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. Author manuscript; available in PMC: 2026 Mar 21.
Published in final edited form as: Aging Ment Health. 2025 Dec 11;30(4):770–780. doi: 10.1080/13607863.2025.2594702

Religious attendance and depressive symptoms in later life: the mediating role of church-based social ties

Mingui Gao a,b, Hui Liu a,b
PMCID: PMC13004539  NIHMSID: NIHMS2150403  PMID: 41379036

Abstract

Objectives:

This study examines the relationship between religious attendance and depressive symptoms among older adults in the United States, focusing on the potential mediating role of church-based social ties.

Method:

Longitudinal data from the Health and Retirement Study (2010–2018) were analyzed, including 10,467 respondents over age 50 at baseline. Associations between religious attendance (2010), church-based social ties (2012), and depressive symptoms (2014–2018) were assessed using a series of regression models. Mediation analysis was conducted using generalized structural equation models with bootstrapped confidence intervals.

Results:

More frequent religious attendance in 2010 predicted fewer depressive symptoms in 2014, 2016, and 2018. Church-based friendship, but not church-based relatives, significantly mediated these associations.

Conclusion:

Religious attendance may protect against later-life depressive symptoms by fostering church-based friendships. Faith-based organizations might consider promoting such connections to support older adults’ mental health.

Keywords: Depressive symptoms, religious attendance, church-based social ties, mediation, HRS

Introduction

Depression is a significant and growing concern among older adults in the United States. Estimates suggest that nearly one in four adults aged 65 and older experience depression or related mental health conditions (National Council on Aging, 2012). More recently, the Centers for Disease Control and Prevention (CDC) reported that about 14%—approximately 10 million—of older Americans have been diagnosed with clinical depression (Lee et al., 2023). Many older adults with depressive symptoms never receive a formal clinical diagnosis, yet these symptoms are associated with increased risk of functional decline, cognitive impairment, and social withdrawal, which can exacerbate health problems and contribute to elevated mortality risk (Blazer, 2003). Identifying protective factors that promote psychological well-being in later life is critical for mitigating these risks, enhancing quality of life, and supporting healthy aging. Religious attendance has long been recognized as a factor associated with fewer depressive symptoms and greater life satisfaction (Ellison et al., 2001; Garssen et al., 2021; Koenig, 2012; Lim & Putnam, 2010; Upenieks & Thomas, 2021). Recent studies further suggest that religious involvement—particularly through church-based social ties—is closely linked to mental health and well-being (Chatters et al., 2011; Ellison et al., 2001; Krause & Wulff, 2005; Nguyen, 2020; Taylor et al., 2022; 2024). However, less is known about whether church-based social ties help explain the association between religious attendance and depressive symptoms, and whether distinct types of church-based relations (friendships versus relatives) play different roles in these processes. Recent reviews also emphasize the need for longitudinal designs to clarify temporal ordering and underline mechanisms in studies of religion and mental health (Coelho-Júnior et al., 2022; Nguyen, 2020).

Guided by the life course and social integration perspectives, we analyzed longitudinal data from the Health and Retirement Study (HRS) 2010–2018 to examine church-based social ties—social connections in a religious context—as a potential mediator linking religious attendance and depressive symptoms among older adults. Given that older adults’ broader social networks often shrink in later life (Cornwell et al., 2008; Hayward & Krause, 2013; Kemperman et al., 2019), church-based social ties, such as friendships and familial relationships, may become especially critical sources of support for promoting psychological well-being. We distinguish between church-based friendship and family ties and examine whether those ties mediate the association between religious attendance and depressive symptoms. Findings from this study may provide new insights into the specific social mechanisms underlying the mental health benefits of religious attendance and inform interventions that leverage church-based social ties to support psychological well-being in later life.

Background

Religious attendance and psychological well-being: previous empirical evidence

Previous studies have shown that regular religious attendance is consistently associated with better mental health, greater well-being, more happiness, and—most notably—fewer depressive symptoms (Ellison et al., 2001; Lim & Putnam, 2010; Upenieks & Thomas, 2021; see also Strawbridge et al., 2001; Chatters et al., 2015; Holt et al., 2018). This association is robust across different outcomes, including faster remission in clinical samples (Koenig, 2007), lower 12-month onset among adolescents (Van Voorhees et al., 2008), and fewer depressive symptoms in community panels (Meertens et al., 2003). Recent reviews and meta-analyses further confirm a modest but reliable association between religious attendance and mental health, while highlighting the need for temporal tests to clarify underlying mechanisms (Coelho-Júnior et al., 2022; Garssen et al., 2021; Koenig & Larson, 2001; Mahdanian, 2018).

