Association between hygiene environment, care needs, and depression among Chinese older adults: A cohort analysis from the CHARLS

Limited research has explored the link between functional dependency, care needs, and depression among older adults. This study aims to explore the association between dependency levels and depression among Chinese older adults, as well as examine the relationship between hygiene environment and these two factors. Data were obtained from the CHARLS 2011-2018. A total of 4871 individuals aged 60 years and older were included. Generalized estimating equations were employed for the analysis. A conceptual framework was established to longitudinally illustrate the pathway from hygiene environment to dependency levels to depression. Findings indicated higher dependency levels and poorer hygiene environments were associated with an increased risk of depression, with dependency serving as a mediator between hygiene environment and depression. Policymakers should prioritize improvements in rural sanitation and long-term care policies, healthcare providers should enhance depression screening and caregiver training, and clinicians should provide personalized interventions to better address mental health challenges. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.