The longitudinal relation between depressive symptoms and change in self-rated health: A nationwide cohort study

Objective: This study aimed to prospectively assess the relationship between depressive symptoms and change in self-rated health (SRH) in middle-aged and elderly Chinese adults. Methods: We used data from the China Health and Retirement Longitudinal Study (CHARLS). The final analysis included 8169 participants (?45 years old) and a multinomial logistic regression model was used to assess the association between baseline depression and follow-up change in SRH. Results: Taking no change in SRH as the reference, depressive symptoms at baseline were positively associated with a 2-year decline in SRH (OR: 1.38, 95% CI: 1.15?1.65) and negatively associated with a 2-year improvement in SRH (OR: 0.74, 95% CI: 0.63?0.85). Over a 4-year period, the OR (95% CI) values increased to 1.41 (1.19?1.67) and decreased to 0.69 (0.59?0.80) for decline and improvement in SRH, respectively. In stratified analyses, the association between depression and 2- or 4-year decline/improvement in SRH persisted in all sex and age subgroups. Conclusions: Baseline depression is an independent predictor of change in SRH among Chinese people aged 45 and above. Early monitoring and management of depressive symptoms may be worthwhile to maintain and improve SRH in the middle-aged and elderly population.