Within this literature, church-based relationships emerge as a central pathway—providing support yet also exposing members to strain. On one hand, connectedness within a congregation is consistently linked to fewer depressive symptoms (Brashears, 2010; Holt et al., 2018; Kidwai et al., 2014; Nooney & Woodrum, 2002). On the other hand, negative exchanges (e.g. criticism, demands) are associated with greater distress (Nguyen, 2020; Nooney & Woodrum, 2002; Taylor et al., 2022) or more suicidal ideation (Chatters et al., 2011). Previous studies suggest that “church support” partly explains the association between religious attendance and depressive symptoms, though support is typically measured as a broad, undifferentiated construct (Kidwai et al., 2014; Orr et al., 2019).

Recent studies further clarify these dynamics in aging populations, particularly among racial and ethnic minorities. For a review, see Taylor et al. (2024). Subjective closeness to church members is negatively associated with suicidal ideation among African Americans and Black Caribbeans (Chatters et al., 2011), whereas frequent contact with church members may increase exposure to conflict among both African Americans and Black Caribbeans (Taylor et al., 2022). A growing body of research has tested social support as a mediator linking religious attendance to depressive symptoms (Ai et al., 2007; Friedman & Saroglou, 2010; Hayward et al., 2012b; Park et al., 2012; Salsman et al., 2005). However, despite theoretical reasons to expect that friendship ties (voluntary, reciprocal) and relative ties (more obligatory, potentially ambivalent) differentially relate to mental health across the life course (Huxhold et al., 2014; Krause & Wulff, 2005; Krause & Cairney, 2009), only a few publications have tried to distinguish friend versus relative ties (McLaughlin et al., 2002; Taylor et al. 2015). Therefore, this study seeks to address this gap by disaggregating church-based social ties into friend and relative components to examine their distinct mediating roles in the relationship between religious attendance and depressive symptoms.

The life course perspective on social integration: linking religious attendance, church-based social ties, and psychological well-being

The life course and social integration perspectives provide a theoretical foundation for understanding how religious attendance shapes psychological well-being over the life course. They suggest that church-based social ties formed through religious attendance enhance social integration by providing social support and fostering a sense of belonging—key pathways through which religious attendance influences psychological well-being over time. Social integration refers to individuals’ participation in structured social networks, including both formal (e.g. religious attendance) and informal relationships (e.g. friendships, family ties) (Durkheim, 1979; Berkman et al., 2000). The life course perspective emphasizes that individuals’ psychological and social outcomes are shaped by the timing, duration, and sequence of life experiences. It highlights the importance of long-term, cumulative processes that unfold over time. From this perspective, religious attendance and the social ties it fosters can serve as enduring resources for social integration that build over time; and the benefits of social integration—such as stress buffering, strengthened support, identity formation, and behavioral changes—may accumulate over time and be especially important in later life (Pearlin et al., 2005; Thoits, 1983).

A growing body of research demonstrates that religious attendance fosters stronger social integration by strengthening congregants’ social networks and promoting deeper interpersonal connections (Lim & Putnam, 2010; Strawbridge et al., 2001; Stroope, 2012). A longitudinal study by Strawbridge et al. (2001) found that weekly attendance predicts expanded social networks and lower levels of social disengagement over time. Lim and Putnam (2010), analyzing data from the Faith Matters Survey, reported that frequent religious service attendance is linked to larger and more diverse social networks, which in turn enhance life satisfaction. Similarly, using nationally representative data from the 2007 Baylor Religion Survey, Stroope (2012) found that frequent attendance is positively associated with church-based social embeddedness, reflected in close friendship ties within churches.

These church-based social ties can serve as key resources for providing emotional and practical support, promoting psychological well-being over time (Cohen, 2004; Ferraro & Kelley-Moore, 2000; Holt et al., 2018; Kawachi & Berkman, 2001; Krause & Hayward, 2014). Using longitudinal survey data, Krause and Hayward (2014) found that spiritual support from fellow congregants buffered the negative effects of functional disability on older adults’ sense of personal control. Their findings suggest that church-based support helps individuals manage stress and maintain psychological resilience. Additional research shows that church-based friendships are associated with reduced depressive symptoms among older adults (Holt et al., 2018; Krause & Wulff, 2005), reinforcing the idea that strong social integration within religious settings fosters mental well-being.

