Association between chronic diseases and depression in the middle-aged and older adult Chinese population—a seven-year follow-up study based on CHARLS

Background With the aging of the Chinese population, the prevalence of depression and chronic diseases is continually growing among middle-aged and older adult people. This study aimed to investigate the association between chronic diseases and depression in this population. Methods Data from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2018 longitudinal survey, a 7-years follow-up of 7,163 participants over 45 years old, with no depression at baseline (2011). The chronic disease status in our study was based on the self-report of the participants, and depression was defined by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). The relationship between baseline chronic disease and depression was assessed by the Kaplan–Meier method and Cox proportional hazards regression models. Results After 7-years follow-up, 41.2% (2,951/7163, 95% CI:40.1, 42.3%) of the participants reported depression. The analysis showed that participants with chronic diseases at baseline had a higher risk of depression and that such risk increased significantly with the number of chronic diseases suffered (1 chronic disease: HR = 1.197; 2 chronic diseases: HR = 1.310; 3 and more chronic diseases: HR = 1.397). Diabetes or high blood sugar (HR = 1.185), kidney disease (HR = 1.252), stomach or other digestive diseases (HR = 1.128), and arthritis or rheumatism (HR = 1.221) all significantly increased the risk of depression in middle-aged and older adult Chinese. Conclusion The present study found that suffering from different degrees of chronic diseases increased the risk of depression in middle-aged and older adult people, and these findings may benefit preventing depression and improving the quality of mental health in this group.

[1]  Yuanli Liu,et al.  Gender differences in the associations between body mass index, depression, anxiety, and stress among endocrinologists in China , 2023, BMC Psychology.

[2]  Haixia Liu,et al.  Association Between Multiple Chronic Conditions and Depressive Symptoms Among Older Adults in China: Evidence From the China Health and Retirement Longitudinal Study (CHARLS) , 2023, International Journal of Public Health.

[3]  Yoosoo Chang,et al.  Association of changes in sleep duration and quality with incidence of depression: A cohort study. , 2023, Journal of affective disorders.

[4]  Dongxu Li,et al.  The association between chronic disease and depression in middle-aged and elderly people: The moderating effect of health insurance and health service quality , 2023, Frontiers in Public Health.

[5]  Dongdong Qin,et al.  Research progress on rheumatoid arthritis-associated depression , 2023, Frontiers in Behavioral Neuroscience.

[6]  C. Codreanu,et al.  Depression in Rheumatoid Arthritis: A Narrative Review—Diagnostic Challenges, Pathogenic Mechanisms and Effects , 2022, Medicina.

[7]  P. Wang,et al.  Anxiety and depression risk in Taiwan women with breast cancer and cervical cancer , 2022, Frontiers in Oncology.

[8]  A. Kaminga,et al.  Associations of depressive symptoms and chronic diseases with activities of daily living among middle-aged and older population in China: A population-based cohort study , 2022, Frontiers in Psychiatry.

[9]  Yaping Ye,et al.  Determining the association between different living arrangements and depressive symptoms among over-65-year-old people: The moderating role of outdoor activities , 2022, Frontiers in Public Health.

[10]  Wei Li,et al.  Association of the depressive scores, depressive symptoms, and conversion patterns of depressive symptoms with the risk of new-onset chronic diseases and multimorbidity in the middle-aged and elderly Chinese population , 2022, EClinicalMedicine.

[11]  G. Foster,et al.  Depression, anxiety, substance misuse and self-harm in children and young people with rare chronic liver disease , 2022, BJPsych Open.

[12]  Xiaowei Zheng,et al.  Prospective bidirectional associations between depression and chronic kidney diseases , 2022, Scientific Reports.

[13]  Yan Liu,et al.  The association between community-level socioeconomic status and depressive symptoms among middle-aged and older adults in China , 2022, BMC Psychiatry.

[14]  S. Brage,et al.  Association Between Physical Activity and Risk of Depression , 2022, JAMA psychiatry.

[15]  A. Akimov,et al.  The Seventh Population Census in the PRC: Results and Prospects of the Country’s Demographic Development , 2021, Herald of the Russian Academy of Sciences.

