Open Access

ARTICLE

Social Engagement and Depressive Symptom Trajectories in Older Adults with Arthritis: A 9-Year Longitudinal Study

Minmin Zhu^1,#, Xudong Yang^2,#, Xiang Li³, Yuanping Deng⁴, Yawen Zheng^5,*, Songmei Du^6,*
1 Department of Psychiatry, The Third People Hospital of Huzhou, the Affiliated Hospital of Huzhou University, Huzhou, China
2 School of Educational Science, Hunan Normal University, Changsha, China
3 College of Education, Wenzhou University, Wenzhou, China
4 Normal College, Jimei University, Xiamen, China
5 Lishui Second People’s Hospital, Wenzhou Medical University, Lishui, China
6 Department of Psychiatry, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
* Corresponding Author: Yawen Zheng. Email: ; Songmei Du. Email:
# These authors contributed equally to this work

International Journal of Mental Health Promotion https://doi.org/10.32604/ijmhp.2026.076602

Received 23 November 2025; Accepted 17 March 2026; Published online 11 May 2026

Abstract

Background: Depression is highly prevalent among older adults with chronic diseases such as arthritis or rheumatism. However, little is known about the longitudinal patterns of their depressive symptoms or the role social engagement plays in shaping these trajectories. This study aimed to identify distinct trajectories of depressive symptoms among older Chinese adults with arthritis or rheumatism and examine the association between baseline social engagement and these trajectories. Methods: Utilizing five waves of data from the China Health and Retirement Longitudinal Study (CHARLS) spanning from 2011 to 2020, our analysis included a final sample of 2022 adults aged 60 and above diagnosed with arthritis or rheumatism. We employed group-based trajectory modeling to classify the trajectories of depressive symptoms based on the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) scores. Subsequently, we utilized multinomial logistic regression to evaluate the relationship between baseline social engagement and trajectory membership, while adjusting for sociodemographic and health-related covariates. Results: Three depressive symptom trajectories were identified: persistently high (n = 558, 27.6%), moderate fluctuating (n = 981, 48.5%), and consistently low (n = 483, 23.9%). Higher baseline social engagement was significantly associated with reduced odds of belonging to the persistently high group (OR = 0.82, 95% CI: 0.69–0.97) and the moderate fluctuating group (OR = 0.87, 95% CI: 0.75–0.99) when compared to the consistently low group. Sensitivity analyses confirmed these findings were robust. The persistently high group had a greater proportion of females, rural residents, and individuals with lower education and living standards. Conclusion: Distinct depressive symptom trajectories exist among older adults with arthritis or rheumatism. Social engagement is associated with a lower risk of following adverse long-term depression outcomes. Promoting social engagement should be integrated into mental health and chronic disease management strategies for this population.

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Keywords

Depressive symptoms; older population; rheumatoid; social engagement; longitudinal studies

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