Association between activity of daily living and depressive symptoms among older adults in China: evidence from the CHARLS

AimLittle is known about the association between activity of daily living (ADL) and depressive symptoms, especially whether there is an interaction between ADL domains, demographic characteristics, and depressive symptoms.Subject and methodsA total of 3396 participants aged 60 and over were selected from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2018. Depressive symptoms and physical function were assessed by the 10-item Center for Epidemiologic Studies Depression scale (CES-D 10) and the Activity of Daily Living scale (ADL), respectively. Data were analyzed using the SPSS V.25.0 program with chi-square tests, logistic regression models, and the classification and regression tree (CART) model.ResultsThe prevalence of depressive symptoms was 48.6% among 3396 participants. The mean score of ADL was (17.74 +/- 4.78). After adjustment, we found that ADL and its domains were significantly related to depressive symptoms (P < 0.05), with the adjusted ORs: ADL (AOR = 1.10; 95% CI 1.08-1.12), personal care (AOR = 2.11; 95%CI 1.77-2.52), transfer (AOR = 1.34; 95% CI 1.15-1.57), household activities (AOR = 1.73; 95% CI 1.47-2.03), medical care (AOR = 1.96; 95% CI 1.37-2.81), and managing money (AOR = 2.24; 95% CI 1.78-2.83). Additionally, the CART model showed that the possibility of having depressive symptoms was highest for those with poor self-rated health, who had problems with personal care, and female gender.ConclusionADL and its domains are positively correlated with depressive symptoms among the elderly population in China. Therefore, the development of targeted intervention strategies to prevent ADL disability may positively influence the older adults with depressive symptoms.