Bidirectional association between depression and multimorbidity in middle-aged and elderly Chinese adults: a longitudinal cohort study

Abstract

Background

Few studies have investigated the bidirectional association between depression and multimorbidity from a longitudinal perspective. We aimed to explore the bidirectional relationship between depression and multimorbidity in a middle-aged and elderly Chinese population.

Methods

Participants aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS) were included. Depression was measured with a 10-item version of the Center for Epidemiological Studies Depression Scale (CESD-10). In stage I, we assessed the association of baseline depression with follow-up multimorbidity. In stage II, we examined whether multimorbidity increases the risk of depression. Logistic regression models were used to estimate the odds ratios (ORs) and confidence intervals (CIs). The ORs were then converted to risk ratios (RRs) using a proposed formula.

Results

A total of 7056 subjects without multimorbidity and 7587 subjects without depression at baseline were included in stage I and stage II. In stage I, the adjusted RRs (95% CIs) of depressed participants developing one disease, two diseases, three diseases, and ≥4 diseases were 1.15 (0.96–1.35), 1.64 (1.36–1.99), 1.84 (1.44–2.35) and 2.42 (1.75–3.34), respectively. In stage II, compared with individuals without any disease, the adjusted RRs (95% CIs) of developing depression for individuals carrying one disease, two diseases, three diseases, and ≥4 diseases were 1.08 (0.96–1.22), 1.39 (1.22–1.57), 1.46 (1.23–1.70) and 1.62 (1.34–1.93), respectively.

Conclusions

Baseline depression increases the risk of future multimorbidity, and multimorbidity also contributes to an increased risk of incident depression in middle-aged and elderly Chinese adults.

Keywords:

• Depression
• multimorbidity
• bidirectional relationship
• CHARLS

Acknowledgements

This analysis uses data or information from the Harmonized CHARLS dataset and Codebook, Version C as of April 2018 developed by the Gateway to Global Aging Data. The development of the Harmonized CHARLS was funded by the National Institute on Ageing (R01 AG030153, RC2 AG036619, R03 AG043052). For more information, please refer to www.g2aging.org.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by National Natural Science Foundation of China (81703316, 81973143, 81703322); Medical Scientific Research Foundation of Guangdong Province of China (A2019438); and A Project Funded by Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).