Associations Between Somatic Multimorbidity Patterns and Depression in a Longitudinal Cohort of Middle-Aged and Older Chinese |
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| Affiliation: | 1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China;2. Medical Informatics Center, Peking University, Beijing, China;3. Department of Medicine, Yale School of Medicine, New Haven, CT;1. Department of Medicine and Geriatrics, Careggi Hospital and University of Florence, Florence, Italy;2. Centro di Valutazione e Ricerca Gerontologica, Chair of Geriatrics, University of Modena and Reggio Emilia, Modena, Italy;3. SCDU Geriatria e Malattie Metaboliche dell''Osso, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy;4. Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy;5. Department of Health Sciences, University of Milano Bicocca and Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy;6. Medicine and Geriatric Unit, Spedali Civili of Brescia, Brescia, Italy;7. Geriatric Department, SS. Trinità Hospital, Cagliari, Italy;8. S. Maria di Ca'' Foncello Hospital, Treviso, Italy;9. Geriatric Unit, Santa Chiara Hospital, Trento, Italy;10. Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy;11. S. Jacopo Hospital, Azienda USL 3, Pistoia, Italy;12. Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy;1. Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy;2. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden;3. National Research Council, Neuroscience Institute, Padova, Italy;4. Stockholm Gerontology Research Center, Stockholm, Sweden;5. Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden;6. Allied Health Professionals, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden |
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| Abstract: | ObjectivesDepressive symptoms are commonly seen among patients with multiple chronic somatic conditions, or somatic multimorbidity (SMM); however, little is known about the relationships between depressive symptoms and different SMM combinations. Our study aimed to delineate the patterns of SMM and their longitudinal associations with depressive symptoms among a nationally representative sample of middle-aged and older Chinese adults.DesignWe employed a longitudinal design.Setting and ParticipantsOlder adults (N = 10,084) aged ≥45 years from the China Health and Retirement Longitudinal Study 2011-2015 participated (mean age = 57.7 years at baseline; 53.3% men).MethodsSixteen chronic somatic conditions were ascertained at baseline via questionnaires. Depression was assessed with the Center for Epidemiological Studies Depression Scale at baseline and during follow-up. Patterns of SMM were identified via exploratory factor analyses. Generalized estimating equations were used to evaluate the longitudinal associations between patterns of SMM and the presence of depressive symptoms at follow-up.ResultsCompared with participants with no somatic condition, those with 1, 2, and 3 or more somatic conditions had a 21%, 66%, and 111% greater risk, respectively, for the presence of depressive symptoms. Increased factor scores for 4 patterns identified, cardio-metabolic pattern [adjusted odds ratio (AOR) 1.12, 95% confidence interval (CI) 1.06, 1.20], respiratory pattern (AOR 1.25, 95% CI 1.17, 1.33), arthritic-digestive-visual pattern (AOR 1.29, 95% CI 1.22, 1.37), and hepatic-renal-skeletal pattern (AOR 1.09, 95% CI 1.02, 1.16), were all associated with a higher risk of having depressive symptoms.Conclusions and ImplicationsAll SMM patterns were independently associated with depression among middle-aged and older Chinese adults, with greater odds for people with comorbid arthritic-digestive-visual conditions and respiratory conditions. Clinical practitioners should treat the middle-aged and older population under a multiple-condition framework combining SMM and mental disorders. |
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| Keywords: | Somatic multimorbidity depression geriatric population |
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