Journal of Affective Disorders · Mar 26, 2025
Depressive symptoms trajectories and cardiovascular disease in Chinese middle-aged and older adults: A longitudinal cohort study
By Yan R, Hu Y, Yang J et al.
OBJECTIVES: Depression is increasingly recognized as a potential factor associated with cardiovascular disease. Unlike single time-point assessments, evaluating the long-term trajectories of depressive symptoms may offer deeper insights into their relationship with CVD. This study examines the association between long-term depressive symptoms trajectories and CVD among middle-aged and older Chinese adults. METHODS: This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2011 and 2018, including 8792 participants aged 45 years and older. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D 10). Self-reported cardiovascular events (such as heart attack and stroke) were recorded in 2018. Group-Based Trajectory Modeling (GBTM) was employed to identify long-term patterns of depressive symptoms trajectories. RESULTS: Three distinct depressive symptoms trajectories were identified: stable low depressive symptoms (53.0 %), moderate increasing depressive symptoms (36.8 %), and high depressive symptoms (10.2 %). Multivariable logistic regression revealed a significant association between depressive symptoms trajectories and CVD after adjusting for covariates. Compared to the stable low depressive symptoms trajectory group, the moderate increasing depressive symptoms trajectory group showed a significantly stronger association with heart disease, while the persistently high depressive symptoms trajectory group exhibited significantly higher likelihoods of both heart disease and stroke. CONCLUSIONS: Long-term depressive symptoms trajectories are strongly related to elevated likelihoods of CVD in middle-aged and older adults in China. These findings highlight the need for sustained depression management to mitigate cardiovascular outcomes.