Healthcare
Allostatic Load, Depressive Symptoms, and Risk of New-Onset Arthritis Among Middle-Aged and Older Adults: A Prospective Study Based on CHARLS
By Feng R, Ni M, Wang X and 4 others.
Abstract
Background
Arthritis is a major cause of pain, functional limitation, and disability among middle-aged and older adults. Although allostatic load (AL) and depressive symptoms have each been linked to adverse health outcomes, prospective evidence on their independent and joint associations with incident arthritis remains limited, particularly in Chinese populations.
Methods
This prospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 8882 participants aged 45 years and older without arthritis at baseline in 2011 were included and followed through 2020. AL was calculated from 11 equally weighted baseline biomarkers (body mass index, systolic and diastolic blood pressure, blood urea nitrogen, total cholesterol, high- and low-density lipoprotein cholesterol, C-reactive protein, glycated hemoglobin, cystatin C, and fasting glucose) using prespecified risk thresholds and categorized as low (0-1), medium (2-3), or high (4-11) burden. Depressive symptoms were measured at baseline using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), with a cutoff score of 10. New-onset (incident) arthritis was defined as a newly reported physician diagnosis of "arthritis or rheumatism" during follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders. Multiplicative and additive interactions between AL and depressive symptoms were also examined.