Key result
Gastrointestinal and hepatic diseases predict ~73% higher odds of stable high depressive symptoms.
Why the study?
To examine associations between gastrointestinal and hepatic diseases and long-term depressive symptom trajectories in older adults across diverse cultural and healthcare settings.
Do gastrointestinal and hepatic diseases predict persistent depressive trajectories in older adults?
Cohort (n=40,161)
Yes
Do gastrointestinal and hepatic diseases predict persistent depressive trajectories in older adults?
Chronic gastrointestinal conditions independently predict persistent severe depressive trajectories in older adults across diverse cultural settings, suggesting a gut-brain axis mechanism.
Answers are grounded in this paper and cite their sources.
May warrant integrated GI-mental health screening in older adults; hypothesis-generating across cultures and leaves causality open.
Objective To examine associations between gastrointestinal and hepatic diseases (GIHD) and long-term depressive symptom trajectories in older adults across diverse cultural and healthcare settings. Methods Longitudinal data from four aging cohorts were harmonized: CHARLS (China), SHARE (Europe), HRS (United States), and KLOSA (South Korea), comprising 40,161 adults aged ≥60 years with 4-6 follow-up waves. Group-based trajectory modeling (GBTM) identified distinct depressive symptom trajectories. Multinomial logistic regression, adjusted for baseline depressive symptoms and covariates, estimated odds of trajectory membership. Random-effects meta-analysis with Hartung-Knapp correction pooled cohort-specific estimates. Inverse probability weighting (IPW) and E-values assessed robustness to confounding. Results Three trajectories were identified in all cohorts: Stable Low, Increasing Mild, and Stable High. After adjustment for baseline depressive symptoms, GIHD independently predicted Stable High trajectory membership (pooled OR = 1.73, 95% CI: 1.31-2.28; I 2 = 21.2%). Upper gastrointestinal disorders showed exceptional cross-cultural consistency (pooled OR = 1.80, 95% CI: 1.69-1.92; I 2 = 0%). Liver disease was significantly associated in CHARLS (OR = 2.64, 95% CI: 1.15-6.07) but not in KLOSA. Associations were consistent across sexes ( P for interaction = 0.417). IPW confirmed robustness (CHARLS OR = 1.40; SHARE OR = 1.11), and E-values indicated resistance to unmeasured confounding (E-value = 1.97). Conclusions Chronic gastrointestinal conditions independently predict persistent severe depressive trajectories in older adults across four countries. The zero heterogeneity for upper gastrointestinal disorders suggests a gut-brain axis mechanism, supporting systematic depression screening in geriatric gastroenterology practice.
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Wu et al. (2026) conducted a cohort in Gastrointestinal and hepatic diseases and depressive symptoms (n=40,161). Gastrointestinal and hepatic diseases (GIHD) vs. Absence of GIHD was evaluated on Stable High depressive symptom trajectory membership (OR 1.73, 95% CI 1.31-2.28). Gastrointestinal and hepatic diseases independently predicted membership in a stable high depressive symptom trajectory among older adults.
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