Hyunmin Kim1, Jaelim Cho2, Oluwaseyi Isehunwa3, Juhwan Noh4, Young Noh5, Sung Soo Oh6, Sang-Baek Koh7, Changsoo Kim8. 1. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN 38152, United States. 2. Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea; School of Medicine, Auckland University, Auckland, New Zealand; Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN 38152, United States; Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Boston, MA, United States. 4. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea. 5. Department of Neurology, Gachon University Gil Medical Center, Incheon, Republic of Korea. 6. Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea. 7. Department of Preventive Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea. 8. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea; Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: PREMAN@yuhs.ac.
Abstract
BACKGROUND: Air pollution is a risk factor for depression or depressive symptoms. However, few studies have examined an effect modifier as a protective factor against depressive symptoms associated with air pollution, including social support. Notably, less is known about a married relationship in the association between exposure to air pollution and depressive symptoms among the elderly. METHODS: This study included 2122 marrieds and 607 non-marrieds, recruited in 2014-2017 from different regions of South Korea. Depressive symptoms were measured by the Korean version of the Geriatric Depression Scale Short Form (SGDS-K). After adjustment for potential confounders using propensity score of being assigned to the marrieds, we examined the extent of whether the effects of exposure to air pollutants (PM10, PM2.5, and NO2) on depressive symptoms were different between marrieds and non-marrieds. Subgroup analyses by gender and residence area were also performed. RESULTS: Marrieds than non-marrieds were less likely to have depressive symptoms and had smaller SGDS-K associated with increased exposure to PM10 and PM2.5 concentrations, respectively. After stratification of subjects by gender and residence area, the interaction term appeared to be significant among men and the non-metropolitan group, indicating the protective effect of married relationships on depressive symptoms attributable to air pollution exposure in them. LIMITATIONS: Although we adjusted the propensity score, our findings might be confounded by the contextual effect associated with married relationships. CONCLUSIONS: A married relationship, as a social tie, may attenuate the effect of exposure to air pollution on depressive symptoms among the elderly. Nonetheless, additional research is worthwhile to explore the extent of other social relationships in the association between air pollution exposure and depressive symptoms.
BACKGROUND: Air pollution is a risk factor for depression or depressive symptoms. However, few studies have examined an effect modifier as a protective factor against depressive symptoms associated with air pollution, including social support. Notably, less is known about a married relationship in the association between exposure to air pollution and depressive symptoms among the elderly. METHODS: This study included 2122 marrieds and 607 non-marrieds, recruited in 2014-2017 from different regions of South Korea. Depressive symptoms were measured by the Korean version of the Geriatric Depression Scale Short Form (SGDS-K). After adjustment for potential confounders using propensity score of being assigned to the marrieds, we examined the extent of whether the effects of exposure to air pollutants (PM10, PM2.5, and NO2) on depressive symptoms were different between marrieds and non-marrieds. Subgroup analyses by gender and residence area were also performed. RESULTS: Marrieds than non-marrieds were less likely to have depressive symptoms and had smaller SGDS-K associated with increased exposure to PM10 and PM2.5 concentrations, respectively. After stratification of subjects by gender and residence area, the interaction term appeared to be significant among men and the non-metropolitan group, indicating the protective effect of married relationships on depressive symptoms attributable to air pollution exposure in them. LIMITATIONS: Although we adjusted the propensity score, our findings might be confounded by the contextual effect associated with married relationships. CONCLUSIONS: A married relationship, as a social tie, may attenuate the effect of exposure to air pollution on depressive symptoms among the elderly. Nonetheless, additional research is worthwhile to explore the extent of other social relationships in the association between air pollution exposure and depressive symptoms.
Authors: Heeseon Jang; Woojin Kim; Jaelim Cho; Jungwoo Sohn; Juhwan Noh; Gayoung Seo; Seung-Koo Lee; Young Noh; Sung Soo Oh; Sang-Baek Koh; Hee Jin Kim; Sang Won Seo; Ho Hyun Kim; Jung Il Lee; Sun-Young Kim; Changsoo Kim Journal: Epidemiol Health Date: 2021-09-16