Background: Gender difference regarding the relationship between
lifestyle choices and depression is unclear in Korea. This study investigated the
relationship between behavioral risk factors and depression by gender in older
Korean adults. Methods: The data used in the current study were obtained from 5024
participants aged 60 years and older (56% women) of the sixth and seventh
editions of the Korea National Health and Examination Survey (KNHANES). The main
outcome was depression, which was assessed using the Patient Health Questionnaire
(PHQ)-9. Exposures included smoking, at-risk alcohol consumption, physical
inactivity, and inadequate sleep. Body mass index (BMI), household income,
educational background, marital status, and number of existing diseases were
included as covariates. Results: Depressed persons were older (p = 0.003), had lower
income (p 0.001), lower marital status (p = 0.021), lower
education (p 0.001), lower smoking (p = 0.003), higher
rates of physical inactivity (p = 0.009) and inadequate sleep
(p = 0.011), and higher number of existing diseases (p
0.001) compared with not depressed persons. Regression analysis showed that
depression was significantly associated with sex (p 0.001), BMI
(p 0.001), income (p 0.001), education (p =
0.001), smoking (p = 0.033), physical inactivity (p = 0.021),
inadequate sleep (p 0.001), and number of existing diseases
(p 0.001). Generalized linear regression analysis showed a
significant interaction between gender and number of unhealthy behaviors on the
PHQ-9 score (p = 0.004), such that depression risk was significantly
associated with clustered unhealthy behaviors in women only. Conclusions: The current findings showed that physical inactivity and
inadequate sleep were independent predictors for depression in women, with no
such relationship in men.