Path Model Factors Associated with Depressive Symptoms among Older Thais Living in Rural Areas

Depressive symptoms are complex and are often more severe in older people. However, there is limited research exploring the causal relationships between depression and its associated factors in the geriatric population, particularly in Thailand. We aimed to evaluate the direction of these complex relationships in the Thai population. A cross-sectional design was conducted on 312 Thai community-dwelling older adults aged 60 years or above who registered for primary care services. The participants were recruited from July 2019 to January 2020, and they responded to standard assessments. The relationships between pain, the number of medications, frailty, locomotive syndrome, and depressive symptoms were investigated using path analysis. The results showed that most participants were women and had multiple diseases, mild pain, frailty, and grade I-II locomotive syndrome. The prevalence of depressive symptoms was 16%. The model showed significant positive direct and indirect paths from locomotive syndrome to depressive symptoms (beta = 0.296, p < 0.01; beta = 0.099, p < 0.01, respectively). There was a significant positive direct path from frailty to depressive symptoms (beta = 0.219, p < 0.01) and a significant positive indirect path from pain to depressive symptoms (beta = 0.096, p < 0.01).