Changes in depression among older adults in China: A latent transition analysis.

Depression in late life is an important public health problem in developing countries. It is timely to investigate stability and transition patterns of depressive symptom subtypes. Longitudinal data were used from the China Health and Retirement Longitudinal Study (CHARLS). A total of 853 women and 930 men aged 60-96 years were recruited. Latent class and latent transition analysis (LCA/LTA) were used to identify meaningful subgroups, transitions between those classes across time, and baseline demographic features that help to predict and design tailored interventions. Three depression subgroups were identified: Class 1 was labeled "Mild Depression"; Class 2 was labeled "Severe Depression" and class 3 was labeled "Lack of Positive Affect". A predominant tendency for stability appeared rather than change, meanwhile individual in Mild Depression and Severe Depression latent status both had a high probability to convert to the Lack of Positive Affect latent status. Social activities played a significant role in buffering the effect of depression, while individuals with chronic diseases, having difficulty with ADLs and smoking might be at-risk groups. The limitations of the present study were inherent limitation in the LTA model and some small proportion of transitions. This study demonstrated a transition pattern in older adult depression within a person-centered approach. Differential treatment effects were found across baseline depression class, suggesting the benefit for tailored intervention programs to improve depression outcomes among older adults.

Ni Y ，Tein JY ，Zhang M ，Yang Y ，Wu G ... -  《-》

Latent transition of social participation and its effects on depression among older adults in China: A National Longitudinal Study.

Wang Y ，Xu X ，He Y ，Liu J ，Lv Q ，Chang H ，Fu L ，Zhao Y ，Zhang X ，Zang X ... -  《-》

Characteristics of the cognitive function transition and influencing factors among Chinese older people: An 8-year longitudinal study.

Cognitive impairment among older people is an important public health problem in developing countries. Therefore, it is necessary to identify the subtypes of cognitive function among older people in China, and explore the transformation patterns and influencing factors. Longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) were used, and included 2140 women and 2049 men aged over 60 years. Latent profile and latent transition analysis (LPA&LTA) were used to identify subgroups and transitions between the profiles over time. Influencing factors were identified by multinomial logistic regression analysis. According to the LPA model, three subgroups of cognitive function were identified: Cognitive Impairment, Mild Cognitive Impairment (MCI) and Normal Cognitive Function. Concurrently, >50 % of participants were likely to progress to MCI after seven years, whereas participants with cognitive impairment had a probability of 54.2 % of transitioning to a better cognitive profile. Older adults are less likely to experience cognitive improvement, higher levels of education affect changes in cognition, and having depression are at a lower risk of cognitive decline. Due to the incompleteness of the cognitive assessment and the large time span, there was a certain bias in the classification and analysis of latent cognitive profiles. This study identified three latent profiles among Chinese older people and showed the stability and heterogeneity. It demonstrated the effects of higher age or levels of education, and depression on changes in cognitive function in older people.

Du Y ，Hu N ，Yu Z ，Liu X ，Ma Y ，Li J ... -  《-》

Prospective relationship of depressive symptoms, drinking, and tobacco smoking among middle-aged and elderly community-dwelling adults: Results from the China Health and Retirement Longitudinal Study (CHARLS).

Previous studies in Western countries have consistently documented positive associations of smoking and heavy drinking with depressive symptoms but a prospective analysis of these relationships among middle-aged and elderly community members in China have not previously been reported. Using data from the China Health and Retirement Longitudinal Study, a two-wave nationally representative survey conducted in 15,628 adults 45 years of age and older, we estimated the prospective association between depressive symptoms and an array of smoking and drinking behaviors. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Inverse associations were the dominant pattern of association. For the population as a whole, individuals with baseline depressive symptoms were less likely to start drinking (OR=0.7, 95% CI=0.5, 0.9) or smoking (OR=0.6, 95% CI=0.4, 0.8). Similarly, baseline drinkers and smokers were less likely to develop depressive symptoms (ORdrinkers=0.6, 95% CI=0.5, 0.7; ORsmokers=0.7, 95% CJ=0.6, 0.9). No evidence was found for an increased incidence or persistence of depressive symptoms among high-frequency drinkers or heavy smokers or vice versa. Males who had never smoked prior to the onset of depressive symptoms tended to have more rapid onset of tobacco dependence compared to those without such symptoms. Males and females had different association patterns. The study is observational in nature and provides limited evidence for causality. The results are inconsistent with previous findings in Western countries, throwing into question the presumed universality of the association between alcohol drinking or tobacco use and depression among middle-aged and elderly adults.

Cheng HG ，Chen S ，McBride O ，Phillips MR ... -  《-》

Life course socioeconomic position and incidence of mid-late life depression in China and England: a comparative analysis of CHARLS and ELSA.

Despite the growing prevalence of depression in the Chinese elderly, there is conflicting evidence of life course socioeconomic position (SEP) and depression onset in China, and whether this association is akin to that observed in Western societies. We compared incident risk of mid-late life depression by childhood and adulthood SEP in China and England, a country where mental health inequality is firmly established. Depression-free participants from the China Health and Retirement Longitudinal Study (N=8508) and the English Longitudinal Study of Ageing (N=6184) were studied over 4 years. Depressive symptoms were classified as incident cases using the Center for Epidemiologic Studies Depression Scale criteria. Associations between SEP (education, wealth, residence ownership and childhood/adolescent deprivation) and depression symptom onset were assessed using Cox proportional hazards models. In China, we also investigated children's government employment status as a SEP marker. Higher education and wealth predicted lower incidence of depression in both countries. The association with non-ownership of residence appeared stronger in England (HR 1.61, 95% CI 1.41 to 1.86) than in China (HR 1.11, 95% CI 0.95 to 1.29), while that with childhood/adolescent deprivation was stronger in China (HR 1.43, 95% CI 1.29 - 1.60) than in England (HR 1.33, 95% CI 0.92 to 1.92). Chinese adults whose children were employed in high-status government jobs, had lower rates of depression onset. Consistent findings from China and England demonstrate that SEP is a pervasive determinant of mid-late life depression in very diverse social contexts. Together with conventional measures of SEP, the SEP of children also affects the mental health of older Chinese.

Ruiz M ，Hu Y ，Martikainen P ，Bobak M ... -  《-》