Abstract
Objectives
Depressive 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.
Design
We employed a longitudinal design.
Setting and Participants
Older 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).
Methods
Sixteen 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.
Results
Compared 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 Implications
All 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.
Keywords
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Article info
Publication history
Published online: January 13, 2020
Footnotes
This work was supported by 2 grants from National Natural Science Foundation of China (grant number 81703304 and 81973130). The sponsors did not play a role in the study design, methods, subject recruitment, data collections, analysis, and preparation of the manuscript.
The authors declare no conflicts of interest.
Identification
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© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
