Depressive Symptoms Trajectories and Chronic Digestive Disease in Chinese Middle-Aged and Older Adults: A Longitudinal Cohort Study

Depression is one of the risk factors for chronic digestive system diseases. As a chronic mental disorder, its occurrence and development process is usually slow and gradual, while there are significant individual differences. Depression varies among different individuals in terms of the speed of onset, the stages of the disease course and its manifestations. Therefore, we speculate that this disease will exhibit different disease development trajectories in the population. This study aims to understand the characteristics of the development trajectory of depression among middle-aged and elderly people in China, explore its association with chronic digestive system diseases, and further propose individualized measures to prevent the occurrence of chronic digestive system diseases in people with different development trajectories of depression. This research can provide scientific value for the precise prevention and management of chronic diseases among middle-aged and elderly people. Data for this analysis were sourced from the China Health and Retirement Longitudinal Study (CHARLS), which included 4565 participants aged 45 years and older. Group-based trajectory modelling was used to identify trajectories of depressive symptoms, and multivariable logistic regression was used to assess the association between these trajectories and chronic digestive diseases. Five distinct depressive symptom trajectories were identified: low-stable, moderate-stable, moderate-increase, high-decrease, and high-stable. Compared to the low-stable group, the risks of chronic digestive diseases in the moderate-stable, moderate-increase, high-decrease, and high-stable groups were 1.62(Odds RatioOR = 1.62, 95% CI: 1.31-2.00), 2.59(OR = 2.59, 95% CI: 1.96-3.41), 3.11(OR = 3.11, 95% CI: 2.35-4.10), and 3.41(OR = 3.41, 95% CI: 2.40-4.81) times higher, respectively. Subgroup analyses confirmed the robustness of these associations across most groups. In China, five distinct depressive symptom trajectories were identified among middle- aged and elderly people. The more severe and persistent the depressive symptoms were, the higher the risk of developing chronic gastrointestinal diseases. For those experiencing more severe or gradually worsening depressive symptoms, timely mental health intervention is of vital importance. These findings indicate that depression, as a key modifiable risk factor, can alleviate the burden of digestive diseases in the elderly population through early intervention.