[16]  Hui Liao,et al.  Relationship between chronic diseases and depression: the mediating effect of pain , 2021, BMC Psychiatry.

[17]  P. Stute,et al.  Assessment of the climacteric syndrome: a narrative review , 2021, Archives of Gynecology and Obstetrics.

[18]  J. Yue,et al.  The mediation role of sleep quality in the relationship between cognitive decline and depression , 2021, BMC Geriatrics.

[19]  E. Fakra,et al.  RA and depression. , 2021, Joint bone spine.

[20]  Hui-Xin Wang,et al.  The relationship between chronic diseases and depression in middle-aged and older adults: A 4-year follow-up study from the China Health and Retirement Longitudinal Study. , 2021, Journal of affective disorders.

[21]  Zifeng Liu,et al.  Association between social determinants of health and direct economic burden on middle-aged and elderly individuals living with diabetes in China , 2021, PloS one.

[22]  Guangshun Wang,et al.  Gender-specific prevalence and influencing factors of depression in elderly in rural China: A cross-sectional study. , 2021, Journal of affective disorders.

[23]  Zhongliang Zhou,et al.  Comparison of Depressive Symptoms and Its Influencing Factors among the Elderly in Urban and Rural Areas: Evidence from the China Health and Retirement Longitudinal Study (CHARLS) , 2021, International journal of environmental research and public health.

[24]  Li Huang,et al.  Chronic Disease and medical spending of Chinese elderly in rural region. , 2020, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[25]  Dan J Stein,et al.  Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 , 2020, Lancet.

[26]  T. Qin,et al.  Relationships between Chronic Diseases and Depression among Middle-aged and Elderly People in China: A Prospective Study from CHARLS , 2020, Current Medical Science.

[27]  K. Nasir,et al.  Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions , 2020, Journal of the American Heart Association.

[28]  X. Lai,et al.  Association of Sensory Impairments With Cognitive Decline and Depression Among Older Adults in China , 2020, JAMA network open.

[29]  Jiayi Zhou,et al.  Relationship between the Number of Noncommunicable Diseases and Health-Related Quality of Life in Chinese Older Adults: A Cross-Sectional Survey , 2020, International journal of environmental research and public health.

[30]  E. Cohn-Schwartz Pathways From Social Activities to Cognitive Functioning: The Role of Physical Activity and Mental Health , 2020, Innovation in aging.

[31]  Xiaoying Zheng,et al.  Individual-level and area-level socioeconomic inequalities in hearing impairment among Chinese adults: a population-based study , 2020, Journal of Epidemiology & Community Health.

[32]  P. Yin,et al.  Burden of depression in China, 1990-2017: Findings from the global burden of disease study 2017. , 2020, Journal of affective disorders.

[33]  J. Hendrikse,et al.  Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity , 2019, Neuroscience & Biobehavioral Reviews.

[34]  C. Murray,et al.  Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 , 2019, The Lancet.

[35]  Ye Luo,et al.  Neighborhood Environments and Cognitive Decline Among Middle-Aged and Older People in China. , 2019, The journals of gerontology. Series B, Psychological sciences and social sciences.

[36]  Xiaoying Zheng,et al.  Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults , 2019, BMJ Open.

[37]  Wonjung Noh,et al.  Short Sleep Duration as a Risk Factor of Cardiovascular Disease in Korean Adults: Secondary Analysis of the Fifth Korean National Health and Nutrition Examination Survey , 2019, Iranian journal of public health.

[38]  J. Banks,et al.  Impacts of migration on health and well-being in later life in China: Evidence from the China Health and Retirement Longitudinal Study (CHARLS). , 2019, Health & place.

[39]  Gebremeskel Mirutse,et al.  Role of socioeconomic status and housing conditions in geriatric depression in rural China: a cross-sectional study , 2019, BMJ Open.

[40]  L. Wang,et al.  [Study of the prevalence and disease burden of chronic disease in the elderly in China]. , 2019, Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi.

[41]  B. Ham,et al.  Relationship of depression, chronic disease, self-rated health, and gender with health care utilization among community-living elderly. , 2018, Journal of affective disorders.

