Multiple trajectories of depressive symptoms in middle and late life: racial/ethnic variations

Abstract

This research aims to identify distinct courses of depressive symptoms among middle-aged and older Americans and to ascertain how these courses vary by race/ethnicity. Data came from the 1995-2006 Health and Retirement Study which involved a national sample of 17,196 Americans over 50 years of age with up to six repeated observations. Depressive symptoms were measured by an abbreviated version of the Center for Epidemiologic Studies Depression scale. Semiparametric group based mixture models (Proc Traj) were used for data analysis. Six major trajectories were identified: (a) minimal depressive symptoms (15.9%), (b) low depressive symptoms (36.3%), (c) moderate and stable depressive symptoms (29.2%), (d) high but decreasing depressive symptoms (6.6%), (e) moderate but increasing depressive symptoms (8.3%), and (f) persistently high depressive symptoms (3.6%). Adjustment of time-varying covariates (e.g., income and health conditions) resulted in a similar set of distinct trajectories. Relative to White Americans, Black and Hispanic Americans were significantly more likely to be in trajectories of more elevated depressive symptoms. In addition, they were more likely to experience increasing and decreasing depressive symptoms. Racial and ethnic variations in trajectory groups were partially mediated by SES, marital status, and health conditions, particularly when both interpersonal and intrapersonal differences in these variables were taken into account.

Level 1 N = 64,674, Level 2 N = 17,196. BIC = Bayesian information criterion.

Figure 1. Trajectory Groups of Depressive Symptoms over Time

a Trajectory #1 = Minimal Depressive Symptoms Trajectory #2 = Low Depressive Symptoms Trajectory #3 = Moderate and Stable Depressive Symptoms Trajectory #4 = High but Decreasing Depressive Symptoms Trajectory #5 = Moderate but Increasing Depressive Symptoms Trajectory #6 = Persistently High Depressive Symptoms b Trajectory #1 = Minimal Depressive Symptoms_tv Trajectory #2 = Low Depressive Symptoms_tv Trajectory #3 = Moderate and Stable Depressive Symptoms_tv Trajectory #4 = High but Decreasing Depressive Symptoms_tv Trajectory #5 = Moderate but Increasing Depressive Symptoms_tv Trajectory #6 = Persistently High Depressive Symptoms_tv

Figure 1. Trajectory Groups of Depressive Symptoms over Time

a Trajectory #1 = Minimal Depressive Symptoms Trajectory #2 = Low Depressive Symptoms Trajectory #3 = Moderate and Stable Depressive Symptoms Trajectory #4 = High but Decreasing Depressive Symptoms Trajectory #5 = Moderate but Increasing Depressive Symptoms Trajectory #6 = Persistently High Depressive Symptoms b Trajectory #1 = Minimal Depressive Symptoms_tv Trajectory #2 = Low Depressive Symptoms_tv Trajectory #3 = Moderate and Stable Depressive Symptoms_tv Trajectory #4 = High but Decreasing Depressive Symptoms_tv Trajectory #5 = Moderate but Increasing Depressive Symptoms_tv Trajectory #6 = Persistently High Depressive Symptoms_tv