ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1656215
This article is part of the Research TopicPerceptions of Diabetes Across LifespanView all 5 articles
Prospective longitudinal study of dynamic depressive symptom trajectories and diabetes onset risk in older adults: A 10-year follow-up of the HRS and ELSA cohorts
Provisionally accepted
- 1Department of Integrated Chinese and Western Medicine, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
- 2Beijing University of Chinese Medicine, Beijing, China
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Background: The study aimed to examine the longitudinal relationship between depressive symptom trajectories and diabetes onset risk in older adults, with particular attention to sex-specific variations. Methods: Data were drawn from the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA). Depressive symptoms were measured using CESD-8, and five trajectories were identified: consistently low, decreasing, fluctuating, increasing, and consistently high. Symptoms were further divided into somatic and cognitive-affective domains. Cox proportional hazards models were applied to estimate diabetes onset risk, controlling for demographics, health behaviors, and comorbidities. Analyses stratified by sex were conducted to assess differential effects. Results: A total of 8,741 participants aged 50 years and older from both cohorts were included. During 10 years of follow-up, increasing (HR = 1.746, 95% CI: 1.195–2.551, P = 0.004) and consistently high (HR = 1.376, 95% CI: 1.042–1.818, P = 0.024) depressive trajectories were associated with greater diabetes risk compared with the consistently low group. No significant associations were detected for decreasing or fluctuating trajectories. Stronger associations were observed in women, including increasing (HR = 2.007, 95% CI: 1.290–3.121, P = 0.002) and consistently high (HR = 1.586, 95% CI: 1.161–2.167, P = 0.004) patterns. Similar associations were present across both cognitive-affective and somatic domains. Conclusion: Persistent or worsening depressive symptoms serve as significant predictors of diabetes onset risk, particularly among women. Both cognitive-affective and somatic domains contribute independently, emphasizing the importance of dynamic mental health surveillance in diabetes prevention.
Keywords: Depressive symptom trajectories, Diabetes risk, cognitive-affective symptoms, Somatic symptoms, longitudinal cohort study, older adults
Received: 29 Jun 2025; Accepted: 23 Sep 2025.
Copyright: © 2025 Yu, Zhang and Zhao. 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: Xiaolin Yu, yuxiaolin0813@163.com
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