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Depression trajectories and obesity among the elderly in Taiwan

Published online by Cambridge University Press:  05 January 2011

S.-Y. Kuo ,
K.-M. Lin ,
C.-Y. Chen ,
Y.-L. Chuang  and
W. J. Chen
S.-Y. Kuo
Affiliation:
Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan
K.-M. Lin
Affiliation:
Division of Mental Health and Addiction Medicine,Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
C.-Y. Chen
Affiliation:
Division of Mental Health and Addiction Medicine,Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
Y.-L. Chuang
Affiliation:
Center for Population and Health Survey Research, Bureau of Health Promotion, Department of Health, Taichung, Taiwan
W. J. Chen*
Affiliation:
Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan Departments of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
*
*Address for correspondence: W. J. Chen, M.D., Sc.D., Institute of Epidemiology, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei 100, Taiwan. (Email: wjchen@ntu.edu.tw)
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Abstract

Background

The present study aimed to (a) characterize 10-year trajectory patterns of depressive symptoms and (b) investigate the association between depressive trajectory and subsequent obesity, metabolic function and cortisol level.

Method

In a prospective study of Taiwanese adults aged ⩾60 years (n=3922) between 1989 and 1999, depression was assessed using a 10-item short-form of the Center for Epidemiologic Studies Depression Scale and information on body mass index (BMI) was collected by self-report. A subsample (n=445) of the original cohort in 1989 was drawn to assess metabolic variables and cortisol levels in a 2000 follow-up. After trajectory analyses were performed, multinomial logistic regression analyses were used to estimate the association estimates.

Results

We identified four distinctive trajectories of depressive symptoms: class 1 (persistent low, 41.8%); class 2 (persistent mild, 46.8%); class 3 (late peak, 4.2%); and class 4 (high-chronic, 7.2%). The results from both complete cases and multiple imputation analyses indicated that the odds of obesity were lower in the class 2, 3 or 4 elderly, as compared with those in class 1, while the odds of underweight were higher. The classes of older adults with more and persistent depressive symptoms showed a trend toward having both a lower BMI (p=0.01) and a higher cortisol level (p=0.04) compared with those with low depressive symptoms.

Conclusions

Incremental increases in depressive symptoms over time were associated with reduced risk of obesity and higher cortisol levels.

Keywords

Body mass indexcortisol levelsdepressive symptomslongitudinal studiestrajectory analysis
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 8 , August 2011 , pp. 1665 - 1676
Copyright
Copyright © Cambridge University Press 2011

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