Trajectories of depressive symptoms and their predictors in Chinese elderly population: growth mixture model

Abstract

Abstract Background Given the acceleration and deepening of China's aging process and the relatively high prevalence of depressive symptoms in Chinese elderly population, this study aimed to identify the trajectories of depressive symptoms and factors associated with trajectory class to gain a better understanding of the long-term course of depressive symptoms in Chinese elderly population. Methods Data were obtained from four waves’ survey of China Health and Retirement Longitudinal Study (CHARLS). A total of 3646 participants who aged 60 or older during baseline survey and completed all follow-ups were retained in this study. Depressive symptoms were measured using the 10-item version of the Centre for Epidemiologic Studies Depression Scale (CES-D-10). Growth mixture modelling (GMM) was adopted to identify the trajectory classes of depressive symptoms, and both linear function and quadratic function were considered. Multivariate logistic regression model was performed to calculate adjusted odds ratios (ORs) of associated factors to predict trajectory class of the participants. Results The four-class quadratic function model was the best fitting model of the trajectories of depressive symptoms in Chinese elderly population. The four trajectories were labelled increasing (16.70%), decreasing (12.31%), high and stable (7.30%) and low and stable (63.69%) according to their trends. Except low and stable trajectory, other trajectories were almost above the critical line of depressive symptoms. Multivariate logistic regression model suggested that trajectories of chronic depressive symptoms could be predicted by being female, living in village, having lower education level and suffering from chronic diseases. Conclusions This study identified four depressive symptoms trajectories in Chinese elderly population and analysed associated factors of trajectory class. These findings can provide references for the prevention and intervention work to reduce chronic course of depressive symptoms in Chinese elderly population.