Evolution of psychological distress with age and its determinants in later life: evidence from 17-wave social survey data in Japan

Abstract

Abstract Background Psychological distress (PD) is a major risk factor for mental health among middle-aged and older adults and affects their quality of life and well-being. This study aimed to examine the evolution of PD with age and the relative importance of its determinants, issues that have been insufficiently studied. Methods We used longitudinal data obtained from 17-wave social surveys conducted in Japan from 2005 to 2021, to track 34,128 individuals (16,555 men and 17,573 women) born between 1946 and 1955. We defined PD as a Kessler 6 score (range: 0–24) ≥ 5 and estimated fixed-effects regression models to examine the evolution of its proportion with age. We also conducted a mediation analysis to examine the relative importance of specific mediators such as self-rated health (SRH), activities of daily living (ADL), and social participation, in the association between age and PD. Results Regression model results confirmed an increase in PD with age. Poor SRH, issues with ADL, and no social participation were key mediators of aging on PD, accounting for 34.2% (95% confidence interval [CI]: 21.0–47.3%), 13.7% (95% CI: 8.2–19.3%), and 10.5% (95% CI: 8.0–13.0%), respectively; consequently increasing PD between 50 and 75 years. Conclusion The results suggest the need for policy support to encourage middle-aged and older adults to promote health and increase social participation in order to prevent depression while aging.

Keywords

• Fixed-effects model
• Mediation analysis
• Psychological distress
• Structural equation modeling