Depressive Symptoms among Older Adults with Rheumatoid Arthritis during the COVID-19 Pandemic: A Repeated Cross-sectional Study.

Background　To compare the prevalence of depressive symptoms among older adults with and without rheumatoid arthritis (RA) in 2019 and 2022 using large-scale population-based data.Methods　This repeated cross-sectional study used data from the Japan Gerontological Evaluation Study 2019 and 2022. A questionnaire was mailed to community-dwelling adults aged ≥65 years, identifying patients with RA undergoing treatment using self-reported information. Depressive symptoms were defined as a Geriatric Depression Scale (GDS) score ≥5. Multivariable logistic regression included an interaction term (RA × survey year) to assess whether the association between RA and depressive symptoms differed by year, adjusting for sociodemographic, health, and lifestyle factors.Results　The number of participants with and without RA were 433 and 16,958 in 2019 and 472 and 16,881 in 2022 (total: 34,744). From 2019 to 2022, depressive symptoms increased among those with RA (35.5% to 40.4%), but changed minimally among those without RA (25.6% to 26.2%). The RA × year interaction was positive (OR 1.37, 95% CI 1.02-1.83; P = 0.036), indicating a greater increase in depressive symptoms among older adults with RA than among non-RA peers. Exploratory stratified analyses showed significant RA-by-year interactions among participants aged ≥75 years, those living alone or unmarried, those with lower educational attainment, never-smokers, and urban residents.Conclusions　The difference in depressive symptoms between older adults with and without RA was greater in 2022 than that in 2019. Public health and clinical strategies that incorporate mental health and social support should be considered for vulnerable older adults with RA.