[42]  Y. Bao,et al.  The bidirectional relationship between sleep duration and depression in community-dwelling middle-aged and elderly individuals: evidence from a longitudinal study. , 2018, Sleep medicine.

[43]  Yu Xu,et al.  Type 2 diabetes is causally associated with depression: a Mendelian randomization analysis , 2018, Frontiers of Medicine.

[44]  F. Diderichsen,et al.  The syndemics of diabetes and depression in Brazil – An epidemiological analysis , 2018, SSM - population health.

[45]  Qun Wang,et al.  Prevalence, awareness, and treatment of depressive symptoms among the middle‐aged and elderly in China from 2008 to 2015 , 2018, The International journal of health planning and management.

[46]  M. Boysan,et al.  Heterogeneity of sleep quality in relation to circadian preferences and depressive symptomatology among major depressive patients. , 2018, Journal of affective disorders.

[47]  Ji-jie Li,et al.  Obesity and the onset of depressive symptoms among middle-aged and older adults in China: evidence from the CHARLS , 2018, BMC Public Health.

[48]  Xiaoying Zheng,et al.  Health Challenges and Opportunities for an Aging China. , 2018, American journal of public health.

[49]  N. Wang,et al.  Prevalence of anxiety and depression symptoms and their associated factors in mild COPD patients from community settings, Shanghai, China: a cross-sectional study , 2018, BMC Psychiatry.

[50]  E. Susser,et al.  Depressive symptoms and their association with social determinants and chronic diseases in middle-aged and elderly Chinese people , 2018, Scientific Reports.

[51]  Z. Mao,et al.  Association between Social Activities and Cognitive Function among the Elderly in China: A Cross-Sectional Study , 2018, International journal of environmental research and public health.

[52]  M. Delgado-Rodríguez,et al.  Systematic review and meta-analysis. , 2017, Medicina intensiva.

[53]  B. Dear,et al.  Multimorbidity and depression: A systematic review and meta-analysis. , 2017, Journal of affective disorders.

[54]  S. Robert,et al.  Neighborhood SES is particularly important to the cardiovascular health of low SES individuals. , 2017, Social science & medicine.

[55]  M. Owolabi,et al.  Depression after Stroke in Sub-Saharan Africa: A Systematic Review and Meta-Analysis , 2017, Behavioural neurology.

[56]  F. Zitman,et al.  Concordance between self‐reported and observer‐rated anxiety severity in outpatients with anxiety disorders: The Leiden routine outcome monitoring study , 2017, Psychology and psychotherapy.

[57]  Zhi-jun Li,et al.  The prevalence of depression in rheumatoid arthritis in China: A systematic review , 2017, Oncotarget.

[58]  N. Watanabe,et al.  Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. , 2017, Sleep medicine.

[59]  L. Jacob,et al.  Depression Risk in Patients with Rheumatoid Arthritis in the United Kingdom , 2017, Rheumatology and Therapy.

[60]  C. Lund,et al.  Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa , 2017, BMC Psychiatry.

[61]  L. Simmons,et al.  Public and personal depression stigma in a rural American female sample. , 2015, Archives of psychiatric nursing.

[62]  R. Olvera,et al.  Depression in Mexican Americans with diagnosed and undiagnosed diabetes , 2015, Psychological Medicine.

[63]  A. Campo‐Arias,et al.  [The Stigma-discrimination Complex Associated With Mental Disorder as a Risk Factor for Suicide]. , 2015, Revista colombiana de psiquiatria.

[64]  S. Chatterji,et al.  The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal? , 2015, BMC Medicine.

[65]  M. Cho,et al.  Factors affecting stigma toward suicide and depression: A Korean nationwide study , 2015, The International journal of social psychiatry.

[66]  T. Britt,et al.  How are perceived stigma, self-stigma, and self-reliance related to treatment-seeking? A three-path model. , 2015, Psychiatric rehabilitation journal.

[67]  J. Wardle,et al.  Sleep and nighttime energy consumption in early childhood: a population‐based cohort study , 2015, Pediatric obesity.

