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. 2024 Feb 22;19(2):e0298360.
doi: 10.1371/journal.pone.0298360. eCollection 2024.

Gender difference on the mediation effects of filial piety on the association between chronic obstructive pulmonary disease and depressive symptoms in older adults: A community-based study

Cheng-Chen Chang  1   2 , Kaichi Hsu  3 , Chun-Min Chen  4 , Si-Sheng Huang  1 , I-Chien Wu  3 , Chih-Cheng Hsu  3 , Agnes C Hsiung  3 , Hsing-Yi Chang  3
Affiliations

Gender difference on the mediation effects of filial piety on the association between chronic obstructive pulmonary disease and depressive symptoms in older adults: A community-based study

Cheng-Chen Chang et al. PLoS One. .

Abstract

Filial piety is viewed as strong family support for older Chinese people, and strongly associated with depressive symptoms. It is unknown if there exists gender difference in the mediation effects of filial piety on the relationship between chronic obstructive pulmonary disease (manifested as lung function) and depression. We investigated whether filial piety mediates the association between lung function and depression in community-dwelling older men and women using the Healthy Aging Longitudinal Study in Taiwan (HALST). Community dwelling adults aged 65 and above were analyzed. Pulmonary function, depressive symptoms, and filial piety expectation (FPE) and receipt of filial piety (RFP) were collected. The interaction and mediation of filial piety between lung function and depression was analyzed. We found that in older men, forced expiratory volume in the first second (FEV1) was inversely correlated with depression (β = -0.1281, p = 0.004) with no mediation effect of FPE. In older women, FEV1 was negatively associated with FPE, but FPE did not increase the risk of depression (β = 0.0605, p = 0.12). In both older men and women, FEV1 was negatively associated with RFP, while RFP reduced the risk of depression (p< 0.001). In older women, the correlation between FEV1 was complete mediation of RFP. Results indicate that feelings of insufficient filial piety may increase the likelihood of depression, especially in elderly women with worse lung function. Although modest, the main mediation effect of filial piety was improvement of lung function in older subjects, which might decrease depression.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Mediating model of FPE and PFPR.
Black line: statistically significant. Gray line: statistically insignificant. c was the original relationship between FEV1 and CES-D. c’ was the relationship after adding mediator and adjusting for covariates. FEV1: forced expiratory volume in 1 second. CESD: Center for Epidemiologic Studies Depression Scale. FPE: filial piety expectation. PRFP: perceived receipt of filial piety.
See this image and copyright information in PMC

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Supplementary concepts