Humans

Depression and physical health decline together in older adults

In 8,961 adults aged 45 and older followed over seven years, 23.96% showed high-risk deteriorating trajectories across depression, chronic diseases, pain, and disability.

Medicine4 Oct 2026, 08:59 BST

In a study of 8,961 Chinese adults aged 45 and older, researchers tracked depressive symptoms alongside chronic diseases, chronic pain, and functional disability across four survey waves from 2011 to 2018. Using data from the China Health and Retirement Longitudinal Study, group-based multi-trajectory modeling identified four distinct health patterns. A stable low-risk group made up 40.84% of participants, and a low-risk improving group comprised 11.24%. In contrast, 23.96% fell into a high-risk deteriorating group and another 23.96% entered a high-risk fluctuating group, demonstrating synchronous deterioration across physical and mental health measures. Multinomial logistic regression showed that older age, female gender, and rural residence were risk factors for unfavorable trajectories, whereas higher education, nonagricultural household registration, and social participation served as protective factors.

Why it matters

The findings show that mental health and physical multimorbidity co-evolve along distinct paths, highlighting subgroups that experience simultaneous decline across multiple health dimensions. Mapping these linked trajectories can help clinicians identify vulnerable older individuals for targeted, multi-faceted interventions.

Caveats

The observational design reveals longitudinal associations but cannot prove that depression causes physical decline or vice versa. The findings may also reflect specific social and healthcare factors unique to the Chinese cohort.