Couple depression concordance and adverse health outcomes among middle-aged and older adults: A longitudinal study in China

Abstract

Objectives

Little is known about the interactive patterns of depressive symptoms and the consequent joint health burden in couples. This study aimed to evaluate the impacts of couple depression concordance on activities of daily living (ADL) disability, instrumental ADL (IADL) disability, hospitalization, and all-cause mortality among middle-aged and older couples.

Study design

This study used a longitudinal research design.

Methods

Data were obtained from the China Health and Retirement Longitudinal Study. At baseline, 3985 couples aged 45 years and older were included, being categorized into four groups: nondepressed husband-nondepressed wife (NN), depressed husband-nondepressed wife (DHNW), nondepressed husband-depressed wife (NHDW), and depressed husband-depressed wife (DD). Modified Poisson regression models were used to estimate relative risks (RRs) in terms of short-term (2011–2013) and long-term (2011–2018) follow-up.

Results

Compared with participants in the NN group, those in the other three groups were at increased risk of ADL and IADL disability (P < 0.001), with the highest risk in the DD group. Any partner with depressive symptoms in a couple was associated with increased risks of ADL and IADL disability for both members. Depressed middle-aged couples were at a higher long-term risk of ADL disability than the elderly (P _interaction = 0.031). Additionally, participants in the DD group had a significantly increased risk of hospitalization.

Conclusions

Depressive symptoms and subsequent health decline are interdependent in couples. Couples where both individuals have depressive symptoms are particularly vulnerable. More consideration should be given to couple-based management and treatment strategies in addressing depression and its detrimental consequences.