Notably, not all church-based social ties may function in the same way. Some evidence suggests that friendships formed in religious settings, which are often more selective of positive relationships, provide companionship and emotional support, while family relationships within congregations may introduce obligations or tensions that do not always alleviate stress (Hsieh & Liu, 2021). In addition, research by Song et al. (2021) suggests that even friendship ties, despite their general association with emotional support, can have negative health effects, such as stress from emotional burdens or interpersonal conflict, which may influence overall mental health outcomes in religious contexts. Yet, empirical research testing different church-based social ties remains limited.

Guided by the life course approach, this study adopts a longitudinal design with mediators and outcomes measured at subsequent waves (i.e. lagged in time), applying a temporally ordered mediation framework to assess how distinct forms of church-based social ties formed after religious attendance may influence later mental health outcomes. Given that older adults’ broader social networks often shrink in later life (Cornwell et al., 2008; Hayward & Krause, 2013; Kemperman et al., 2019), different types of church-based social ties—such as friendships and familial relationships—may become especially critical sources of support for promoting psychological well-being. Yet prior research has rarely examined whether these distinct forms of church-based social ties explain the relationship between religious attendance and depressive symptoms in the same way.

Building on prior evidence linking religious attendance, social ties, and mental health, we extend this work using a temporally ordered longitudinal mediation design to test the following hypotheses:

Hypothesis 1. Higher frequency of religious attendance will predict fewer depressive symptoms among older adults over time.

Hypothesis 2. Greater church-based social ties will predict fewer depressive symptoms among older adults over time.

Hypothesis 3. Higher frequency of religious attendance will predict greater development of church-based social ties among older adults over time.

Hypothesis 4. Church-based social ties will mediate the relationship between religious attendance and depressive symptoms in older adults.

Methods

Data and sample

We used five waves (2010–2018) of longitudinal data from the Health and Retirement Study (HRS), a nationally representative panel of U.S. adults over age 50 conducted biennially by the University of Michigan, with support from the National Institute on Aging (Health and Retirement Study, 2021, 2022; RAND HRS, 2025). The HRS collects data through in-person and telephone interviews on a wide range of topics, including mental health, religious participation, social connections, and self-rated health, and oversamples Black and Hispanic respondents to support subgroup analysis (Langa et al., 2008; Sonnega et al., 2014).

For analysis, we primarily used the RAND HRS Longitudinal File (Version Q), a harmonized dataset designed for longitudinal research (RAND HRS, 2025). Several key variables—such as religious attendance and church-based friendships and relatives—were not included in the RAND file and were therefore extracted from the original HRS core data (FAT 2010 and FAT 2012) and the Leave-Behind Questionnaire (LBQ), which was administered to a rotating half-sample of respondents (Motchnik, 2018). To establish temporal ordering for mediation analysis, we measured religious attendance at baseline (2010), church-based social ties two years later (2012), and depressive symptoms across three subsequent follow-up waves: 2014 (short-term lag), 2016 (intermediate lag), and 2018 (long-term lag). This temporal sequencing reflects life course principles emphasizing the timing of exposures and outcomes and ensures that the mediators and outcomes follow religious attendance in time.

Data preparation proceeded in four sequential steps. First, we merged the RAND longitudinal file with the FAT 2010 and 2012 files, resulting in a combined dataset of 42,406 respondents. Second, we applied study eligibility criteria, retaining only respondents with (a) valid religious attendance data in 2010, (b) completed LBQ items on church-based friendships and/or relatives in 2012, and (c) non-missing depressive symptom scores in 2014, 2016, and 2018. This yielded an eligible sample of 11,332 individuals. Third, we excluded cases with item-level missingness (e.g. “don’t know,” “refused”) on any focal variables, reducing the sample to 11,261. We used listwise deletion rather than multiple imputation because the proportion of missing data on focal variables was very low (<1%), and preliminary checks suggested the missingness was not systematically related to key variables. Finally, we restricted the sample to respondents aged 51 or older in 2010 to align with the core HRS target population (HRS, 2025; RAND Corporation, 2025), resulting in a final analytic sample of 10,467 older adults. Figure 1 presents the sample selection flowchart for this study.

Figure 1.

Figure 1.

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A flow chart demonstrating the sampling process of this study.

