ArticleBMC public health2026
Depressive symptom trajectories and the association with diabetes and cardiovascular diseases in middle-aged and older Chinese adults: a cohort study.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundsPrevious studies have reported that depressive symptoms were associated with diabetes and cardiovascular diseases(CVDs). However, the association between long-term depressive symptom patterns and risk of diabetes and CVDs remains unclear. The aim of this study was to assess the association between depressive symptom trajectories and subsequent new-onset diabetes and CVDs in middle-aged and older adults in China.
methodsThis is a longitudinal study conducted in China. The study included 7,568 middle-aged and older adults individuals aged 45 and above from the first to fifth waves of the Chinese Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), and Group-Based Trajectory Modeling (GBTM) were used to identify the longitudinal changes in depressive symptoms over an 8-year period. The average age of these individuals was 56.66 ± 8.41 years, and the average CESD-10 score was 7.61 ± 4.61. The outcomes were incident diabetes and CVDs. Logistic regression was performed to explore the relationship between depressive symptoms, diabetes and CVDs.
resultsA total of four trajectories of CESD-10 were identified: no depressive symptoms group (4812 participants, [63.58%]), decreasing depressive symptoms group (991participants, [13.10%]), increasing depressive symptoms group (1260 participants, [16.65%]), and persistently high depressive symptoms group (505 participants, [6.67%]).With follow-up until 2020, 320[4.23%] and 503[6.65%] participants were newly diagnosed with diabetes and CVDs, respectively. In the multiple-adjusted model, participants in the increasing depressive symptoms and persistently high depressive symptoms group had an increased risk of developing diabetes compared with participants in the no depressive symptoms group, with Odds Ratios [ORs] (95% Confidence Intervals [CI]) of 1.51 (1.12–2.03) and 1.74 (1.15–2.65), respectively. Compared with the no depressive symptoms group, those who followed decreasing depressive symptoms (ORs = 1.33, 95%CI: 1.01–1.75), increasing depressive symptoms (ORs = 1.48, 95%CI: 1.16–1.89), persistently high depressive symptoms group (ORs = 1.68, 95%CI: 1.21–2.35) participants had a significantly higher risk of developing CVDs.
conclusionsIndividuals with increased and persistent depressive symptoms over time were associated with an increased risk of developing diabetes and CVDs. These long-term depressive symptom trajectories are strong predictors of developing diabetes and cardiovascular disease, highlighting the urgent need to improve depression management in China to reduce the burden of these related diseases.
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