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Background <p>Social activity in older adults is often correlated with their depressive symptoms, and this correlation is stronger in older adults with multimorbidity than in those without. However, few studies have analyzed this longitudinal association over time. This study aimed to examine the bidirectional longitudinal associations between social activity and depressive symptoms in older adults with multimorbidity. Additionally, we examined subjective life expectancy’s (SLE) moderating association in this bidirectional longitudinal association.</p> Methods <p>Data were obtained from <i>Waves 3</i> and <i>4</i> survey of 1435 older adults with multimorbidity (≥ 60 years) enrolled in <i>the China Health and Retirement Longitudinal Study</i>. We used cross-lagged panel models and grouped regression models to analyze the bidirectional longitudinal association between social activity and depressive symptoms, as well as the moderating association of subjective life expectancy, among Chinese older adults with multimorbidity.</p> Results <p>T1 social activity was significantly negatively associated with T2 depressive symptoms (<i>β</i>=-0.054, <i>P</i> &lt; 0.050), and T1 depressive symptoms were significantly negatively associated with T2 social activity (<i>β</i>=-0.112, <i>P</i> &lt; 0.010). SLE significantly moderated the association between T1 social activity and T2 depressive symptoms. Further, among participants with high SLE, the absolute value of the regression coefficient for the negative association of T1 social activity with T2 depressive symptoms (<i>β</i>=-0.134, <i>P</i> &lt; 0.010) was larger than that for the association of T1 depressive symptoms with T2 social activity (<i>β</i>=-0.114, <i>P</i> &lt; 0.050), indicating a more pronounced negative association for the former. All reported standardized coefficients were relatively modest; nevertheless, these statistically significant longitudinal associations are clinically and public health-relevant in this high-risk cohort of older adults with multimorbidity, who are disproportionately vulnerable to depressive symptom progression and social disengagement.</p> Conclusion <p>Reciprocal longitudinal associations between social activity and depressive symptoms were observed among Chinese older adults with multimorbidity, with the negative longitudinal association from baseline depressive symptoms to subsequent social activity being larger in magnitude than the reverse association. Additionally, subjective life expectancy (SLE) showed a significant moderating effect on the association from baseline social activity to subsequent depressive symptoms.</p>

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Bidirectional longitudinal associations between social activity and depressive symptoms among Chinese older adults with multimorbidity: the moderating role of subjective life expectancy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月3日

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  • Xinru Li,
  • Lei Shi,
  • Shujuan Xiao,
  • Benli Xue,
  • Lingli Yang,
  • Xiao Zheng,
  • Xinyi Zhang,
  • Mengjie Zhang,
  • Yanming Liao,
  • Chichen Zhang

摘要

Background

Social activity in older adults is often correlated with their depressive symptoms, and this correlation is stronger in older adults with multimorbidity than in those without. However, few studies have analyzed this longitudinal association over time. This study aimed to examine the bidirectional longitudinal associations between social activity and depressive symptoms in older adults with multimorbidity. Additionally, we examined subjective life expectancy’s (SLE) moderating association in this bidirectional longitudinal association.

Methods

Data were obtained from Waves 3 and 4 survey of 1435 older adults with multimorbidity (≥ 60 years) enrolled in the China Health and Retirement Longitudinal Study. We used cross-lagged panel models and grouped regression models to analyze the bidirectional longitudinal association between social activity and depressive symptoms, as well as the moderating association of subjective life expectancy, among Chinese older adults with multimorbidity.

Results

T1 social activity was significantly negatively associated with T2 depressive symptoms (β=-0.054, P < 0.050), and T1 depressive symptoms were significantly negatively associated with T2 social activity (β=-0.112, P < 0.010). SLE significantly moderated the association between T1 social activity and T2 depressive symptoms. Further, among participants with high SLE, the absolute value of the regression coefficient for the negative association of T1 social activity with T2 depressive symptoms (β=-0.134, P < 0.010) was larger than that for the association of T1 depressive symptoms with T2 social activity (β=-0.114, P < 0.050), indicating a more pronounced negative association for the former. All reported standardized coefficients were relatively modest; nevertheless, these statistically significant longitudinal associations are clinically and public health-relevant in this high-risk cohort of older adults with multimorbidity, who are disproportionately vulnerable to depressive symptom progression and social disengagement.

Conclusion

Reciprocal longitudinal associations between social activity and depressive symptoms were observed among Chinese older adults with multimorbidity, with the negative longitudinal association from baseline depressive symptoms to subsequent social activity being larger in magnitude than the reverse association. Additionally, subjective life expectancy (SLE) showed a significant moderating effect on the association from baseline social activity to subsequent depressive symptoms.