The vicious cycle of depressive symptoms and disability in older adults
Background: Unidirectional researches have suggested a correlation between depressive symptoms and disability, but it remains uncertain whether this association is bidirectional. Methods: The study is based on the 1st-10 th waves of the NHATS (National Health and Aging Trends Study). The subset A an...
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| Format: | Article |
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Elsevier
2025-09-01
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| Series: | The Journal of Nutrition, Health and Aging |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1279770725001745 |
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| author | Mengzhen Sun Xiaoru Sun Hui Zhang Xiaoyan Jiang Xiaofeng Wang Qi Zhang |
| author_facet | Mengzhen Sun Xiaoru Sun Hui Zhang Xiaoyan Jiang Xiaofeng Wang Qi Zhang |
| author_sort | Mengzhen Sun |
| collection | DOAJ |
| description | Background: Unidirectional researches have suggested a correlation between depressive symptoms and disability, but it remains uncertain whether this association is bidirectional. Methods: The study is based on the 1st-10 th waves of the NHATS (National Health and Aging Trends Study). The subset A and subset B included 3,459 and 3,801 samples, respectively. A random-intercept cross-lagged panel model was employed to explore the bidirectional dynamic relationship between depressive symptoms and physical function indicators, including BADL (basic ADL), IADL (instrumental ADL), and ADL (a combination of BADL and IADL). Results: An increase in depressive symptoms led to a decline in physical function at all levels, and vice versa. When older adults experienced poorer physical function than usual, their subsequent depressive symptoms were stronger (BADL, β = 0.082, p < 0.0001; IADL, β = 0.072, p < 0.001; ADL, β = 0.098, p < 0.0001). Conversely, an increase in earlier depressive symptoms resulted in a future decline in physical function (BADL, β = 0.042−0.057, p < 0.05; IADL, β = 0.048, p < 0.05; ADL, β = 0.061, p < 0.01). Conclusions: This study is the first to reveal a mutually reinforcing spiral effect between increased depressive symptoms and declines in any level of physical function. These findings highlight the importance of prevention strategies guided by a unity of mental-physical approach, offering a new perspective for the coordinated management of mental and physical health, and providing scientific evidence for policymaking and resource allocation. |
| format | Article |
| id | doaj-art-01a5634bfc564fb6bbb9123bc4df13a5 |
| institution | Kabale University |
| issn | 1760-4788 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Journal of Nutrition, Health and Aging |
| spelling | doaj-art-01a5634bfc564fb6bbb9123bc4df13a52025-08-26T04:14:10ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882025-09-0129910064910.1016/j.jnha.2025.100649The vicious cycle of depressive symptoms and disability in older adultsMengzhen Sun0Xiaoru Sun1Hui Zhang2Xiaoyan Jiang3Xiaofeng Wang4Qi Zhang5Human Phenome Institute and MOE Key Laboratory of Contemporary Anthropology, School of Life Science, Fudan University, Shanghai, China; Fudan University People’s Hospital of Rugao Joint Research Institute of Longevity and Aging, Rugao, Jiangsu Province, ChinaInstitute for Medical Dataology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaHuman Phenome Institute and MOE Key Laboratory of Contemporary Anthropology, School of Life Science, Fudan University, Shanghai, China; School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaState Key Laboratory of Cardiovascular Diseases and Medical Innovation Center, Shanghai East Hospital, School of Medicine, Tongji University, China; Corresponding authors.Human Phenome Institute and MOE Key Laboratory of Contemporary Anthropology, School of Life Science, Fudan University, Shanghai, China; Fudan University People’s Hospital of Rugao Joint Research Institute of Longevity and Aging, Rugao, Jiangsu Province, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; Corresponding authors.Department of Cardiology, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China; Corresponding authors.Background: Unidirectional researches have suggested a correlation between depressive symptoms and disability, but it remains uncertain whether this association is bidirectional. Methods: The study is based on the 1st-10 th waves of the NHATS (National Health and Aging Trends Study). The subset A and subset B included 3,459 and 3,801 samples, respectively. A random-intercept cross-lagged panel model was employed to explore the bidirectional dynamic relationship between depressive symptoms and physical function indicators, including BADL (basic ADL), IADL (instrumental ADL), and ADL (a combination of BADL and IADL). Results: An increase in depressive symptoms led to a decline in physical function at all levels, and vice versa. When older adults experienced poorer physical function than usual, their subsequent depressive symptoms were stronger (BADL, β = 0.082, p < 0.0001; IADL, β = 0.072, p < 0.001; ADL, β = 0.098, p < 0.0001). Conversely, an increase in earlier depressive symptoms resulted in a future decline in physical function (BADL, β = 0.042−0.057, p < 0.05; IADL, β = 0.048, p < 0.05; ADL, β = 0.061, p < 0.01). Conclusions: This study is the first to reveal a mutually reinforcing spiral effect between increased depressive symptoms and declines in any level of physical function. These findings highlight the importance of prevention strategies guided by a unity of mental-physical approach, offering a new perspective for the coordinated management of mental and physical health, and providing scientific evidence for policymaking and resource allocation.http://www.sciencedirect.com/science/article/pii/S1279770725001745Depressive symptomsDisabilityRI-CLPMWithin-PersonVicious cycle |
| spellingShingle | Mengzhen Sun Xiaoru Sun Hui Zhang Xiaoyan Jiang Xiaofeng Wang Qi Zhang The vicious cycle of depressive symptoms and disability in older adults The Journal of Nutrition, Health and Aging Depressive symptoms Disability RI-CLPM Within-Person Vicious cycle |
| title | The vicious cycle of depressive symptoms and disability in older adults |
| title_full | The vicious cycle of depressive symptoms and disability in older adults |
| title_fullStr | The vicious cycle of depressive symptoms and disability in older adults |
| title_full_unstemmed | The vicious cycle of depressive symptoms and disability in older adults |
| title_short | The vicious cycle of depressive symptoms and disability in older adults |
| title_sort | vicious cycle of depressive symptoms and disability in older adults |
| topic | Depressive symptoms Disability RI-CLPM Within-Person Vicious cycle |
| url | http://www.sciencedirect.com/science/article/pii/S1279770725001745 |
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