Measures

Depressive symptoms

Depressive symptoms were assessed using the 8-item version of the Center for Epidemiologic Studies Depression Scale (CES-D 8), a validated and widely used measure of psychological distress (Steffick, 2000). Respondents reported whether they experienced eight symptoms during the past week, including feeling depressed, sad, lonely, having restless sleep, feeling that everything was an effort, and having trouble getting going. Two positively worded items (“felt happy” and “enjoyed life”) were reverse-coded. Responses were summed to create a total score ranging from 0 to 8, with higher scores indicating greater depressive symptom burden. Internal consistency in this sample was good (Cronbach’s α = 0.82). CES-D 8 scores from 2014, 2016, and 2018 were used as outcomes at the 4-, 6-, and 8-year follow-ups, respectively, while baseline (2010) CES-D 8 scores were included as a covariate to adjust for initial depressive symptom levels.

Religious attendance

Frequency of religious attendance was measured in 2010 with the question: “About how often have you attended religious services during the past year?” Responses were recorded on a five-point scale: (1) more than once a week, (2) once a week, (3) two or three times a month, (4) one or more times a year, and (5) not at all. For analytic consistency, this variable was reverse-coded such that higher values indicate more frequent attendance (1 = “not at all” to 5 = “more than once a week”).

Church-based social ties

Church-based social ties were measured in 2012 using two binary items drawn from the Leave-Behind Questionnaire. First, respondents were asked whether they had any good friends in their place of worship (1 = yes, 0 = no). Second, they were asked whether they had any relatives (excluding spouse, parents, or children) in the congregation (1 = yes, 0 = no). Respondents who did not attend religious services in 2012 (and thus were not asked these questions) were coded 0 for both items, indicating no church-based friendships or relatives. Baseline measures of church-based friendships and relatives from 2010 were included as controls to adjust for preexisting ties.

Covariates

Baseline (2010) socio-demographic and health covariates included: age (in years), gender (male vs. female), race/ethnicity (non-Hispanic White [reference], non-Hispanic Black, Hispanic, Other), education (years of schooling), marital status (married vs. not married), total household wealth (cube-root transformed), and self-rated health (1 = poor to 5 = excellent). Baseline church-based social ties and baseline CES-D 8 scores were also included to adjust for preexisting levels of the mediators and outcome. Descriptive statistics for all measures are shown in Table 1.

Table 1.

Descriptive statistics for depressive symptoms, religious attendance, church-based social ties, and covariates (N = 10,467).

Mean/Prop. SD Min. Max.
CES-D Depression Score 2010 1.36 1.95 .00 8.00
CES-D Depression Score 2014 1.38 1.97 .00 8.00
CES-D Depression Score 2016 1.35 1.92 .00 8.00
CES-D Depression Score 2018 1.39 1.94 .00 8.00
Religious Attendance 2010 2.93 1.43 1.00 5.00
Religious Attendance 2012 2.91 1.43 1.00 5.00
Friends in Congregation 2010 .58 .49 .00 1.00
Friends in Congregation 2012 .58 .49 .00 1.00
Relatives in Congregation 2010 .26 .44 .00 1.00
Relatives in Congregation 2012 .26 .44 .00 1.00
Gender .60 .49 .00 1.00
 Men a .40
 Women .60
Race/Ethnicity
 White a .64
 Black .19
 Hispanic .14
 Other .03
Age in Years 2010 63.92 9.15 51.00 93.00
Education in Years 2010 12.94 3.14 .00 17.00
Household Wealth in $10,000 2010 42.27 91.55 −116.50 2064.70
Marital Status 2010
 Unmarried a .33
 Married .67
Self-Rated Health 2010 3.29 1.05 1.00 5.00
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NOTES:

a

=reference group.

Analytic strategy

We first employed a series of lagged dependent variable regression models to assess the associations between religious attendance frequency in 2010 and depressive symptoms in short-term (2014), intermediate-term (2016), and long-term (2018). For each outcome year, four sequential models were estimated. Model 1 used ordinary least squares (OLS) regression to predict depressive symptoms based on religious attendance, adjusting for all covariates. Models 2 and 3 added church-based friendship and church-based relatives separately, while Model 4 included all variables simultaneously.

To explore the potential mediations, we then estimated two binary logistic regression models. Model 5 predicted the likelihood of reporting a church-based friend in 2012, and Model 6 predicted the likelihood of reporting a church-based relative, both as functions of religious attendance in 2010. These models controlled for baseline church-based social ties in 2010 and all covariates.

