You Yinghui, Wang Zimo, Sun Runzhou, Wu Chunyan, Ban Jing, Pang Ziang, Wang Ling, Liu Pengtao
Shandong Second Medical University, Weifang, Shandong Province, 261053, China.
Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, 100000, China.
BMC Public Health. 2025 Mar 6;25(1):905. doi: 10.1186/s12889-025-21862-w.
Childhood health significantly influences mental well-being in later life, but this relationship remains underexplored in China. This study aims to investigate the long-term associations between childhood health status and depressive symptoms in older adults, emphasizing the need for early interventions to promote lifelong mental health.
We utilized data from a nationally representative survey conducted across 28 provinces of China, comprising 15,581 adults aged 45 years and older. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression scale. Logistic regression and decision tree models were applied to examine the association between childhood health and depressive symptoms in later life.
The overall prevalence of depressive symptoms among participants was 33.75%. Those reporting excellent or very good childhood health had a lower prevalence (29.99%), while those with poor childhood health reported a markedly higher rate (47.57%). After adjusting for demographics and lifestyle factors, poor childhood health was associated with a higher likelihood of depressive symptoms (AOR 1.83, 95% CI 1.56-2.14, P < 0.0001). Other risk factors included aged 65-74 years (AOR 1.23, 95% CI 1.10-1.38, P = 0.0009), female gender (AOR 2.01, 95% CI 1.78-2.28, P < 0.0001), and never drinking (AOR 1.24, 95% CI 1.11-1.38, P = 0.0012). Protective factors included tertiary education (AOR 0.45, 95% CI 0.32-0.65, P = 0.0030), higher BMI (BMI 24-27.9 kg/m: AOR 0.72, 95% CI 0.60-0.87 kg/m, P = 0.0033; BMI ≥ 28 kg/m: AOR 0.69, 95% CI 0.56-0.85 kg/m, P = 0.0030), sleep duration of seven or more hours (7-10 h sleep: AOR 0.52, 95% CI 0.48-0.57, P < 0.0001; ≥10 h sleep: AOR 0.50, 95% CI 0.43-0.58, P < 0.0001), never smoked (AOR 0.77, 95% CI 0.68-0.86, P < 0.0001), and urban residency (AOR 0.57, 95% CI 0.50-0.64, P < 0.0001). The decision tree model highlighted key factors associated with depressive symptoms, including childhood health, non-communicable diseases, sleep duration, residency, alcohol consumption, and smoking status.
Our findings suggest that childhood health may influence mental well-being in later life. Promoting healthy behaviors from early childhood could help reduce depression risk in older age. However, the reliance on self-reported data and a cross-sectional design limit causal interpretation. Preventive care and targeted interventions for vulnerable children should be prioritized to improve long-term mental health outcomes.
儿童期健康对成年后的心理健康有显著影响，但在中国，这种关系仍未得到充分探索。本研究旨在调查老年人童年健康状况与抑郁症状之间的长期关联，强调早期干预对促进终身心理健康的必要性。
我们利用了在中国28个省份进行的具有全国代表性的调查数据，该调查涵盖了15581名45岁及以上的成年人。使用流行病学研究中心抑郁量表评估抑郁症状。应用逻辑回归和决策树模型来检验童年健康与成年后抑郁症状之间的关联。
参与者中抑郁症状的总体患病率为33.75%。报告童年健康状况为优秀或非常好的人患病率较低（29.99%），而童年健康状况较差的人患病率明显较高（47.57%）。在调整了人口统计学和生活方式因素后，童年健康状况较差与抑郁症状的可能性较高相关（调整后的比值比[AOR]为1.83，95%置信区间[CI]为1.56 - 2.14，P < 0.0001）。其他风险因素包括年龄在65 - 74岁（AOR为1.23，95% CI为1.10 - 1.38，P = 0.0009）、女性（AOR为2.01，95% CI为1.78 - 2.28，P < 0.0001）以及从不饮酒（AOR为1.24，95% CI为1.11 - 1.38，P = 0.0012）。保护因素包括接受高等教育（AOR为0.45，95% CI为0.32 - 0.65，P = 0.0030）、较高的体重指数（BMI为24 - 27.9 kg/m²：AOR为0.72，95% CI为0.60 - 0.87 kg/m²，P = 0.0033；BMI≥28 kg/m²：AOR为0.69，95% CI为0.56 - 0.85 kg/m²，P = 0.0030）、睡眠时间为7小时或更长时间（7 - 10小时睡眠：AOR为0.52，95% CI为0.48 - 0.57，P < 0.0001；≥10小时睡眠：AOR为0.50，95% CI为0.43 - 0.58，P < 0.0001）、从不吸烟（AOR为0.77，95% CI为0.68 - 0.86，P < 0.0001）以及居住在城市（AOR为0.57，95% CI为0.50 - 0.64，P < 0.0001）。决策树模型突出了与抑郁症状相关的关键因素，包括童年健康、非传染性疾病、睡眠时间、居住情况、饮酒和吸烟状况。
我们的研究结果表明，童年健康可能会影响成年后的心理健康。从幼儿期开始促进健康行为有助于降低老年人患抑郁症的风险。然而，对自我报告数据的依赖和横断面设计限制了因果关系的解释。应优先为弱势儿童提供预防性护理和针对性干预，以改善长期心理健康结果。
