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A study on the trajectory of depression in Chinese middle-aged and elderly patients with cardiometabolic
Li Yueren1, Geng Yadong2, Liu Honglin2
1Department of Emergency Medicine, the First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, P.R. China.
Insights
Cardiovascular metabolic comorbidity (CMM) is linked to depression trajectories in older adults. Short sleep and lack of social activity increase the risk of fluctuating depression, highlighting the need for integrated care.
Area of Science:
- Gerontology
- Public Health
- Psychiatry
Background:
- Cardiovascular metabolic comorbidity (CMM) is a known risk factor for depression in middle-aged and older adults.
- The specific relationship between depression trajectories and CMM requires further investigation.
Purpose of the Study:
- To explore the relationship between depression trajectories and CMM in middle-aged and older Chinese adults.
- To identify distinct patterns of depressive symptoms over time in this population.
Main Methods:
- Utilized four waves of data (2011-2018) from the China Health and Retirement Longitudinal Study (CHARLS).
- Included 848 participants aged 45+ with CMM and at least three depressive symptom assessments.
- Applied group-based trajectory modeling (GBTM) to identify depression trajectories and multinomial logistic regression for association analysis.
Main Results:
- Identified four distinct depression trajectories: Low-stable (45.01%), Relieved (31.48%), Worsen (12.20%), and High-fluctuating (11.32%).
- Short sleep duration (<7 hours) was associated with increased odds of the High-fluctuating trajectory (OR=3.01).
- Non-participation in social activities also increased odds of the High-fluctuating trajectory (OR=1.87).
Conclusions:
- Depressive symptoms in older Chinese adults with CMM follow distinct long-term patterns.
- Integrating sleep management, gender-sensitive care, and social support is crucial for managing CMM and mitigating depression risk.
Abstract:
Research indicates that cardiovascular metabolic comorbidity (CMM) is an important risk factor for depression in middle-aged and older adults. However, the relationship between depression trajectories and CMM remains unclear. This study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS) to explore the relationship between depression trajectories and CMM in middle-aged and older adults. This study utilized four waves of data (2011, 2013, 2015, and 2018) from the China Health and Retirement Longitudinal Study (CHARLS), including 848 participants aged 45 years and older with CMM, each with depressive symptom assessments at a minimum of three time points. Group-based trajectory modeling (GBTM) was applied to identify distinct depressive symptom trajectories, with model fit evaluated using the Bayesian information criterion (BIC), average posterior probability (AvePP), and odds of correct classification (OCC). Multinomial logistic regression was used to examine associations between sociodemographic characteristics and trajectory membership. Four depression trajectories were identified: Low-stable (45.01%), Relieved (31.48%), Worsen (12.20%), and High-fluctuating (11.32%). Pronounced gradients were observed for sex (p < 0.001), education (p < 0.001), rural residence (p < 0.001), marital status (p = 0.048), contact with children (p = 0.032), smoking (p = 0.031) and sleep duration (p < 0.001). In multivariable analyses, short sleep duration (<7 h) was consistently associated with increased odds of the High-fluctuating trajectory (OR = 3.01, 95% CI 1.81-5.00). Non-participation in social activities was associated with increased odds of the High-fluctuating trajectory (OR = 1.87, 95% CI 1.16-3.01). Among middle-aged and older Chinese adults living with CMM, depressive symptoms follow four distinct long-term patterns: Low-stable, Relieved, Worsen, and High-fluctuating. These findings underscore the importance of integrating sleep pattern, gender-sensitive care and social support into routine management of CMM to mitigate the risk of chronic or relapsing depression in this population.
