Gender difference on the mediation effects of filial piety on the association between chronic obstructive pulmonary disease and depressive symptoms in older adults: A community-based study

PLoS One. 2024 Feb 22;19(2):e0298360. doi: 10.1371/journal.pone.0298360. eCollection 2024.

Abstract

Filial piety is viewed as strong family support for older Chinese people, and strongly associated with depressive symptoms. It is unknown if there exists gender difference in the mediation effects of filial piety on the relationship between chronic obstructive pulmonary disease (manifested as lung function) and depression. We investigated whether filial piety mediates the association between lung function and depression in community-dwelling older men and women using the Healthy Aging Longitudinal Study in Taiwan (HALST). Community dwelling adults aged 65 and above were analyzed. Pulmonary function, depressive symptoms, and filial piety expectation (FPE) and receipt of filial piety (RFP) were collected. The interaction and mediation of filial piety between lung function and depression was analyzed. We found that in older men, forced expiratory volume in the first second (FEV1) was inversely correlated with depression (β = -0.1281, p = 0.004) with no mediation effect of FPE. In older women, FEV1 was negatively associated with FPE, but FPE did not increase the risk of depression (β = 0.0605, p = 0.12). In both older men and women, FEV1 was negatively associated with RFP, while RFP reduced the risk of depression (p< 0.001). In older women, the correlation between FEV1 was complete mediation of RFP. Results indicate that feelings of insufficient filial piety may increase the likelihood of depression, especially in elderly women with worse lung function. Although modest, the main mediation effect of filial piety was improvement of lung function in older subjects, which might decrease depression.

MeSH terms

  • Aged
  • Depression*
  • East Asian People*
  • Family Support*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Pulmonary Disease, Chronic Obstructive* / complications
  • Sex Factors

Supplementary concepts

  • Chinese people

Grants and funding

Part of this study was sponsored by the National Health Research Institutes (PH-110-SP-01) and Changhua Christian Hospital (CCH grant no. 105-CCH-IRP-001). There was no additional external funding received for this study. The funders had no role in study design, analysis, decision to publish, and preparation of the manuscript.