Changes in depression among older adults in China: A latent transition analysis

Abstract

Background: Depression in late life is an important public health problem in developing countries. It is timely to investigate stability and transition patterns of depressive symptom subtypes.

Methods: Longitudinal data were used from the China Health and Retirement Longitudinal Study (CHARLS). A total of 853 women and 930 men aged 60-96 years were recruited. Latent class and latent transition analysis (LCA/LTA) were used to identify meaningful subgroups, transitions between those classes across time, and baseline demographic features that help to predict and design tailored interventions.

Results: Three depression subgroups were identified: Class 1 was labeled "Mild Depression"; Class 2 was labeled "Severe Depression" and class 3 was labeled "Lack of Positive Affect". A predominant tendency for stability appeared rather than change, meanwhile individual in Mild Depression and Severe Depression latent status both had a high probability to convert to the Lack of Positive Affect latent status. Social activities played a significant role in buffering the effect of depression, while individuals with chronic diseases, having difficulty with ADLs and smoking might be at-risk groups.

Limitations: The limitations of the present study were inherent limitation in the LTA model and some small proportion of transitions.

Conclusions: This study demonstrated a transition pattern in older adult depression within a person-centered approach. Differential treatment effects were found across baseline depression class, suggesting the benefit for tailored intervention programs to improve depression outcomes among older adults.

Keywords: Depression; Latent transition analysis; Older adults; Predictive factors.