Relationship Between Sarcopenia and the Trajectories of Depressive Symptoms Among Chinese Older Adults: The Mediating Effect of Social Participation.

Background: This study evaluated the relationship between sarcopenia and the trajectories of depressive symptoms among Chinese older adults and verified the mediating role of social participation.

Method: The sample included 1832 participants aged ≥ 60 years from five waves of the China Health and Retirement Longitudinal Study (CHARLS). The optimal trajectory class of depressive symptoms was identified using the latent growth mixture model (LGMM). The association between sarcopenia and the trajectories of depressive symptoms was assessed by multinomial logistic regression. The potential mediating effect of social participation was evaluated through mediation analysis. Subgroup and interaction analyses were also carried out.

Results: The results showed that the depressive symptom score trajectory of the sarcopenia group was higher than that of the normal group. The depressive symptoms of the general participants had three trajectories: "Anterior high level," "Posterior high level," and "Stable low level". Sarcopenia was related to the increased odds of adverse trajectory of depressive symptoms ("Anterior high level" trajectory) (adjusted OR = 1.53, 95% CI: 1.02-2.30). Social participation mediated 10.69% of the association between sarcopenia and adverse trajectory of depressive symptoms. Sex, education, marital status, chronic disease, self-rated health status, and self-rated standard of living were modifiable factors affecting the relationship of sarcopenia and adverse trajectory of depressive symptoms.

Conclusion: Comprehensive measures including early screening and treatment for sarcopenia, the strengthening of social participation levels, and formulating targeted intervention strategies are recommended to alleviate depressive symptoms and enhance mental health.