{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:44:49Z","timestamp":1789177489954,"version":"build-2803163510"},"reference-count":40,"publisher":"BMJ","issue":"10","funder":[{"name":"Open Research Project of the Jiangsu Engineering Research Center for Intelligent TCM Health Services","award":["ZHZYY202515"],"award-info":[{"award-number":["ZHZYY202515"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2026,4,20]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used panel data from the China Health and Retirement Longitudinal Study from 2011 to 2018, including 6122 adults aged \u226550 years (22\u2009198 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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&lt;0.001). For multimorbidity, \u03b2 coefficients were smaller in areas with better infrastructure (1.50 vs 1.73), stronger social services (1.47 vs 1.85) and higher participation (1.47 vs 2.09). A similar pattern was observed for individuals with a single condition, with smaller \u03b2 coefficients in areas with better infrastructure (0.41 vs 0.79), stronger social services (0.35 vs 0.78) and higher participation (0.35 vs 0.89).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Age-friendly environments may ameliorate the effects of multimorbidity on depressive symptoms. Interventions can target modifiable community-level factors to better support older adults with chronic conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2025-223769","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T17:20:25Z","timestamp":1781284825000},"page":"757-763","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Chronic health conditions and trajectories of depressive symptoms in late adulthood: role of age-friendly community"],"prefix":"10.1136","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5462-7357","authenticated-orcid":false,"given":"Xiaowei","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Aging Services and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China"},{"name":"School of Public Health and Community Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, V\u00e4stra G\u00f6taland County, Sweden"},{"name":"Jiangsu Engineering Research Center for Intelligent TCM Health Services, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawi","family":"Ng","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, V\u00e4stra G\u00f6taland County, Sweden"},{"name":"Department of Epidemiology and Global Health, Umea University Faculty of Medicine, Umea, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Jacobsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Ume\u00e5 University, Ume\u00e5, V\u00e4sterbotten County, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailiana","family":"Santosa","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, V\u00e4stra G\u00f6taland County, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"2026091107001836000_80.10.757.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114511"},{"key":"2026091107001836000_80.10.757.2","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.jad.2021.06.050","article-title":"Prevalence of depressive symptoms among older adults in mainland China: A systematic review and meta-analysis","volume":"293","author":"Tang","year":"2021","journal-title":"J Affect Disord"},{"key":"2026091107001836000_80.10.757.3","doi-asserted-by":"publisher","DOI":"10.1037\/0022&ndash;0167.53.4.411"},{"key":"2026091107001836000_80.10.757.4","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-psych-010416-044014"},{"key":"2026091107001836000_80.10.757.5","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.socscimed.2003.11.038","article-title":"Chronic diseases and depression: the modifying role of psychosocial resources","volume":"59","author":"Bisschop","year":"2004","journal-title":"Social Science & Medicine"},{"key":"2026091107001836000_80.10.757.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.08.011"},{"key":"2026091107001836000_80.10.757.7","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/58.6.P320"},{"key":"2026091107001836000_80.10.757.8","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0640"},{"key":"2026091107001836000_80.10.757.9","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2011.0987"},{"key":"2026091107001836000_80.10.757.10","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt032"},{"key":"2026091107001836000_80.10.757.11","doi-asserted-by":"crossref","unstructured":"Bekkers R , V\u00f6lker B , Gaag M , et al . 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