Longitudinal Trajectories of Housing Quality and Their Associations with Elderly Depression: A Prospective Cohort Study Based on the China Longitudinal Aging Social Survey, 2018–2023

Prior studies have demonstrated the crucial role of housing quality in the mental health of older adults. However, there remains insufficient evidence regarding how longitudinal trajectories of housing quality relate to elderly depression. Based on the China Longitudinal Aging Social Survey conducted from 2018 to 2023, this study used the group-based trajectory model to identify distinct longitudinal trajectories of housing quality (measured using nine housing characteristics) in Chinese older adults and subsequently examined their associations with depressive symptoms, as well as potential mediations and urban–rural differences. Three group-based trajectories, including “consistently high-level”, “moderate-fluctuating growth”, and “low-fluctuating growth”, were yielded. Compared with the “low-fluctuating growth” trajectory, older adults in the “consistently high-level” trajectory exhibited significantly lower depression levels (β = −0.484, p < 0.001), whereas those in the “moderate-fluctuating growth” trajectory exhibited no significant changes. This association did not differ significantly between urban and rural areas. Mechanism analysis indicated that, in rural areas, better physical health, stronger social support networks, and higher levels of social adaptation served as important mediators that linked elevated housing quality with reduced depression. By contrast, in urban areas, social support networks and social adaptation did not demonstrate significant mediating effects, and better physical health may mask the association between housing quality and elderly depression. These findings suggest that we should avoid staged declines in housing quality among the elderly and pay attention to urban–rural differences in the mechanisms linking housing quality trajectories with elderly depression.