Longitudinal association of spirituality with depressive symptom trajectories among older adults in mainland China

ObjectivesThe relationship between spirituality and depressive symptoms among the Chinese elderly is not well known. The current study explores this relationship using longitudinal data and trajectory modeling of depressive symptoms.MethodsA longitudinal study design was used to measure depressive symptoms repeatedly from 2012 to 2021 using the Geriatric Depression Scale (GDS). Group-based trajectory modeling analysis was conducted to determine the trajectories of depressive symptoms, and multiple logistic regression was used to explore the association between spirituality and depressive symptom trajectories.ResultsA total of 2333 participants completed at least two GDS measures, and these were included in the Group-based trajectory modeling analysis. An optimal model of three trajectories was derived: no depressive symptoms group (75.2%), new-onset depressive symptoms group (14.4%), and persistent depressive symptoms group (10.4%). Logistic regression modeling revealed that higher spirituality was associated with a lower risk of both new-onset depressive symptoms (OR = 0.68, 95% CI = 0.49-0.93) and persistent depressive symptoms (OR = 0.32, 95% CI = 0.23-0.45).ConclusionsSpirituality predicts a lower risk of new-onset depressive symptoms and persistent symptoms among older adults in mainland China. An optimal model of three trajectories was derived: no depressive symptoms group, new-onset depressive symptoms group, and persistent depressive symptoms group. The present study found that age >= 65 years old, being female, hypertension and severe medical comorbidity were risk factors for the development of depressive symptoms. Higher spirituality was associated with a lower risk of both new-onset depressive symptoms and persistent depressive symptoms. Provide primary evidence support the implementation of depression-targeted spiritual integrated community intervention program among older adults in mainland China.