Association between depression and subjective well-being among older adults in China: the mediating effect of self-assessed health

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Abstract

Background: As the aging population gradually intensifies, it becomes particularly important to pay attention to the quality of life of older adults and improve their sense of happiness. Depression in older adults is a potential risk factor for subjective well-being (SWB). Methods: This study selected self-assessed health(SAH) as a mediating variable and constructed a mediation effect model to reveal this relationship and its underlying mechanism. The research data were obtained from the 2020 Chinese Family Panel Studies (CFPS). We selected 4606 Chinese older adults aged 60 years and older as the research subjects. Propensity score matching (PSM) was used to explore the association between depression and SWB. Additionally, a range of potential covariates were adjusted, and the bootstrap method PROCESS program was used to detect the mediating effect of SAH. Results: PSM analysis confirmed that depression significantly reduced the SWB of older adults, with a decrease of 1.203 points in SWB after controlling for confounding variables (P < 0.001). Mediation effect analysis revealed that SAH (B = -0.138) mediated the relationship between depression and SWB, and the effect was statistically significant according to bootstrap testing. Conclusions: Depression in older Chinese adults affects their subjective well-being through self-assessed health, which may provide new insights for enhancing the well-being of older adults.

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Wang, W., Zhao, M., Wang, F., Xiao, W., He, J., Ma, X., & Qiao, H. (2026). Association between depression and subjective well-being among older adults in China: the mediating effect of self-assessed health. BMC Public Health, 26(1). https://doi.org/10.1186/s12889-025-25613-9

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