To formally test mediation effects, we employed generalized structural equation models (GSEM) in Stata 19 (StataCorp, 2025). GSEM allows for the simultaneous estimation of multiple mediation pathways while flexibly integrating both binary and continuous variables within a unified analytical framework. Unlike traditional structural equation modeling (SEM), which assumes normally distributed, continuous variables, GSEM accommodates categorical mediators by specifying appropriate non-linear link functions (e.g. logit). This approach models binary outcomes as Bernoulli-distributed variables rather than treating them as continuous proxies (Oksanen et al., 2018). As a result, GSEM is increasingly used in sociological and public health research where mediators vary in measurement scale (e.g. Anzai et al., 2021; Nakimuli-Mpungu et al., 2022).

Results

Results from sequential regression models

Table 2 presents results from four lagged dependent variable OLS regression models predicting depressive symptoms at the 4-, 6-, and 8-year follow-ups (2014, 2016, and 2018). All models adjusted for baseline (2010) depressive symptoms, baseline church-based social ties, and socio-demographic and health covariates. In Model 1, a higher frequency of religious attendance in 2010 was significantly associated with fewer depressive symptoms in 2014 (β = −0.05, p < 0.001), 2016 (β = −0.04, p < 0.05), and 2018 (β = −0.05, p < 0.01), providing support for Hypothesis 1.

Table 2.

OLS regression models of religious attendance and church-based social ties predicting depressive symptoms in 2014, 2016, and 2018 (N = 10,467).

Depressive symptoms 2014 Depressive symptoms 2016 Depressive symptoms 2018
Model 1 Model 2 Model 3 Model 4 Model 1 Model 2 Model 3 Model 4 Model 1 Model 2 Model 3 Model 4
Religious Attendance 2010 −0.05*** −0.04** −0.05*** −0.04** −0.04* −0.03† −0.03* −0.03† −0.05** −0.04* −0.05** −0.04*
Church-based friends 2012 −0.11** −0.11* −0.08† −0.08† −0.10* −0.10*
Church-based relatives 2012 −0.05 −0.02 −0.02 −0.00 −0.06 −0.04
Women (ref: Men) 0.20*** 0.20*** 0.20*** 0.20*** 0.23*** 0.23*** 0.23*** 0.23*** 0.19*** 0.19*** 0.19*** 0.19***
Race (ref: White)
 Black 0.09† 0.09* 0.09* 0.10* 0.02 0.03 0.02 0.03 0.01 0.02 0.02 0.02
 Hispanic 0.14* 0.14* 0.14** 0.14* 0.09† 0.09† 0.09† 0.09† −0.03 −0.03 −0.03 −0.03
 Other 0.02 0.01 0.02 0.02 0.12 0.12 0.12 0.12 0.14 0.14 0.14 0.14
Age 0.00 0.00 0.00 0.00 0.01*** 0.01*** 0.01*** 0.01*** 0.01*** 0.01*** 0.01*** 0.01***
Education −0.01† −0.01† −0.01† −0.01† −0.01 −0.01 −0.01 −0.01 −0.02* −0.02** −0.02** −0.02**
Household wealth −0.06*** −0.06*** −0.06*** −0.06*** −0.06*** −0.06*** −0.06*** −0.06*** −0.05*** −0.05*** −0.05*** −0.05***
Married (ref: Unmarried) −0.02
Health −0.27*** −0.27*** −0.27*** −0.27*** −0.23*** −0.23*** −0.23*** −0.23*** −0.28*** −0.28*** −0.28*** −0.28***
Depressive Symptoms 2010 0.46*** 0.46*** 0.46*** 0.46*** 0.42*** 0.42*** 0.42*** 0.42*** 0.40*** 0.40*** 0.40*** 0.40***
Church-based friendship 2010 −0.01 0.04 −0.01 0.04 −0.09* −0.05 −0.09* −0.05 −0.06 −0.01 −0.06 −0.01
Church-based relatives 2010 −0.05 −0.05 −0.03 −0.04 0.04 0.04 0.05 0.04 −0.02 −0.01 0.02 0.01
Constant 1.77*** 1.76*** 1.80*** 1.78*** 1.27*** 1.27*** 1.27*** 1.27*** 1.26*** 1.26*** 1.28*** 1.27***
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Notes.

