Chronic health conditions and trajectories of depressive symptoms in late adulthood: role of age-friendly community

BACKGROUND: Contextual factors influence how older adults perceive and adapt to chronic health conditions. We examined the impact of chronic health conditions on trajectories of depressive symptoms among older Chinese adults and investigated whether age-friendly communities buffer this effect. METHODS: We used panel data from the China Health and Retirement Longitudinal Study from 2011 to 2018, including 6122 adults aged ≥50 years (22 198 observations). Factor analysis of mixed data (FAMD) was performed to construct composite variables of community characteristics. The cross-level interactions between community variables and multimorbidity were included in growth curve models to assess the moderating effects. RESULTS: Individuals with multimorbidity had Centre for Epidemiologic Studies Depression Scale (CES-D) scores that were, on average, 1.60 points higher (95% CI 1.31 to 1.89) than those without chronic conditions, indicating a relatively modest effect size. Associations with depressive symptoms were weaker in more favourable community environments and among individuals with higher participation (all P for interaction