[68]  W. Tan,et al.  Association of Socioeconomic Status (SES) and Social Support with Depressive Symptoms among the Elderly in Singapore. , 2014, Annals of the Academy of Medicine, Singapore.

[69]  Eun-Cheol Park,et al.  A change in social activity and depression among Koreans aged 45 years and more: analysis of the Korean Longitudinal Study of Aging (2006–2010) , 2014, International Psychogeriatrics.

[70]  Anusha Prabhakaran,et al.  Depression and Stigma in Medical Students at a Private Medical College , 2014, Indian journal of psychological medicine.

[71]  John Strauss,et al.  Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). , 2014, International journal of epidemiology.

[72]  Huajuan Chen,et al.  Factorial validity of the Center for Epidemiologic Studies Depression Scale short form in older population in China , 2013, International Psychogeriatrics.

[73]  David W. Johnson,et al.  Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies. , 2013, Kidney international.

[74]  G. Miller,et al.  Socioeconomic status and health: mediating and moderating factors. , 2013, Annual review of clinical psychology.

[75]  P. Marik,et al.  Narrative Review , 2012, Journal of intensive care medicine.

[76]  S. Wyke,et al.  Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study , 2012, The Lancet.

[77]  F. Zitman,et al.  PREDICTING OUTCOME OF DEPRESSION USING THE DEPRESSIVE SYMPTOM PROFILE: THE LEIDEN ROUTINE OUTCOME MONITORING STUDY , 2012, Depression and anxiety.

[78]  Chen Changsheng,et al.  Prevalence and risk factors for depression in older people in Xi′an China: a community‐based study , 2012, International journal of geriatric psychiatry.

[79]  J. Clarke,et al.  What is a systematic review? , 2011, Evidence Based Nursing.

[80]  Pedagógia,et al.  Cross Sectional Study , 2019 .

[81]  Yoshio Sato,et al.  Current State and Future Directions , 2009 .

[82]  S. Chadban,et al.  Patients' experiences and perspectives of living with CKD. , 2009, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[83]  L. Hasche,et al.  Structural relationships between social activities and longitudinal trajectories of depression among older adults. , 2009, The Gerontologist.

[84]  D. Ahn,et al.  Effect of cross-level interaction between individual and neighborhood socioeconomic status on adult mortality rates. , 2006, American journal of public health.

[85]  Thomas A Glass,et al.  Social Engagement and Depressive Symptoms in Late Life , 2006, Journal of aging and health.

[86]  P. Kimmel,et al.  Depression in patients with end-stage renal disease treated with dialysis: has the time to treat arrived? , 2006, Clinical journal of the American Society of Nephrology : CJASN.

[87]  Sheung-Tak Cheng,et al.  The Center for Epidemiologic Studies Depression Scale in older Chinese: thresholds for long and short forms , 2005, International journal of geriatric psychiatry.

[88]  E. Freeman,et al.  Acute consequences of the menopausal transition: the rise of common menopausal symptoms. , 2004, Endocrinology and metabolism clinics of North America.

[89]  C. Guilleminault,et al.  Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. , 2004, Sleep.

[90]  M. Ohayon Interactions between sleep normative data and sociocultural characteristics in the elderly. , 2004, Journal of psychosomatic research.

[91]  L. Berkman,et al.  From social integration to health: Durkheim in the new millennium. , 2000, Social science & medicine.

[92]  D L Patrick,et al.  Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). , 1994, American journal of preventive medicine.

[93]  S. Leeder,et al.  A population based study , 1993, The Medical journal of Australia.

[94]  L. Radloff The CES-D Scale , 1977 .

[95]  M. Mipando,et al.  A cross-sectional survey , 2021 .

[96]  J. Strauss,et al.  China Health and Retirement Longitudinal Study (CHARLS) , 2019, Encyclopedia of Gerontology and Population Aging.

[97]  Dan Li,et al.  A meta-analysis of the prevalence of depressive symptoms in Chinese older adults. , 2014, Archives of gerontology and geriatrics.

[98]  S. Weich,et al.  The cohort study , 1998 .

[99]  L. Radloff The CES-D Scale: A Self-Report Depression Scale for Research in the General Population — Source link , 2022 .