{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:14:31Z","timestamp":1792512871026,"version":"4.5.0"},"reference-count":57,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82505754"],"award-info":[{"award-number":["82505754"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physical activity and depressive symptoms have each been associated with cardiometabolic multimorbidity (CMM), but evidence on their joint longitudinal trajectories across diverse ageing populations remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used harmonized data from four population\u2010based ageing cohorts, including ELSA, HRS, SHARE, and CHARLS. Among 29\u2009523 adults aged 45\u2009years or older, joint trajectories of physical activity and depressive symptoms were identified across three trajectory\u2010defining survey waves using the KmL3D algorithm. Cox proportional hazards models were used to examine associations with incident CMM, defined as the coexistence of two or more of hypertension, diabetes, heart disease, and stroke. Sensitivity and supplementary analyses included proportional hazards diagnostics, time\u2010stratified and extended Cox models, early\u2010event exclusion analyses, conservative covariate adjustment, BMI exclusion, extended covariate models, Z\u2010score\u2010standardized trajectory re\u2010analysis, and E\u2010value calculation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four joint trajectory phenotypes were identified within each cohort. Participants in trajectories characterised by lower physical activity and high depressive symptoms had the highest risk of incident CMM compared with the cohort\u2010specific reference trajectory: ELSA, HR 2.15 (95% CI, 1.67\u20132.77); HRS, HR 1.46 (95% CI, 1.22\u20131.74); SHARE, HR 1.85 (95% CI, 1.69\u20132.03); and CHARLS, HR 2.28 (95% CI, 1.52\u20133.44). Findings were directionally consistent across sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Joint trajectories of physical activity and depressive symptoms were associated with incident CMM across four international ageing cohorts. Combined behavioural and psychological profiles may help inform CMM risk stratification in middle\u2010aged and older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71115","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T09:28:48Z","timestamp":1784712528000},"page":"9210-9221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Joint Trajectories of Physical Activity and Depressive Symptoms and Incident Cardiometabolic Multimorbidity: A Multi\u2010Cohort Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3657-0737","authenticated-orcid":false,"given":"Wenxuan","family":"Zhang","sequence":"first","affiliation":[{"name":"Acupuncture and Moxibustion and Massage College of Anhui University of Chinese Medicine  Hefei 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Modernization of Traditional Chinese Medicine of IHM  Hefei China"},{"name":"Key Laboratory of Xin'an Medical Education Department  Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Gao","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine Anhui University of Chinese Medicine  Hefei 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