Heterogeneous trajectories of depressive symptoms in the aging process: A sequence analysis within nine-year follow-ups of Chinese cohorts.

Abstract

Objective: Depression in later life has increasingly become alarming with the progressive population aging worldwide, but the dynamics of depressive symptoms may vary across individuals in the aging process. This study aims to investigate heterogeneity in trajectories of depressive symptoms among Chinese cohorts as they age and examine demographic and socioeconomic factors associated with different trajectory patterns.

Methods: Using data from the 2011-2020 China Health and Retirement Longitudinal Study (CHARLS), the study employed sequence analysis to address heterogeneity in the trajectories of depressive symptoms for Chinese cohorts aged 45-64 years (n = 6161) in 2011 and conducted multinomial logistic regression to examine factors associated with the trajectory membership.

Results: 43% of respondents did not report depressive symptoms over the study period. An additional eight types of trajectories of depressive symptoms were identified among respondents who experienced the emergence, persistence, or remission of depression over time. Better socioeconomic conditions were associated with decreased risks of entering depressive trajectories. Age was not necessarily linked to the presence of depression; yet, age-related events and experiences, such as the loss of spouse, diminishing family connections, and declining physical health, played significant roles in developing and sustaining depressive symptoms as people aged.

Conclusions: Trajectories of depressive symptoms exhibit great heterogeneity across populations entering older ages. While long-term efforts should target socioeconomic inequalities, promoting social connections offers a modifiable pathway to mitigate depressive risk in the aging population.