Guo Juncheng, Su Mengxue, Huang Jingbiao, Wang Xiaohu, Li Jianji, Wu Haisheng, He Yuan
Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China.
Changzhi Medical College, Changzhi, Shanxi, China.
Arch Public Health. 2025 Jul 1;83(1):171. doi: 10.1186/s13690-025-01671-8.
Longitudinal reciprocity between gastrointestinal disease (GID) and depression has not been explored among middle-aged and older adults.
This study included 12,366 participants aged 45 and above from the 2015, 2018 and 2020 survey waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted in China. Depression was defined as a score of 10 or higher on the 10-item Center for Epidemiological Studies Depression Scale (CES-D-10). The GID was identified on the basis of the presence of physician-diagnosed stomach or other digestive diseases, excluding tumors or cancers. Cox proportional hazards models were used to explore the longitudinal relationship between baseline GID and subsequent depression onset, as well as the association between baseline depression and newly reported GID. To assess bidirectional associations and the strength of different directional associations simultaneously, cross-lagged panel models (CLPMs) were also employed. Stratification analyses were performed to identify vulnerable populations for each directional path.
The baseline prevalence rates of GID and depression were 24.6% and 32.8%, respectively. Cox models revealed significant associations between baseline GID and new-onset depression (HR = 1.36, 95% CI: 1.25, 1.48) and between baseline depression and newly reported GID (HR = 1.61, 95% CI: 1.41, 1.84). After controlling for both confounders and interwave correlations, the CLPM demonstrated longitudinal bidirectional associations between GID and depression across three survey waves (P value < 0.001 for all cross-lagged coefficients) and revealed that gastrointestinal health was the stronger driving force in its dynamic interaction with depression. Females and urban residents are more susceptible to the impact of GID on depression onset, with females also being more vulnerable to depression influencing GID onset.
GID may stem from worsening depression, whereas GID itself contributes to the aggravation of depression among middle-aged and older adults, suggesting that targeted interventions for either gastrointestinal health or depression may yield reciprocal benefits over time.
尚未在中老年人群中探讨胃肠疾病（GID）与抑郁症之间的纵向相互关系。
本研究纳入了来自中国健康与养老追踪调查（CHARLS）2015年、2018年和2020年调查波次的12366名年龄在45岁及以上的参与者。抑郁症定义为在10项流行病学研究中心抑郁量表（CES-D-10）上得分10分或更高。GID是根据医生诊断的胃部或其他消化系统疾病（不包括肿瘤或癌症）来确定的。采用Cox比例风险模型探讨基线GID与随后抑郁症发病之间的纵向关系，以及基线抑郁症与新报告的GID之间的关联。为了同时评估双向关联和不同方向关联的强度，还采用了交叉滞后面板模型（CLPM）。进行分层分析以确定每个方向路径的脆弱人群。
GID和抑郁症的基线患病率分别为24.6%和32.8%。Cox模型显示基线GID与新发抑郁症之间存在显著关联（HR = 1.36，95%CI：1.25，1.48），以及基线抑郁症与新报告的GID之间存在显著关联（HR = 1.61，95%CI：1.41，1.84）。在控制了混杂因素和波次间相关性后，CLPM显示在三个调查波次中GID与抑郁症之间存在纵向双向关联（所有交叉滞后系数的P值<0.001），并表明胃肠健康在其与抑郁症的动态相互作用中是更强的驱动力。女性和城市居民更容易受到GID对抑郁症发病的影响，女性也更容易受到抑郁症影响GID发病。
GID可能源于抑郁症的恶化，而GID本身会导致中老年人群抑郁症的加重，这表明针对胃肠健康或抑郁症的针对性干预可能会随着时间的推移产生相互的益处。
