Factors Affecting Depression in the Elderly Over 65 Years in Korea: Using Andersen's Behavioral Model

한국 65세 이상 노인의 우울증에 영향을 미치는 요인 : 앤더슨 모형을 활용한 융합적 연구

  • Park, Hyo-Eun (Division of Nursing, Suwon Women's University) ;
  • Seo, In Soon (Division of Nursing, Suwon Women's University)
  • 박효은 (수원여자대학교 간호학과) ;
  • 서인순 (수원여자대학교 간호학과)
  • Received : 2019.07.08
  • Accepted : 2019.08.20
  • Published : 2019.08.28


The purpose of this study was to comprehensively investigate predictive factors influencing on geriatric depression of the elderly by applying the Andersen's Behavioral Model of Health Service Use,. The research data was focused on the final analysis of 3,585 elderly population aged 65 or older among 21,724 participants in the 6th (2013-2015) Korea National Health and Nutrition Examination Survey. Hierarchical logistic regression analysis was conducted to multivariate analysis method of the variables for possible depression by the Andersen's Behavioral Model of Health Service Use. As a result of hierarchical regression analysis, there was a negative correlation of 0.49 times(0.31-0.78) for males. In addition, there was a positive correlation of pain 1.56 times(1.05-2.31), stress 0.55 times(1.10-2.19), walking exercise 1.44 times(1.03-2.00) and outpatient use 1.48 times(1.10-1.98). Therefore, differentiated support according to the gender of the community residents is necessary, and stress intervention or additional support for exercise is required.