†

p < 0.1

*

p < 0.05

**

p < 0.01

***

p < 0.001.

All models controlled for baseline depressive symptoms in 2010, and covariates, including age, sex, race-ethnicity, education, wealth, and physical health.

Models 2–4 sequentially introduced the two church-based social tie variables measured in 2012. Having relatives in the congregation was not significantly associated with depressive symptoms at any follow-up. In contrast, having friends in the congregation was associated with fewer depressive symptoms in 2014 (β = −0.11, p < 0.05) and 2018 (β = −0.09, p < 0.05), and was marginally significant in 2016 (β = −0.08, p = 0.07) in the fully adjusted model (Model 4). Although the coefficient for religious attendance decreased slightly when these mediators were added, it remained significant across waves, suggesting partial mediation. These findings provide partial support for Hypothesis 2, indicating that church-based friendships—but not relatives—are consistently linked with lower depressive symptoms over time.

Predicting church-based social ties

We next examined whether religious attendance frequency in 2010 predicted the development of church-based social ties in 2012. Table 3 presents the odds ratios (ORs) from logistic regression models predicting the likelihood of reporting a church-based friend (Model 5) and a church-based relative (Model 6), adjusting for baseline (2010) social ties and all covariates. Religious attendance frequency in 2010 was significantly associated with higher odds of both outcomes: having a church-based friend (OR = 1.90, p < 0.001) and having a church-based relative (OR = 1.24, p < 0.001) in 2012. These findings support Hypothesis 3.

Table 3.

Logistic regression models predicting church-based friendships and relatives in 2012 from religious attendance in 2010 (N = 10,467).

Church-based friends 2012 Church-based relatives 2012
Model 5 Model 6
Religious Attendance 2010 1.90*** 1.24***
Women (ref: Men) 1.03 1.03
Race (ref: White)
 Black 1.49*** 1.67***
 Hispanic 0.91 1.14
 Other 0.90 1.40*
Age 1.01* 0.98***
Education 0.98 0.95***
Household wealth 1.04* 1.01
Married (ref: Unmarried) 1.18** 1.00
Health 1.02 0.99
Depressive Symptoms 2010 0.95** 0.96**
Church-based friends 2010 8.36*** 1.25**
Church-based relatives 2010 1.20** 11.62***
cons 0.04*** 0.43**
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Notes.

*

p < 0.05

**

p < 0.01

***

p < 0.001.

All models controlled for baseline depressive symptoms in 2010, and covariates, including age, sex, race-ethnicity, education, wealth, and physical health.

Formal mediation analysis using GSEM models

We next used generalized structural equation models (GSEM) to formally test whether church-based friendships and church-based relatives (both measured in 2012) mediated the association between religious attendance in 2010 and depressive symptoms at the 4-, 6-, and 8-year follow-ups. GSEM simultaneously estimated the logistic paths predicting each binary mediator and the continuous depressive symptom outcomes (CES-D 8 scale). In Table 4, we report odds ratios (ORs) and 95% confidence intervals for the logistic paths and unstandardized coefficients for the depressive symptom outcomes.

Table 4.

GSEM models assessing the mediation effect of church-based social ties in the association between religious attendance and depressive symptoms using (N = 10,467).

Odds ratio 95% CI p-value
Church-based Friendship in 2012
 Religious attendance in 2010 1.90*** 1.81, 2.00 0.000
Church-based Relatives in 2012
 Religious attendance in 2010 1.24*** 1.18, 1.30 0.000
Coefficients 95% CI p-value
Depressive Symptoms in 2014
 Religious attendance in 2010 −0.04** −0.07, −0.01 0.006
 Church-based friendship 2012 −0.11* −0.20, −0.02 0.014
 Church-based relatives 2012 −0.03 −0.11, 0.06 0.546
Depressive Symptoms in 2016
 Religious attendance in 2010 −0.03† −0.06, 0.00 0.083
 Church-based friendship 2012 −0.08† −0.17, 0.01 0.066
 Church-based relatives 2012 −0.00 −0.09, 0.09 0.96
Depressive Symptoms in 2018
 Religious attendance in 2010 −0.04* −0.07, −0.01 0.020
 Church-based friendship 2012 −0.10* −0.019, −0.00 0.039
 Church-based relatives 2012 −0.04 −0.13, 0.05 0.338
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Notes.

†

p < 0.1

*

p < 0.05

**

p < 0.01

***

p < 0.001.

