Sex differences in quality of life and depressive symptoms among middle-aged and elderly Europeans: results from the SHARE survey

Abstract

Objectives

We examine sex differences in quality of life (QoL) and depressive symptoms across age and European regions.

Methods

We performed a large cross-sectional study based on 64,552 women and 53,647 men aged 50+ who participated in the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2004-2020. Linear and logistic regression models were used to examine associations with QoL (CASP-12) and depressive symptoms (EURO-D).

Results

Women reported slightly lower QoL (coefficient −0.78, 95% CI −0.92; −0.65) and more depressive symptoms (odds ratio (OR) 2.23, 95% CI 2.13; 2.34) than men. Sex differences in QoL increased with advancing age, whereas sex differences in depressive symptoms were stable across age groups. No overall sex difference in QoL was found in Northern Europe, but women had lower QoL than men in Western (coefficient −0.49, 95% CI −0.69; −0.29), Southern (coefficient −1.35, 95% CI −1.61; −1.09) and Eastern (coefficient −0.72, 95% CI −1.05; −0.39) Europe. However, sex differences varied within the specific CASP-12 items, with women having overall lower control and autonomy, but more self-realisation, than men. Women reported more depressive symptoms than men in all regions, with the largest overall sex difference in Southern Europe (OR 2.62, 95% CI 2.40; 2.86). A female disadvantage was found for most of the EURO-D items, with the largest sex differences for ‘tearfulness’, ‘depression’ and ‘sleep’.

Conclusion

Middle-aged and elderly European women report lower QoL and more depressive symptoms than European men, lending support for the male-female health survival paradox.

Keywords:

• Sex difference
• quality of life
• depression
• Europe
• SHARE

Disclosure statement

The authors declare that they have no conflict of interests.

Data availability statement

SHARE data is free of charge for scientific use globally http://www.share-project.org/data-access.html.

Additional information

Funding

This research was funded by Demography of Sex Differences in Health and Survival, grant number P01 AG031719 (LJA).