Age-related differences in the number of chronic diseases in association with trajectories of depressive symptoms: a population-based cohort study

• Published in: BMC public health 2024-09, Vol.24 (1), p.2496-9, Article 2496
• Main Authors: Huang, Jinghong, Xu, Tianwei, Dai, Yue, Li, Yueping, Tu, Raoping
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adults; Age; Age Factors; Age factors in disease; Aged; Analysis; Arthritis; Cardiovascular diseases; Care and treatment; CHARLS; China - epidemiology; Chronic Disease - epidemiology; Chronic diseases; Chronic illnesses; Cohort Studies; Complications and side effects; Demographic aspects; Depression - epidemiology; Depression, Mental; Depressive symptoms; Development and progression; Diabetes mellitus; Diagnosis; Digestive system diseases; Dyslipidemia; Epidemiology; Female; Gastrointestinal diseases; Group-based trajectory modeling; Heart diseases; Humans; Hypertension; Kidney diseases; Liver; Liver cancer; Liver diseases; Longitudinal Studies; Lung cancer; Lung diseases; Male; Mental depression; Mental disorders; Middle Aged; Number of chronic diseases; Older people; Population studies; Psychology; psykologi; Signs and symptoms; Stroke (Disease)
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-19975-9

The number of chronic diseases has been associated with changes in depressive symptoms over time among middle-aged and older adults. This study aimed to explore the association between the number of chronic diseases and trajectories of depressive symptoms and the role of age in this association. A total of 12,974 middle-aged and older Chinese adults (≥ 45 years) participated in the China Health and Retirement Longitudinal Study (CHARLS) in waves 2011, 2013, 2015, 2018, and 2020. The number of chronic diseases was determined by self-reported hospital diagnosis of hypertension, dyslipidemia, diabetes, cancer, chronic lung diseases, liver disease, heart diseases, stroke, kidney diseases, digestive diseases, emotional, nervous, or psychiatric problems, memory-related disease, arthritis or rheumatism, asthma, and then obtaining the total number of chronic diseases. Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Group-based trajectory modeling (GBTM) was adopted to capture the trajectories of depressive symptoms over time. Multinomial logistic regressions were conducted to examine the association between the number of chronic diseases and trajectories of depressive symptoms and the role of age in this association. Four distinct trajectories of depressive symptoms were observed in 34.68% individuals in mild, 40.76% in moderate, 19.41% in increasing, and 5.15% in severe group. Compared to participants without chronic diseases, those with one, two, three or more chronic diseases had a 1.81, 3, and 7.49-fold higher risk of developing severe depressive symptom trajectory, respectively. Moreover, the association between the number of chronic diseases and severe depressive symptoms trajectory differed by age (45-59 and ≥ 60 years) (P for interaction