Association between swallowing function and depressive symptoms among community-dwelling older adults: A cross-sectional study in Central China

BACKGROUND: Swallowing dysfunction and depressive symptoms are prevalent among older adults. This study explored the association between swallowing function and depressive symptoms among community-dwelling older adults. METHODS: This cross-sectional study included Chinese community-dwelling older adults (≥65 years old) in 2023, using cluster random sampling. Questionnaires were used to collect information on swallowing function (10-item Eating Assessment Tool), depressive symptoms (9-item Patient Health Questionnaire), sociodemographic characteristics, health status, and lifestyle. Multivariable logistic regression models and Directed Acyclic Graphs were used to identify factors associated with depressive symptoms. Propensity Score Matching (PSM) was used to explore the association between swallowing function and depressive symptoms. RESULTS: Totally, 8388 participants were included. The prevalences of depressive symptoms and swallowing dysfunction were 16.40 % (95 % CI: 15.52 %-17.19 %) and 22.06 % (95%CI: 19.86 %-24.25 %), respectively. The multivariate regression model showed that swallowing function was one of the factors associated with depressive symptoms (OR = 1.699, 95 % CI = 1.448-1.995, P < 0.001). The risk ratio for depressive symptoms was significantly higher in the participants with swallowing dysfunction than those with normal swallowing function [(23.29 %, 431/1850) vs. (945/6538, 14.45 %), P < 0.001] There were 17 out 38 of variates enrolled in the PSM covariate set. A total of 1850 pairs of participants were matched and PSM revealed a 6.64 % difference in the risk ratio for depressive symptoms [(23.29 %, 431/1850) vs. (16.65 %, 308/1850), P < 0.001]. The PSM robustness test supported the stability and reliability of the results. CONCLUSIONS: In Chinese community-dwelling older adults, swallowing dysfunction was positively associated with depressive symptoms.