating alone transition. This study aims to explore the longitudinal association between eating alone, its transition and depressive symptoms among two national surveys using a cohort study design. METHODS: The participants aged ≥ 45 years were recruited for the 2016 to 2018 waves China Family Panel Data (CFPS) and 2015 to 2018 waves China Health and Retirement Longitudinal Study (CHARLS). Eating alone was assessed by self-reported. Depressive symptoms were evaluated by Center for Epidemiologic Studies Depression Scale. Cox hazard regression was used to explore the associations between eating alone, its transition and depressive symptoms after adjusting for covariates. RESULTS: A total of 21,476 participants were included in this study. The Cox model showed that compared with commensality, eating alone was associated with a higher risk of depressive symptoms, both in the CFPS, CHARLS and pooled analysis. In addition, compared with commensality consistently, the transition from commensality to alone and eating alone consistently were associated with a higher risk of depressive symptoms. The sensitivity analyses showed that the association remained robust. CONCLUSIONS: Eating alone and a change from commensality to eating alone were associated with higher risks of depressive symptoms among Chinese middle-aged and older adults in two cohorts. This study suggested that providing eating partners may be an effective intervention method to prevent depressive symptoms in middle-aged and older adults.