Longitudinal effects of empathy on depression in community-dwelling older adults: the mediating role of apathy

BACKGROUND: Late life depression is a prevalent and under-treated public health concern. Empathy may be relevant to depressive symptoms in older adults, but different empathy dimensions may have different implications. Apathy, characterized by reduced motivation and goal-directed engagement, may help explain how empathy is linked to later depressive symptoms. METHODS: Older adults aged 60-85 years from two communities in Beijing were recruited as participants. A three-wave longitudinal survey design was employed at intervals of 1.5 and 3 months following the baseline measurement. Perspective-taking, empathic concern, fantasy, personal distress, apathy, and depressive symptoms were assessed at each wave. Cross-lagged panel model was used to test direct and indirect effects over time. RESULTS: reduced T2 apathy (indirect effect= -0.083, 95% CI [-0.172, -0.009]); indirect effects for empathic concern and fantasy were nonsignificant, and personal distress predicted T3 depression directly without mediation. CONCLUSION: Perspective-taking may be prospectively linked to later depression through apathy, although the effect was small and should be interpreted cautiously. These findings suggest that assessing both cognitive empathy and apathy may provide additional information for understanding depression risk in community-dwelling older adults.