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Weight and Depressive Symptoms in Older Adults: Direction of Influence?

¹ Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), Iowa City Veteran's Affairs Medical Center, Iowa.
Departments of ² Internal Medicine, ³ Epidemiology, and ⁴ Health Management and Policy, University of Iowa, Iowa City.

Address correspondence to Valerie Hoffman, PhD, Department of Internal Medicine, University of Iowa College of Medicine, SE 605 GH; 200 Hawkins Drive, Iowa City, IA 52242. E-Mail: valerie-hoffman{at}uiowa.edu

Objectives. The purpose of this study was to clarify the direction of the relationship between changes in depressive symptoms and changes in weight in older adults.

Methods. The sample included a prospective cohort of individuals aged 53–63 (n = 9,130) enrolled in the Health and Retirement Study. We used separate cross-lagged models for men and women in order to study the impact of weight change on subsequent increases in depressive symptoms 2 years later and vice versa.

Results. Weight gain did not lead to increased depressive symptoms, and weight loss preceded increased depressive symptoms only in unadjusted models among men (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.04–1.53). Increased depressive symptoms were not predictive of subsequent weight loss, but they were predictive of subsequent weight gain in unadjusted models only (men: OR = 1.24, 95% CI = 1.00–1.54; women: OR = 1.12, 95% CI = 1.00–1.26). In adjusted models, baseline depressive symptoms predicted both weight loss and weight gain among both men and women. Increase in functional limitations and medical conditions were significant predictors of both weight loss and weight gain. Baseline functional limitations also predicted increased depressive symptoms.

Discussion. Based on our findings, it is apparent that researchers need to examine the pathways between changes in weight and increases in depressive symptoms in the context of functional limitations and medical comorbidity.