The relationships between self-neglect and depression, social networks, and health literacy in Turkish older adults: a cross-sectional study

Abstract Background Self-neglect is common among older adults and may have devastating health consequences. Objective This study aims to examine the relationships between self-neglect and depression, social networks, and health literacy (HL) in older adults. Methods The cross-sectional study was con...

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Main Authors: Nesrin İlhan, Cemile Savci
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22609-3
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author Nesrin İlhan
Cemile Savci
author_facet Nesrin İlhan
Cemile Savci
author_sort Nesrin İlhan
collection DOAJ
description Abstract Background Self-neglect is common among older adults and may have devastating health consequences. Objective This study aims to examine the relationships between self-neglect and depression, social networks, and health literacy (HL) in older adults. Methods The cross-sectional study was conducted between March and May 2024 at four family health centres located in a district of Istanbul, Turkey. A total of 370 older adults, aged 65 years and above, were selected by simple random sampling from among those who visited the family health centres during the study period. A Sociodemographic Information Form, the Revised Turkish version of Mini Mental State Examination, the Istanbul Medical School Elder Self-Neglect Questionnaire, the Lubben Social Network Scale, the Geriatric Depression Scale-Short Form, and the Turkish Health Literacy Scale-32 were used for data collection. Data were analysed using descriptive statistics, Pearson’s correlation analysis, hierarchical linear regression analysis, and serial multiple mediation analysis. Results The mean age of the participants was 71.42 ± 5.54 (65–90) years, and 55.7% were women. The prevalence of self-neglect among the participants was 34.9%, and the prevalence of depressive symptoms was 46.2%. The HL levels of 62.7% of the participants were inadequate, and those of 31.6% were problematic-limited. HL, depression, social networks, gender, education status, and income status were statistically significant predictors of self-neglect (R2 = 0.508, p < 0.001). Depression had a significant direct effect on self-neglect (effect = -0.148, p < 0.001), as did social networks (effect = 0.107, p < 0.001) and HL (effect = 0.107, p < 0.001). The mediating effect of social networks in the relationship between depression and self-neglect was significant (LLCI = -0.043, ULCI = -0.015), with an effect size of -0.028. The mediating effect of HL in the relationship between depression and self-neglect was also significant (LLCI = -0.121, ULCI = -0.063), with an effect size of -0.089. Conclusion Our findings showed that HL, depression, and social networks play a critical role in predicting self-neglect in older adults, and social networks and HL partially mediate the relationship between depression and self-neglect. Based on these results, efforts to improve HL and strengthen social support systems would be beneficial in mitigating the effects of depression and reducing self-neglect in older adults.
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spelling doaj-art-e4bdd7a6ee27496fb996dea6efa5806e2025-08-20T02:16:59ZengBMCBMC Public Health1471-24582025-04-0125111010.1186/s12889-025-22609-3The relationships between self-neglect and depression, social networks, and health literacy in Turkish older adults: a cross-sectional studyNesrin İlhan0Cemile Savci1Department of Nursing, Faculty of Health Sciences, Istanbul Medeniyet UniversityDepartment of Nursing, Faculty of Health Sciences, Istanbul Medeniyet UniversityAbstract Background Self-neglect is common among older adults and may have devastating health consequences. Objective This study aims to examine the relationships between self-neglect and depression, social networks, and health literacy (HL) in older adults. Methods The cross-sectional study was conducted between March and May 2024 at four family health centres located in a district of Istanbul, Turkey. A total of 370 older adults, aged 65 years and above, were selected by simple random sampling from among those who visited the family health centres during the study period. A Sociodemographic Information Form, the Revised Turkish version of Mini Mental State Examination, the Istanbul Medical School Elder Self-Neglect Questionnaire, the Lubben Social Network Scale, the Geriatric Depression Scale-Short Form, and the Turkish Health Literacy Scale-32 were used for data collection. Data were analysed using descriptive statistics, Pearson’s correlation analysis, hierarchical linear regression analysis, and serial multiple mediation analysis. Results The mean age of the participants was 71.42 ± 5.54 (65–90) years, and 55.7% were women. The prevalence of self-neglect among the participants was 34.9%, and the prevalence of depressive symptoms was 46.2%. The HL levels of 62.7% of the participants were inadequate, and those of 31.6% were problematic-limited. HL, depression, social networks, gender, education status, and income status were statistically significant predictors of self-neglect (R2 = 0.508, p < 0.001). Depression had a significant direct effect on self-neglect (effect = -0.148, p < 0.001), as did social networks (effect = 0.107, p < 0.001) and HL (effect = 0.107, p < 0.001). The mediating effect of social networks in the relationship between depression and self-neglect was significant (LLCI = -0.043, ULCI = -0.015), with an effect size of -0.028. The mediating effect of HL in the relationship between depression and self-neglect was also significant (LLCI = -0.121, ULCI = -0.063), with an effect size of -0.089. Conclusion Our findings showed that HL, depression, and social networks play a critical role in predicting self-neglect in older adults, and social networks and HL partially mediate the relationship between depression and self-neglect. Based on these results, efforts to improve HL and strengthen social support systems would be beneficial in mitigating the effects of depression and reducing self-neglect in older adults.https://doi.org/10.1186/s12889-025-22609-3Older adultsSelf-neglectDepressionSocial networkHealth literacy
spellingShingle Nesrin İlhan
Cemile Savci
The relationships between self-neglect and depression, social networks, and health literacy in Turkish older adults: a cross-sectional study
BMC Public Health
Older adults
Self-neglect
Depression
Social network
Health literacy
title The relationships between self-neglect and depression, social networks, and health literacy in Turkish older adults: a cross-sectional study
title_full The relationships between self-neglect and depression, social networks, and health literacy in Turkish older adults: a cross-sectional study
title_fullStr The relationships between self-neglect and depression, social networks, and health literacy in Turkish older adults: a cross-sectional study
title_full_unstemmed The relationships between self-neglect and depression, social networks, and health literacy in Turkish older adults: a cross-sectional study
title_short The relationships between self-neglect and depression, social networks, and health literacy in Turkish older adults: a cross-sectional study
title_sort relationships between self neglect and depression social networks and health literacy in turkish older adults a cross sectional study
topic Older adults
Self-neglect
Depression
Social network
Health literacy
url https://doi.org/10.1186/s12889-025-22609-3
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