ArticleBMC public health2026
Associations between depressive symptoms and cognitive function in China older adults based on a dual-trajectory model.
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
backgroundCognitive decline and depressive symptoms often co-occur in older adults, but research on the trajectories of these two conditions and their interrelationships remains limited.
methodsUsing data from 2,823 adults aged ≥ 60 years in the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018), we identified depressive-symptom and cognitive-function trajectories using group-based trajectory modeling (GBTM) and then used a group-based dual-trajectory modeling (GBDTM) to quantify their interdependence by estimating conditional and joint probabilities across trajectory groups. Multinomial logistic regression was used to examine how baseline characteristics predicted the likelihood of membership in each trajectory group.
resultsThree distinct trajectories were identified for depressive symptoms (low: 31.0%, moderate: 46.2%, high: 22.8%) and cognitive function (high: 47.8%, declining: 34.6%, low: 17.6%). Depressive symptom trajectories mainly differed by symptom level with small fluctuations, whereas cognitive trajectories differed more in decline patterns, with modest decline in the high-functioning group and steeper declines in the other groups. Conditional and joint probabilities showed clear cross-domain linkage between depressive-symptom and cognitive-function trajectories. Dual-trajectory analysis revealed that 61.1% of participants in the low depressive symptoms group had high cognitive function, while 49.1% of the low cognition group had moderate depressive symptoms. The joint probability results showed that older adults with milder depressive symptoms were more likely to maintain high cognitive function. Higher education, better ADL function, and self-rated health were associated with favorable trajectory membership (P < 0.05).
conclusionDepressive symptoms and cognitive function were negatively associated among older Chinese adults. Interventions targeting depressive symptoms may help preserve cognitive health in aging populations.
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