Supported by : Suwon Women's University


  1. B. Saraceno. (2002). The WHO world health report 2001 on mental health. Epidemiology and Psychiatric Sciences, 11(2), 83-87.
  2. C. J. Murray et al. (2012). Disability adjusted life years(DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9589), 2197-2223. DOI : 10.1016/S0140-6736(12)61689-4.
  3. A. D. Lopez & C. J. Murray. (1998). The global burden of disease, 1990-2020. Nature medicine, 4(11), 1241-1243. DOI : 10.1038/3218
  4. WHO. (2001). The world health report: Mental health: New understandings, new hope. Geneva : World Health Organization.
  5. KIHASA. (2011). Korea Health Statistics 2010. Sejong : Korea Institute for Health and Social Affairs.
  6. H. Hendin et al. (2008). Suicide and Suicide Prevention in Asia. Geneva : World Health Organization.
  7. R. M. Andersen. (1995). Revisiting the behavioral model and access to medical dare : Does it matter?. Journal of Health and Social Behavior, 36(1), 1-10. DOI: 10.2307/2137284
  8. S. K. Kang & K. C. Boo. (2010). Predictors of Elderly Depression Using the Andersen Model. Journal of Gerontological Social welfare, 49(49), 7-30. DOI : 10.21194/kjgsw..49.201009.7
  9. D. Y. Lee & J. D. Park. (2011). A Study on the Factors for the Elderly Living Alone at Home to Determine Their Participation in a Health Promotion Activity Program: With the application of Anderson Model. Journal of Social Welfare Policy, 38(4), 1-23. DOI : 10.15855/swp.2011.38.4.1
  10. N. L. Chappell & A. A. Blandford. (1987). Health service utilization by elderly persons, Canadian Journal of Sociology, 12, 195-215. DOI : 10.2307/3340699
  11. S. Y. Kim & S. K. Kang. (2014). Factors Associated with Service Utilization among Individuals with Severe Mental Illness: Using the Andersen's Behavioral Model. Korean journal of social welfare studies, 45(1), 175-202. DOI : 10.16999/kasws.2014.45.1.175
  12. K. W. Schaie & S. L. Willis. (2010). Handbook of the Psychology of Aging. Cambridge, MA : Academic Press.
  13. J. H. Sang. (2019). Analysis on the Differences in Outpatient Service Use among the Pre-Elderly with Disability Applying the Anderson Model. Journal of Digital Contents Society, 20(5), 973-80.
  14. W. S. Lee. (2018). A Longitudinal Study on the Use of Medical Services. Social Welfare Policy, 45(2), 5-37.
  15. H. Y. Lim & E. S .Jeong. (2017). Factors Affecting Intention to Use Community Organizing Services at a Community Welfare Center: The Impact of Welfare Consciousness based on Andersen's Behavioral Model. The Journal of the Korea Contents Association, 17(9), 159-172.
  16. D. H. Kim & Y. J. Seo. (2017). Factors influencing the regular oral check-ups: based on the data of the 2014 Korea National Health and Nutrition Examination Survey. Journal of Dental Hygiene Science, 17(4), 323-332.
  17. S. J. Hoe. (2010). Factors influencing unmet needs for health care by income groups. Master Thesis. Seoul University, Seoul.
  18. J. Y. Yang. (2010). The longitudinal trend and association factors of unmet medical need. Doctoral dissertation. Korea University, Seoul.
  19. G. G. Kim. (2007). Study on Determinats of Medical Care Utilization Behavior of the Poor. Korean journal of social welfare studies, (34), 29-53. DOI : 10.16999/kasws.2007..34.29
  20. T. M. Song. (2013). An Anderson Model Approach to the Mediation Effect of Stress-Vulnerability Factors on the Use of Outpatient Care by the Elderly. Journal of population and health studies, 33(1), 547-576. DOI : 10.15709/hswr.2013.33.1.547
  21. M. Cavalieri. (2013). Geographical variation of unmet medical needs in Italy: a multivariate logistic regression analysis. International Journal of Health Geographics, 12(1), 27-37. DOI : 10.1186/1476-072X-12-27
  22. H. J. Lee, T. J. Lee, B. Y. Jeon & Y. I. Jung. (2009). Factors Related to Health Care Utilization in the Poor and the General Populations, Korean Journal of Health Economics and Policy, 15(1), 79-106.
  23. KCDC. (2013). 2013 Korea National Health and Nutrition Examination Survey, Chungju : Korea Centers for Disease Control and Prevention.
  24. KCDC. (2014). 2014 Korea National Health and Nutrition Examination Survey, Chungju : Korea Centers for Disease Control and Prevention.
  25. KCDC. (2015). 2015 Korea National Health and Nutrition Examination Survey, Chungju : Korea Centers for Disease Control and Prevention.
  26. KCDC. (2016). 2015 National Health Statistics, Chungju : Korea Centers for Disease Control and Prevention.
  27. Ministry of Health & Welfare. (2011). The Epidemiological Survey of Menta Disorders in Korea 2011. Academic Research Service Project Report, Sejong : Ministry of Health & Welfare.
  28. Y. B. Seo, A. L Han, S. R. Shin. (2019). The Association of Health Related Quality of Life and Depression between Obesity in Korean Population. Journal of Health Informatics and Statistics, 44(2), 117-124..
  29. R. C. Kessler et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Archives of General Psychiatry, 51, 593-602. DOI : 10.1001/archpsyc.1994.03950010008002
  30. N. H. Susan. (2001). Gender differences in depression. Current Directions in Psychological Science, 10(5), 79-106. DOI : 10.1111/1467-8721.00142
  31. S. J. Oliver & B. B. Toner. (1990). The influence of gender role typing on the expression of depressive symptoms. Sex Roles, 22(11-12), 775-790. DOI : 10.1007/BF00292060
