Psychological medicine · 2026
Spousal concordance and interdependence in depression among older adults: A cross-cultural longitudinal study in China, the United States, and England.
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Miao Jinfeng, Zhu Ruhan, Huang Mingzhu, Gan Shujuan, Chen Zhiting, Wu Yanmin, Guan Jianhua, Chen Jintao, Zhuang Bingbo, Dong Hanrong, Xu Yuxin, Zhang Min, Li Yuanxiao, Liu Jianmin, Chen Wenhuo, Yi Tingyu
Аннотация
BACKGROUND: Late-life depression often extends to the marital partner, yet mechanisms of dyadic interdependence and their cross-cultural generalizability remain unclear.
METHODS: We analyzed harmonized longitudinal data from couples in the China Health and Retirement Longitudinal Study (CHARLS; n = 3,532; 5 waves, 2011-2020), the Health and Retirement Study (HRS; n = 2,332; 8 waves, 2006-2020), and the English Longitudinal Study of Ageing (ELSA; n = 1,895; 9 waves, 2002-2018). Depressive symptoms (CES-D) and activities of daily living (ADL)/instrumental ADL (IADL) limitations were measured at every wave. Complementary actor-partner interdependence models (APIM) and random-intercept cross-lagged panel models (RI-CLPM) were applied, with multiplicity adjustment, full-information maximum likelihood (FIML), and 20-imputation triangulation.
RESULTS: Within-couple correlations of depressive symptoms were positive in every cohort (r = 0.34-0.43 in CHARLS, 0.14-0.20 in HRS, 0.23-0.29 in ELSA). APIM partner effects were robust in CHARLS but sparse elsewhere. After partialling out stable between-couple similarity, RI-CLPM within-person cross-spouse associations were attenuated, reaching consistent significance under FIML and multiple imputation only in ELSA. Four-variable RI-CLPMs showed bidirectional depression-disability coupling, strongest in HRS and ELSA, with cross-spouse function-to-depression effects in Western cohorts but not in CHARLS. Sex distinguishability was not supported, and half-longitudinal mediation through ADL/IADL did not survive multiplicity correction.
CONCLUSIONS: Concordance in late-life depressive symptoms replicates across three major aging cohorts; in CHARLS, it primarily reflects stable between-couple similarity, whereas modest within-person prospective coupling persists in ELSA and in the multiple-imputation HRS estimates. Bidirectional depression-disability coupling in Western cohorts is the most replicable within-person signal, supporting combined depression management and functional rehabilitation for older couples.
METHODS: We analyzed harmonized longitudinal data from couples in the China Health and Retirement Longitudinal Study (CHARLS; n = 3,532; 5 waves, 2011-2020), the Health and Retirement Study (HRS; n = 2,332; 8 waves, 2006-2020), and the English Longitudinal Study of Ageing (ELSA; n = 1,895; 9 waves, 2002-2018). Depressive symptoms (CES-D) and activities of daily living (ADL)/instrumental ADL (IADL) limitations were measured at every wave. Complementary actor-partner interdependence models (APIM) and random-intercept cross-lagged panel models (RI-CLPM) were applied, with multiplicity adjustment, full-information maximum likelihood (FIML), and 20-imputation triangulation.
RESULTS: Within-couple correlations of depressive symptoms were positive in every cohort (r = 0.34-0.43 in CHARLS, 0.14-0.20 in HRS, 0.23-0.29 in ELSA). APIM partner effects were robust in CHARLS but sparse elsewhere. After partialling out stable between-couple similarity, RI-CLPM within-person cross-spouse associations were attenuated, reaching consistent significance under FIML and multiple imputation only in ELSA. Four-variable RI-CLPMs showed bidirectional depression-disability coupling, strongest in HRS and ELSA, with cross-spouse function-to-depression effects in Western cohorts but not in CHARLS. Sex distinguishability was not supported, and half-longitudinal mediation through ADL/IADL did not survive multiplicity correction.
CONCLUSIONS: Concordance in late-life depressive symptoms replicates across three major aging cohorts; in CHARLS, it primarily reflects stable between-couple similarity, whereas modest within-person prospective coupling persists in ELSA and in the multiple-imputation HRS estimates. Bidirectional depression-disability coupling in Western cohorts is the most replicable within-person signal, supporting combined depression management and functional rehabilitation for older couples.