TOPLINE:

Older adults with a low socioeconomic status had an increased risk for depression, and unfavorable lifestyle habits accounted more than 60% of that association.

METHODOLOGY:

• Researchers investigated whether lifestyle habits could be the cause of an association between socioeconomic status and depression.
• They used longitudinal data from five cohorts across 20 countries from 2008 to 2018 and included 48,760 participants aged 50 years or older (53% women).
• Socioeconomic status was analyzed using education, income, and wealth; 60% of the participants had low socioeconomic status.
• A composite score based on smoking status, alcohol consumption, physical activity, and social participation categorized the lifestyles of the participants as unfavorable, intermediate, or favorable.
• The primary outcome was the incidence of depressive symptoms, assessed using scales across the cohorts.

TAKEAWAY:

• Overall, 14,320 participants developed depression over a follow-up period of 179,913 person-years, with a pooled incidence rate of 11.5 per 100 person-years.
• Low socioeconomic status was independently associated with a 41% increased risk for depression (pooled adjusted hazard ratio [aHR], 1.41; 95% CI, 1.37-1.46; I² = 91.7%)
• Unfavorable lifestyle explained 62.8% of the association between socioeconomic status and depression, whereas intermediate lifestyle explained 6% of the association.
• Participants with low socioeconomic status and an unfavorable lifestyle had the highest risk for depression (pooled aHR, 2.47; I² = 98.8%; P < .001).

IN PRACTICE:

“Healthy lifestyle behaviors play a crucial role in mitigating depression risk among individuals with low socioeconomic status. Nevertheless, cultural and national differences suggest that promoting healthy lifestyles alone may not be universally effective in addressing socioeconomic inequalities in depression,” the researchers wrote.

SOURCE:

This study was led by Xinfeng Wang, MSc, of Institute for Global Public Policy at Fudan University in Shanghai, China. It was published online on October 7, 2025, in the American Journal of Preventive Medicine.

LIMITATIONS: 

Socioeconomic status, lifestyle, and depression were self-reported and were measured differently across cohorts. Sleep and dietary habits were not assessed. Preexisting depression may have influenced the findings.

DISCLOSURES:

No funding source was explicitly mentioned. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.