All models controlled for baseline depressive symptoms in 2010, and covariates, including age, sex, race-ethnicity, education, wealth, and physical health.

Religious attendance in 2010 was significantly associated with higher odds of having a church-based friend (OR = 1.90, p < 0.001) and a church-based relative (OR = 1.24, p < 0.001) in 2012. In turn, church-based friendship significantly predicted fewer depressive symptoms in 2014 (β = −0.11, p < 0.05) and 2018 (β = −0.10, p < 0.05) and was marginally significant in 2016 (β = −0.08, p = 0.07). Church-based relatives, however, did not significantly predict depressive symptoms in any wave. Overall, these findings provide partial support for Hypothesis 4, suggesting that church-based friendships, but not relatives, mediated the longitudinal association between religious attendance and depressive symptoms.

Bootstrapping indirect effects

To assess the statistical significance of the indirect effects estimated in the GSEM models, we used a non-parametric bootstrapping procedure with 1,000 resamples (Table 5). The indirect path through church-based friendship was statistically significant in 2014 (indirect effect = −0.01, 95% CI [−0.02 to −0.00], p = 0.019) and 2018 (−0.01, 95% CI [−0.02 to 0.00], p = 0.043), and marginally significant in 2016 (−0.01, 95% CI [−0.01 to 0.00], p = 0.073). In contrast, the indirect path through church-based relatives was not significant in any wave.

Table 5.

Bootstrapped indirect effects of religious attendance on depressive symptoms in 2014, 2016, and 2018 through church-based friendships and relatives (N = 10,467).

Coefficients Bootstrapped 95% CI p-value
Religious attendance 2010 → CES-D 2014
 Indirect effect through friendship −0.01* −0.02, −0.00 0.012
 Indirect effect through relatives −0.00 −0.00, 0.00 0.553
 Direct effect −0.04** −0.07, −0.01 0.006
 Total effect −0.05*** −0.08, −0.02 0.001
Religious attendance 2010 → CES-D 2016
 Indirect effect through friendship −0.01† −0.01, 0.00 0.082
 Indirect effect through relatives −0.00 −0.00, 0.00 0.961
 Direct effect −0.03† −0.06, 0.01 0.099
 Total effect −0.03** −0.07, −0.00 0.030
Religious attendance 2010 → CES-D 2018
 Indirect effect through friendship −0.01* −0.02, −0.00 0.043
 Indirect effect through relatives −0.00 −0.00, 0.00 0.370
 Direct effect −0.04* −0.07, −0.01 0.025
 Total effect −0.05** −0.08, −0.02 0.004
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Notes.

†

p < 0.1

*

p < 0.05

**

p < 0.01

***

p < 0.001.

All models controlled for baseline depressive symptoms in 2010, and covariates, including age, sex, race-ethnicity, education, wealth, and physical health.

Taken together, these results provide further support for Hypothesis 4, underscoring the unique role of church-based friendships in linking religious attendance to depressive symptoms over time.

Discussion

This study advances prior research by pinpointing a specific social mechanism—church-based friendships—through which religious attendance is associated with reduced depressive symptoms in later life. Drawing on nationally representative longitudinal data from older adults in the United States, we find that more frequent religious attendance predicts the presence of church-based friendships, which in turn are linked to fewer depressive symptoms in subsequent years. By contrast, familial ties within congregations do not exhibit a significant mediating role. These findings highlight the crucial role of church-based friendships in promoting mental health across later life.

We found that older adults who attended religious services more frequently had fewer depressive symptoms in subsequent years. These findings are consistent with our hypotheses and with previous literature suggesting that religious attendance may promote mental health in aging populations (Ellison et al., 2001; Koenig, 2012; Li et al., 2016; Lim & Putnam, 2010; Upenieks & Thomas, 2021; VanderWeele, 2021). Regular participation in a religious community appears to serve as a sustained resource for psychological well-being, providing immediate and enduring benefits against depressive symptoms.