  32. J. D. Carter, P. R. Joyce, R. T. Mudler, S. E. Luty & J. McKenzie. (2000). Gender differences in the presentation of depressed outpatients: a comparison of descriptive variables. Journal of Affective Disorder, 61(1-2), 59-67. DOI : 10.1016/S0165-0327(00)00151-8
  33. M. S. Chung. (2005). Age differences in satisfaction in life. Korean Journal of Developmental Psychology, 18(4), 87-108.
  34. L. L. Lim & T. P. Ng. (2010). Living alone, lack of a confidant and psychological well-being of elderly women in Singapore: the mediating role of loneliness. Asia-Pacific Psychiatry, 2, 33-40. DOI : 10.1111/j.1758-5872.2009.00049.x
  35. R. Chen, Z. Hu, L. Wei, Q. Xia, C. McCracken, J. R. Copeland. (2008). Severity of depression and risk for subsequent dementia: Cohort studies in China and the UK. British Journal of Psychiatry, 193(5), 373-377. DOI : 10.1192/bjp.bp.107.044974.
  36. H. S. Kang & K. J. Kim. (2000). The Correlation between Depression and Physical Health among the Aged. Korean public health research, 20(4), 451-459
  37. H. J. Jun & M. Y. Kim. (2014). The Gender Difference in the Longitudinal Effect of Employment on Depressive Symptoms among Older Adults. Journal of the Korea Gerontological Society, 34(2), 315-331.
  38. M. Y. Choi, S. E. Lee & H. S. Park. (2015). The Effect of Elderly's Social Exclusion on Elderly Depression : Focusing on the Mediating Role of Working. Korean Journal of Gerontological Social Welfare, 69, 9-29. DOI : 10.21194/kjgsw..69.201509.9
  39. Y. Hao. (2008). Productive activities and psychological well-being among older adults. The Journals of Gerontology: Series B, 63(2), 64-72. DOI : 10.1093/geronb/63.2.S64
  40. K. S. Choi, R. Stewart & M. Dewey. (2013). Participation in Productive Activities and Depression among Older Europeans: Survey of Health, Ageing and Retirement in Europe(SHARE). International Journal of Geriatric Psychiatry, 28(11), 1157-1165. DOI : 10.1002/gps.3936.
  41. M. G. Hwang & E. J. Kim. (2008). The effect of senior employment promotion project on the cognitive ability, depression and self-esteem and the relationship between personal characteristics and activities satisfaction among the elderly. Journal of Career Education Research, 21(3), 137-156.
  42. E. H. Kim & J. H. Kang. (2011). Analysis of the Effect of Job Business of the Aged on the Change in Depression of the Aged. Korean society and public administration, 22(3), 363-378.
  43. S. N. Jang et al. (2009). Employment status and depressive symptoms in koreans: Results from a baseline survey of the korean longitudinal study of aging. Journals of Gerontology: Series B 64B(5), 677-683. DOI : 10.1093/geronb/gbp014
  44. J. Eckenrod & N. Bolger. (1995). Daily and within-day event measurement. New York : Oxford University Press.
  45. H. S. Jeon & R. E. Dunkle. (2009). Stress and depression among the oldest-old: a longitudinal analysis. Research on aging, 31(6), 661-687. DOI : 10.1177/0164027509343541
  46. E. H. Kua, M. Rathi, L. Feng & T. P. Ng. (2013). Preventive Psychiatry in Late Life: Studies on Depression and Dementia from the Singapore Gerontology Research Programme. Taiwanese Journal of Psychiatry, 27(4), 267-275.
  47. M. S. Lee. (2010). Chronic Diseases, Depressive Symptoms and the Effects of Social Networks in Korean Elderly Population. Health and Social Science, 27, 5-30.
  48. C. Q. Huang, X. M. Zhang, B. R. Dong, Z. C. Lu, J. R. Yue & Q. X. Liu. (2010). Health status and risk for depression among the elderly: a meta-analysis of published literature. Age Aging, 39(1), 23-30. DOI : 10.1093/ageing/afp187
  49. Y. Li, L. Xu, I. Chi, & P. Guo. (2013). Participation in Productive Activities and Health Outcomes among Older Adults in Urban China. The Gerontologist, 54(5), 784-796. DOI : 10.1093/geront/gnt106
  50. J. H. Han, J. E. Lee, J. H. Park, S. H. Lee & H. S. Kang. (2014). Effect of a 12 Week-Aerobic Exercise Program on Physical Fitness, Depression, and Cognitive Function in the Elderly. Exercise science, 23(4), 375-385. DOI : 10.15857/ksep.2014.23.4.375
  51. I. S. Nam, & S. R. Yeom. (2013). Effect of socioeconomic status on depression : Focusing on the mediating effect of regular exercise. Journal of Gerontological Social Welfare, 62, 109-126. DOI : 10.21194/kjgsw..62.201312.109
  52. C. D. Rethorst , B. M. Wipfli & D. M. Landers. (2009). The antidepressive effects of exercise. Sports Medicine, 39(6), 491-511. DOI : 10.2165/00007256-200939060-00004
  53. J. Krogh , M. Nordentoft & J. A. Sterne. (2010). The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials. Journal of clinical psychiatry, 72(4), 529-538. DOI : 10.4088/JCP.08r04913blu
  54. D. M. Landers & S. M. Arent. (2007). Physical activity and mental health. In: Tenenbaum G, Eklund RC, eds. Handbook of Sport psychology. Hoboken, NJ : John Wiley. 469-491.
  55. M. P. Matud. (2004). Gender differences in stress and coping styles. Personality and individual differences, 37(7), 1401-1415. DOI : 10.1016/j.paid.2004.01.010
  56. D. M. Fergusson, R. D. Goodwin & L. J. Horwood. (2003). Major depression and cigarette smoking: results of a 21-year longitudinal study. Psychol Med, 33(8), 1357-1367. DOI : 10.1017/S0033291703008596