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Loneliness and depression symptoms among the elderly in nursing homes: A moderated mediation model of resilience and social support
Abstract
Loneliness has been identified as a risk factor for depressive symptoms. Resilience and social support have been regarded as underlying protective factors. Little is known about the complex relations among these factors in the nursing home elderly. This study aimed to assess the prevalence of depressive symptoms, explore whether resilience mediated the association between loneliness and depressive symptoms, and investigate whether social support moderated the indirect or direct effect of mediation model. A total of 323 nursing home elderly were recruited in Jinan City, China. Loneliness, resilience, social support and depressive symptoms were measured. Results shown the association between loneliness and depressive symptoms was partially mediated by resilience. Besides, the indirect effect of the mediation model was moderated by social support. When the level of social support was higher, the indirect effect of loneliness on depressive symptoms through resilience was weaker. The incidence of depressive symptoms among the nursing home elderly could not be neglected. The findings suggest that interventions, such as improving resilience and social support, may help break the link between loneliness and depressive symptoms among the elderly in nursing homes.
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“Several cross-sectional studies across different age groups have highlighted resilience’s protective role.”
From The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study (2025) · cites this paper as [94]
In the citing paper
“For instance, Zhao et al. found resilience mediated the link between loneliness and depression in the elderly, while studies on working-age adults and Norwegian adolescents showed resilience moderated this relationship [92–94].”
From The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study (2025) · cites this paper as [94]
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Zhang, Y. C., Chen, X., Sun, Y., Feng, S., Wang, F., Gu, H., Jia, H., Zhang, Q., Ding, W., Lu, H., et al. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1257133 · Cited by 7
Institutional Residence Protects Against Cognitive Frailty: A Cross-Sectional Study
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Self-citationXia, M., Yang, C., Zhou, Y., Cheng, G., & Yu, J. (2021) · Current Psychology · doi:10.1007/s12144-021-01441-z · Cited by 7
Metadata
- Authors
- Zhao, X., Zhang, D., Wu, M., Yang, Y., Xie, H., Li, Y., Jia, J., & Su, Y.
- Affiliations
- Shandong University (CN)
- Corresponding author
- Su, Yonggang
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2018-10
- Volume
- 268
- Pages
- 143-151
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2833840127
- Cited by
- 202
- References
- 71
- Citations by year
- 2026: 14 · 2025: 24 · 2024: 47 · 2023: 39 · 2022: 31 · 2021: 25 · 2020: 16 · 2019: 5 · 2018: 1
- FWCI
- 11.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Reform and Research Program of Cheeloo College of Medicine, Shandong University (qlyxjy-201706)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Clinical Psychology › Health and Well-being Studies
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- loneliness, depressive symptoms, resilience, social support, older adults, moderated mediation, protective factors, long-term care
- MeSH terms
- Aged, Aged, 80 and over, China, Cross-Sectional Studies, Depression, Female, Homes for the Aged, Humans, Loneliness, Male, Middle Aged, Nursing Homes, Risk Factors, Social Support, Negotiating, Resilience, Psychological
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