Older adults in the Netherlands who rely on formal care report more depressive symptoms than those supported by a partner, privately paid help, or no care at all, and loneliness and insufficient care appear to partly explain that gap, according to a study published in the European Journal of Ageing. The research, based on nearly three decades of longitudinal data, also finds that the picture differs notably between men and women.
The study drew on ten observation waves of the Longitudinal Aging Study Amsterdam, covering 18,954 observations from 4,925 older Dutch adults collected between 1992 and 2022. The researchers distinguished six types of care networks: partner care, informal care, formal care, institutionalised care, privately paid care, and no care. They then examined how network type related to depressive symptoms, stratifying all analyses by gender.
A central methodological strength of the work lies in its use of hybrid mixed-model hierarchical regression, which separates two kinds of effects. Between-person effects capture differences among individuals, for instance whether people who use formal care differ in depression from those who rely on a partner. Within-person effects track changes inside the same individual over time, such as whether a person reports more depressive symptoms after moving into a formal care arrangement than before.
Across both types of effects, the results were consistent for men and women: users of partner care, privately paid care, and no care reported fewer depressive symptoms than formal care users. For women, the same advantage extended to informal care, but for men it did not. In other words, informal support from family or friends was associated with fewer depressive symptoms among older women, while no such association emerged for older men.
To explain these differences, the authors turned to Self-Determination Theory, testing two mechanisms. Loneliness served as an indicator of relatedness, the human need for meaningful connection, while care sufficiency indicated autonomy, the sense that one’s needs are adequately met. Both mechanisms partly accounted for the differences between care network types, for men and women alike.
The pathways operated differently, however. Loneliness explained the gaps through both between-person and within-person effects, meaning that people who were lonelier were more depressed and that becoming lonelier over time was accompanied by more depressive symptoms. Care sufficiency worked only through between-person effects, suggesting that individuals whose care needs feel adequately met tend to report fewer symptoms, without a clear parallel intraindividual change.
Gender shaped the sensitivity of these mechanisms. Changes in loneliness and care sufficiency had a stronger impact on women’s depressive symptoms than on men’s, offering one explanation for why the associations between care networks and depression diverge by gender. The findings suggest that older women’s mental health is more responsive to shifts in their social connection and in how well their care needs are covered.
The most robust result concerns formal care. The observation that formal care users show more depressive symptoms held across models, and the authors interpret it as a signal that formal care must align more closely with needs for emotional support. Because loneliness partly accounted for the elevated symptoms among formal care users, strengthening the relational side of professional care may be one route to narrowing the gap.
The hybrid modelling, which separates stable individual differences from changes over time, partly addresses this concern, but the authors frame their contribution as exploratory work on gendered mechanisms rather than definitive causal evidence. Published as open access research, the article offers a long-run Dutch perspective on how the composition of everyday care, from a spouse’s help to professional services, is entwined with the mental health of ageing men and women.
Subject of Research: Gender differences in the association between care network types and depressive symptoms among older adults in the Netherlands
Article Title: Explaining gender differences in the associations between care network type and depressive symptoms of older adults in the Netherlands
Article References: Swinkels, J. C., Klokgieters, S., & Broese van Groenou, M. I. (2026). Explaining gender differences in the associations between care network type and depressive symptoms of older adults in the Netherlands. European Journal of Ageing. https://doi.org/10.1007/s10433-026-00944-7
Image Credits: AI Generated
DOI: 10.1007/s10433-026-00944-7
Keywords: depressive symptoms, care networks, older adults, loneliness, formal care, informal care, gender differences, Longitudinal Aging Study Amsterdam, Self-Determination Theory, Netherlands, mental health, longitudinal study
News Source: Glenn Wilkins. (October 29, 2026). Research report: Explaining gender differences in the associations between care network type and depressive symptoms of older adults in the Netherlands. Scienmag.
