The association between healthy lifestyle trajectory and depressive symptoms: Findings from the Chinese Longitudinal Healthy Longevity Survey (CLHLS).

Objective: Depression places a significant burden on older people, and some studies have found that certain lifestyles are associated with depressive symptoms. This study aimed to observe the relationship between integrated lifestyles and depressive symptoms from the perspective of dynamic change.

Method: The data for this study comes from the China Health and Longevity Longitudinal Survey (CLHLS) conducted in three waves in 2011-2012, 2014, and 2017-2018. Group-based trajectory analysis was used to determine the healthy lifestyle trajectory. Then, the relationship between the trajectory and depressive symptoms was explored using the polynomial logistic regression model. Additionally, network analysis was used to calculate the expected influence (EI) of depressive symptoms between the two trajectories and to compare whether there was a difference between the two network structures.

Results: This study identified two trajectories: the declining healthy lifestyle group (52.18 %) and the consistently unhealthy lifestyle group (47.82 %). In the fully adjusted model, the odds ratio for depressive symptoms was 0.693 (95 % CI: 0.552-0.869) for the declining healthy lifestyle group compared with the consistently unhealthy lifestyle group. There was no significant difference in the network structure model between the two trajectory groups, but their core symptoms were different.

Conclusions: A long-term integrated healthy lifestyle reduces the risk of depressive symptoms. Adopt different intervention measures for the core symptoms of different lifestyle groups.