ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1551356
This article is part of the Research TopicIntegrated Strategies for Lifelong Health: Multidimensional Approaches to Aging and Lifestyle InterventionsView all 27 articles
Associations Between Pulmonary Function and Depression: Evidence from the CHARLS Cohort 2015-2018
Provisionally accepted- 1Zhejiang Chinese Medical University, Hangzhou, China
- 2Zhejiang University, Hangzhou, Zhejiang Province, China
- 3Shanghai University of Traditional Chinese Medicine, Shanghai, Shanghai Municipality, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background The relationship between lung function and depression in middle-aged and older adults remains poorly understood. To address this knowledge gap, we conducted cross-sectional and longitudinal analyses using data from the nationally representative China Health and Retirement Longitudinal Study (CHARLS) to examine the association between peak expiratory flow (PEF) status and depression among middle-aged and older Chinese adults.Methods A total of 15,137 participants aged 45 years and older were included from the 2015 China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized into three PEF status groups based on their percentage of predicted PEF: severe impairment (<80%), average lung function (80-100%), and good lung function (≥100%). A total of 12,304 participants were included in the longitudinal analysis from 2015 to 2018. To address potential confounding, propensity score matching was employed using a gradient-boosting model to balance covariates between participants with and without depression. Logistic regression analyses as well as restricted cubic spline (RCS) regression analyses were performed to examine the association between (PEF) status and depression incidence.Findings The prevalence of depression was 9.53% (n=1044) in the cross-sectional sample, with higher rates observed in participants with poorer lung function (9.53%, 7.11%, and 5.03% for good, moderately good, and poorer lung function, respectively). During a 3.6-year follow-up, 6.73% (n=130) of participants developed depression. Fully adjusted logistic regression analysis demonstrated a significant inverse linear association between PEF percentage and depression risk (OR: 0.898, 95% CI: 0.862-0.935, per 1 SD increase). These findings were corroborated by restricted cubic spline (RCS) regression analysis, which revealed a linear relationship without evidence of nonlinearity (P for nonlinearity = 0.631).Conclusions Our study revealed a noteworthy correlation between PEF percentage and depression among the middle-aged and older population. The PEF percentage emerges as a valuable tool that may enhance the primary prevention and treatment of depression.
Keywords: Depression, peak expiratory flow (PEF), CHARLS, prospective cohort study, cognitive
Received: 25 Dec 2024; Accepted: 30 Jun 2025.
Copyright: © 2025 Yang, Cao, Huang, Xie, Zhou, Wang and Wen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hui Yang, Zhejiang Chinese Medical University, Hangzhou, China
Chengping Wen, Zhejiang Chinese Medical University, Hangzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.