{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T17:43:59Z","timestamp":1786211039093,"version":"build-2736575974"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Psychiatry Med"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine associations between gastrointestinal and hepatic diseases (GIHD) and long-term depressive symptom trajectories in older adults across diverse cultural and healthcare settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Longitudinal data from four aging cohorts were harmonized: CHARLS (China), SHARE (Europe), HRS (United States), and KLOSA (South Korea), comprising 40,161 adults aged \u226560\u00a0years with 4-6 follow-up waves. Group-based trajectory modeling (GBTM) identified distinct depressive symptom trajectories. Multinomial logistic regression, adjusted for baseline depressive symptoms and covariates, estimated odds of trajectory membership. Random-effects meta-analysis with Hartung-Knapp correction pooled cohort-specific estimates. Inverse probability weighting (IPW) and E-values assessed robustness to confounding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three trajectories were identified in all cohorts: Stable Low, Increasing Mild, and Stable High. After adjustment for baseline depressive symptoms, GIHD independently predicted Stable High trajectory membership (pooled OR = 1.73, 95% CI: 1.31-2.28; I\n                      <jats:sup>2<\/jats:sup>\n                      = 21.2%). Upper gastrointestinal disorders showed exceptional cross-cultural consistency (pooled OR = 1.80, 95% CI: 1.69-1.92; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%). Liver disease was significantly associated in CHARLS (OR = 2.64, 95% CI: 1.15-6.07) but not in KLOSA. Associations were consistent across sexes (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      for interaction = 0.417). IPW confirmed robustness (CHARLS OR = 1.40; SHARE OR = 1.11), and E-values indicated resistance to unmeasured confounding (E-value = 1.97).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chronic gastrointestinal conditions independently predict persistent severe depressive trajectories in older adults across four countries. The zero heterogeneity for upper gastrointestinal disorders suggests a gut-brain axis mechanism, supporting systematic depression screening in geriatric gastroenterology practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00912174261475436","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:28:36Z","timestamp":1786062516000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gastrointestinal Diseases and Persistent Depressive Trajectories in Older Adults Across Four International Aging Cohorts"],"prefix":"10.1177","author":[{"given":"Fangli","family":"Wu","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Chengdu Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Xi\u2019an Jiaotong University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7613-6615","authenticated-orcid":false,"given":"Jiahui","family":"Yang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Xi\u2019an Jiaotong University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00395-3"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.11.033"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.35"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.112.118307"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-009-1245-8_1"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","unstructured":"Cui G Li S Ye H et al. 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