Our results further reveal that friendships and familial relationships play markedly different roles: only friendships—not familial ties—within the congregation significantly mediated the effect of religious attendance on depressive symptoms. This distinction can be understood through both life course and relational contexts. For example, from a life-course perspective, religious influence from family members is strongest during formative developmental stages (Smith & Denton, 2005; Voas & Storm, 2012), as intergenerational influence is typically unidirectional, flowing more strongly from older to younger generations, with older adults serving as exemplars for relatives rather than as recipients of religious influence (Bengtson, 2017). Religious influence tends to diminish in adulthood and later life, when religious orientations tend to be more established and thus less susceptible to familial influence (Ingersoll-Dayton et al., 2002). Moreover, the social functions of these two ties may diverge significantly in later life. Church-based friendships are particularly crucial for expanding networks and creating new, meaningful interactions that directly buffer loneliness. In contrast, familial relationships, while critical, often provide support through secular contexts (e.g. caregiving, shared routines) and can sometimes involve obligations or ambivalence that do not uniformly reduce stress (Chatters et al., 2015; Hsieh & Liu, 2021). Indeed, our findings align with broader evidence that friendship-based support often predicts late-life well-being as strongly as, or more strongly than, family support (Huxhold et al., 2014). By distinguishing church-based friendships and familial connections, our analysis provides a more nuanced understanding of how social integration functions within religious contexts—an area that has been underexplored in longitudinal research.

Finally, the protective effects of church-based friendship emerged consistently across short-, intermediate-, and longer-term follow-ups (4, 6, and 8 years), suggesting that these social ties may yield durable benefits for mental health. These patterns align with the life course perspective, which emphasizes the cumulative benefits of sustained social integration over time (Pearlin et al., 2005; Thoits, 1983). Our results, therefore, highlight the potential long-term value of church-based friendships for mental health promotion among older adults. Future research should explore whether continued or increasing religious participation further strengthens these effects.

This study has several limitations. First, our measures of church-based social ties were limited to two binary indicators—having friends and having relatives in the congregation—captured only in a single wave (2012). Therefore, the church-based social ties in this study do not fully capture the multidimensional nature of social support networks, including aspects such as interaction frequency, relationship quality, and received support (Chatters et al., 2011; Krause & Wulff, 2005; Nguyen, 2020; Scheid & Brown, 2009; Taylor et al., 2022; 2024). This limitation reflects a common challenge when utilizing large-scale secondary datasets such as the HRS, which were not designed to measure church-based support with fine-grained specificity. Future studies should use datasets with more granular measures of church-based and other social ties to capture the multidimensional nature of religious integration. Second, as the social tie measures were administered to a subsample of respondents, the potential for non-random response bias cannot be ruled out. Furthermore, although we adjusted for baseline depressive symptoms and a wide range of demographic and health controls, unmeasured factors—such as personality traits or early life adversities—may influence both religious participation and mental health outcomes. Therefore, causal interpretations should be made with caution.

Conclusion

This study provides robust longitudinal evidence that more frequent religious attendance is associated with lasting mental health benefits in older adults. It also sheds light on the underlying mechanisms by identifying church-based social ties—particularly friendships—as a key mediator. Not all social connections within religious settings contribute equally to psychological well-being; our findings suggest that friendships formed within a congregation offer greater protective benefits against depressive symptoms than familial ties. This distinction refines our understanding of religious social support in later life.

Practically, these insights highlight the value of fostering social interactions within faith communities. Religious congregations may promote mental health by implementing or strengthening programs that encourage fellowship and friendship, such as small groups, social events, or mentoring initiatives. By facilitating meaningful connections, these efforts can enhance emotional support networks and help protect older members from depressive symptoms. From a clinical perspective, our findings suggest that integrating social and religious engagement into holistic mental health care may be beneficial for older adults. Mental health professionals working with older adults might consider encouraging socially isolated clients to participate in community-based or faith-oriented groups when aligned with the individual’s values. Such involvement may provide both emotional support and a renewed sense of purpose, complementing traditional therapeutic approaches. As societies continue to age, promoting the social integration of older adults through religious institutions or other community settings may help foster healthy and fulfilling aging. Future research should explore these dynamics across diverse cultural and denominational contexts and further investigate the quality and function of church-based relationships in supporting psychological well-being.

Supplementary Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2025.2594702.

Acknowledgments

We thank Patricia Thomas, Shawn Bauldry, Wencheng Zhang, Bing Han, Juwen Wang, Ranran He, Sigrid Ren, Mallory Bell, Ruiqian Li, Eric Gao, and Corey Resweber for their helpful comments on an earlier draft of this manuscript.

Footnotes

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data supporting the findings of this study are openly available on the website of the University of Michigan: https://hrs.isr.umich.edu/data-products

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Data Availability Statement

The data supporting the findings of this study are openly available on the website of the University of Michigan: https://hrs.isr.umich.edu/data-products

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