Physical multimorbidity and depression: A mediation analysis of influential factors among 34129 adults aged ≥50 years from low- and middle-income countries

Smith, Lee and Shin, Jae Il and Butler, Laurie T. and Barnett, Yvonne A. and Oh, Hans and Jacob, Louis and Kostev, Karel and Veronese, Nicola and Soysal, Pinar and Tully, Mark A. and López-Sánchez, Guillermo F. and Koyanagi, Ai (2022) Physical multimorbidity and depression: A mediation analysis of influential factors among 34129 adults aged ≥50 years from low- and middle-income countries. Depression and Anxiety, 39 (5). pp. 376-386. ISSN 1520-6394

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Abstract

Background- There is a scarcity of literature on the association between physical multimorbidity (i.e., ≥2 chronic physical conditions) and depression among older adults, especially from low- and middle-income countries (LMICs). In addition, the mediators in this association are largely unknown. Therefore, we aimed to examine this association among adults aged ≥50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa), and to identify potential mediators. Methods- Cross-sectional, nationally representative data from the Study on Global Ageing and Adult Health were analyzed. Depression was defined as past-12 months DSM-IV depression or receiving depression treatment in the last 12 months. Information on 11 chronic physical conditions were obtained. Multivariable logistic regression and mediation analyses were conducted. Results- Data on 34,129 individuals aged ≥50 years were analyzed [mean (SD) age 62.4 (16.0) years; maximum 114 years; 52.1% females]. Compared to no chronic conditions, 2, 3, 4, and ≥5 chronic conditions were associated with 2.55 (95% CI = 1.90–3.42), 3.12 (95% CI = 2.25–4.34), 5.68 (95% CI = 4.02–8.03), and 8.39 (95% CI = 5.87–12.00) times higher odds for depression. Pain/discomfort (% mediated 39.0%), sleep/energy (33.2%), mobility (27.5%), cognition (13.8%), perceived stress (7.3%), disability (6.7%), loneliness (5.5%), and food insecurity (1.5%) were found to be significant mediators in the association between physical multimorbidity and depression. Conclusions- Older adults with physical multimorbidity are at increased odds of depression in LMICs. Future studies should assess whether addressing the identified potential mediators in people with physical multimorbidity can lead to reduction in depression in this population.

Item Type:	Journal Article
Keywords:	physical multimorbidity, depression, low- and middle-income countries, mediation, epidemiology, middle-age adults, older adults
Faculty:	Faculty of Science & Engineering
SWORD Depositor:	Symplectic User
Depositing User:	Symplectic User
Date Deposited:	28 Feb 2022 12:04
Last Modified:	13 Jun 2022 14:23
URI:	https://arro.anglia.ac.uk/id/eprint/707353

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