Prevalent physical multimorbidity patterns and depressive symptom trajectories among community dwelling U.S. older adults.

OBJECTIVES: Depression may be accelerated by multimorbidity (≥2 chronic conditions). We used data from the Health and Retirement Study (HRS; 2012-2020) to examine whether trajectories of depressive symptoms varied across prevalent physical multimorbidity patterns among U.S. adults aged ≥65. METHODS: Analyses included 9,004 respondents that self-reported doctor diagnosed chronic conditions (arthritis, hypertension, heart disease, diabetes, cancer, lung disease, stroke) and completed the HRS-adapted Center for Epidemiological Studies Depression questionnaire. Prevalent physical multimorbidity patterns were identified in 2012 and latent growth models were used to estimate depressive trajectories from 2012-2020. Growth models were adjusted for covariates and complex sample design of the HRS. Sensitivity analyses examined alternative model specifications and potential bias due to non-random dropout. RESULTS: The latent intercept of depressive symptoms varied across physical multimorbidity patterns, but longitudinal change in depressive symptoms did not. The physical multimorbidity pattern including the greatest number of conditions (i.e. arthritis + hypertension + diabetes + heart disease) was associated with the greatest depressive symptom burden. Arthritis emerged as a key indicator of greater depressive symptom burden. Attrition did not influence findings. CONCLUSION: Targeting specific physical multimorbidity patterns including high condition counts and arthritis may help reduce the burden of depressive symptoms among older U.S. adults.