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Arthritis/Rheumatism and Depressive Symptoms in Middle-Aged and Older Chinese Adults: Regression and Symptom Network
Zhujun Chen1, Xiang Duan2, Hong Yang1
1Department of Spine Surgery, Wuhan Fourth Hospital, Hubei Provincial Sports Medicine Center, Hubei Provincial Clinical Research Center for Orthopaedics, Hubei Key Laboratory of Sports Injury and Precision Therapy, Wuhan 430033, China.
Insights
Arthritis and rheumatic diseases are linked to increased depressive symptoms in older adults. Specific symptoms like sleep disturbance and low perceived effort are notably connected, suggesting targeted screening is beneficial.
Area of Science:
- Gerontology
- Psychiatry
- Rheumatology
Background:
- Arthritis and rheumatic diseases commonly co-occur with depression in older adults.
- Previous research often focused on total depression scores, neglecting symptom-level analysis.
- This study addresses the need for detailed symptom-level associations between these conditions.
Purpose of the Study:
- To investigate population-level and symptom-level associations between arthritis/rheumatism and depressive symptoms.
- To identify specific depressive symptoms linked to arthritis/rheumatism.
- To explore differences in depressive symptom networks between individuals with and without arthritis/rheumatism.
Main Methods:
- Utilized data from 15,721 adults aged ≥ 45 from the 2018 China Health and Retirement Longitudinal Study (CHARLS).
- Employed hierarchical linear regression to assess overall associations.
- Applied network analysis to examine symptom-level connections and compare networks.
Main Results:
- Arthritis/rheumatism showed a significant association with higher depressive symptom levels (β = 0.07, p < 0.001) after covariate adjustment.
- Depressed mood and perceived effort were identified as the most central depressive symptoms.
- Restless sleep and perceived effort demonstrated the strongest bridge connections to arthritis/rheumatism; low hope centrality decreased in this group.
Conclusions:
- Arthritis/rheumatism is associated with a higher burden of depressive symptoms.
- Specific symptom-level connections, particularly involving sleep disturbance and perceived effort, are highlighted.
- Screening for sleep and effort-related symptoms in adults with arthritis/rheumatism may offer clinical value.
Abstract:
Background: Arthritis and rheumatic diseases frequently co-occur with depressive symptoms in middle-aged and older adults. However, most previous studies have relied on total depression scores and have paid less attention to symptom-level associations. This study aimed to examine population-level and symptom-level associations between arthritis/rheumatism and depressive symptoms. Methods: Data were drawn from 15,721 adults aged ≥ 45 years from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey in China. Hierarchical linear regression analyses were used to examine the associations between arthritis/rheumatism and depressive symptoms. Network analysis was used to estimate symptom-level networks and compare depressive symptom networks between participants with and without arthritis/rheumatism. Results: After adjustment for sociodemographic and health-related covariates, arthritis/rheumatism remained significantly associated with higher depressive symptom levels (β = 0.07, p < 0.001). Network analysis showed that depressed mood and perceived effort were the most central symptoms, while restless sleep and perceived effort showed the strongest bridge connections with arthritis/rheumatism. Network comparison analyses indicated no significant differences in global network structure or global strength between participants with and without arthritis/rheumatism. However, four symptom connections were significantly stronger, and low hope showed reduced centrality in participants with arthritis/rheumatism. Conclusions: Arthritis/rheumatism was associated with greater depressive symptom burden and with specific symptom-level connections involving sleep disturbance and perceived effort. These findings highlight the potential value of screening for sleep problems and effort-related symptoms in adults with arthritis/rheumatism.
