Assari Shervin
Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
Geriatrics (Basel). 2019 Jan 18;4(1):14. doi: 10.3390/geriatrics4010014.
Although obesity and depression have a bidirectional association, this link may vary based on race. The current study tested racial variation in bidirectional links between depressive symptoms and body mass index (BMI) over 24 years of follow-up in older adults over the age of 50 in the United States. We hypothesized weaker bidirectional links in Blacks compared to Whites.
Data came from waves 1 to 12 (1990 to 2014) of the Health and Retirement Study (HRS), an ongoing state-of-the-art national cohort. The study followed a representative sample of Americans (n = 15,194; 2,200 Blacks and 12,994 Whites) over the age of 50. Dependent variables were average depressive symptoms and BMI over 24 years, based on measurements every other year, from 1990 to 2014. Independent variables included baseline depressive symptoms and BMI. Covariates included age, gender, marital status, veteran status, and activities of daily living. Structural equation models were fitted to the data for data analysis.
In the pooled sample, bidirectional associations were found between BMI and depressive symptoms as baseline BMI predicted average depressive symptoms over time and baseline depressive symptoms predicted average BMI over 24 years. Racial differences were found in the bidirectional association between BMI and depressive symptoms, with both directions of the associations being absent for Blacks. For Whites, baseline BMI predicted average depressive symptoms over the next 24 years.
Reciprocal associations between BMI and depressive symptoms over a 24-year period among individuals over the age of 50 vary for Blacks and Whites. As these associations are stronger for Whites than Blacks, clinical and public health programs that simultaneously target comorbid obesity and depression may be more appropriate for Whites than Blacks.
尽管肥胖与抑郁存在双向关联，但这种联系可能因种族而异。本研究在美国50岁以上老年人24年的随访中，测试了抑郁症状与体重指数（BMI）之间双向联系的种族差异。我们假设黑人的双向联系比白人弱。
数据来自健康与退休研究（HRS）的第1至12轮（1990年至2014年），这是一个持续进行的先进的全国性队列研究。该研究跟踪了50岁以上具有代表性的美国样本（n = 15,194；2,200名黑人，12,994名白人）。因变量是基于1990年至2014年每隔一年的测量得出的24年期间的平均抑郁症状和BMI。自变量包括基线抑郁症状和BMI。协变量包括年龄、性别、婚姻状况、退伍军人身份和日常生活活动。采用结构方程模型对数据进行分析。
在汇总样本中，发现BMI与抑郁症状之间存在双向关联，因为基线BMI可预测随时间变化的平均抑郁症状，而基线抑郁症状可预测24年期间的平均BMI。在BMI与抑郁症状的双向关联中发现了种族差异，黑人在这两个关联方向上均不存在。对于白人，基线BMI可预测未来24年的平均抑郁症状。
50岁以上个体在24年期间BMI与抑郁症状之间的相互关联在黑人和白人中有所不同。由于白人的这些关联比黑人更强，同时针对肥胖和抑郁共病的临床和公共卫生项目可能对白人群体比对黑人群体更合适。
