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Life-course disadvantages and unhealthy lifestyles are well-known to independently induce depressive symptoms, but whether adopting healthy lifestyles can dilute the depressive risks attributed to life-course disadvantages remain unknown in China. This population-based cross-sectional study included 5724 middle-aged and older people from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms and healthy lifestyles (including regular exercise, reasonable sleep, never smoking, and no heavy alcohol consumption) were collected in 2018 while life-course disadvantages were collected in 2014. Multiple healthy lifestyles were associated with decreased depressive risks more significantly as the life-course disadvantages increased, with odds ratios (ORs) and 95 % confidence intervals (CIs) of 0.44 (0.25–0.80) and 0.33 (0.21–0.53) for 4 healthy lifestyles in participants with mild and severe life-course disadvantages, respectively. Life-course disadvantages and unhealthy lifestyles had enormous joint effects on depressive symptoms. Finally, adopting multiple healthy lifestyles can dilute the depressive risks attributed to life-course disadvantages and even mask some risks attributed to childhood disadvantages. Given that dietary data were not gathered by the CHARLS, diet was not included in this study. In addition, information on life-course disadvantages was primarily self-reported, which may lead to potential recall bias. Finally, the cross-sectional design of this study cannot capture causal associations well. Adopting multiple healthy lifestyles can well-dilute the depressive risks attributed to life-course disadvantages in middle-aged and older Chinese, which is of great importance for reducing the depressive burden and the construction of healthy aging in China. • Unhealthy lifestyles mediate the effects of life-course disadvantages on depressive symptoms. • Life-course disadvantages and unhealthy lifestyles have joint effects on depressive symptoms. • Healthy lifestyles help reduce depressive risks attributed to life-course disadvantages. • Adopting healthy lifestyles can mask depressive risks attributed to childhood disadvantages. [ABSTRACT FROM AUTHOR]

Background and Aims: Cardiovascular disease (CVD) has become a growing public health concern. Normal weight central obesity (NWCO) has emerged as a potential risk factor for cardiometabolic dysregulation. To date, the association between NWCO and new-onset CVDs remains unclear. We aimed to evaluate the associations of NWCO and its longitudinal transitions with cardiovascular risks in middle-aged and older Chinese.Methods and Results: Data were from the China Health and Retirement Longitudinal Study 2011-2018. NWCO was defined as the combination of a body mass index (BMI) of <24.0 kg/m2 and a waist circumference (WC) of >85 cm in males or >80 cm in females. CVDs included heart diseases and stroke. Cause-specific hazard models and subdistribution hazard models with all-cause death as the competing event were applied. In 2011, 9856 participants without prior CVDs were included, of whom 1814 developed CVDs during a 7-year follow-up. Compared to normal weight and non-central obesity (NWNCO), NWCO was significantly associated with new-onset CVDs, with cause-specific hazard ratios (cHRs) and 95% confidence intervals (CIs) of 1.21 (1.04-1.41) for heart diseases and 1.40 (1.11-1.76) for stroke. From 2011 to 2013, 571 NWNCO participants developed NWCO who subsequently demonstrated a 45% higher risk of CVDs than those with maintained NWNCO.Conclusion: NWCO and transition from NWNCO to NWCO are associated with higher risks of CVDs. Identification and prevention of NWCO may be useful in the management of CVDs. [ABSTRACT FROM AUTHOR]

Whether adverse childhood experiences (ACEs) preferentially induce depressive symptoms or somatic conditions remains to be explored. Data were from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2018. Fourteen ACEs were retrospectively reported and divided into 0, 1, 2, 3, and 4 or more. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression (CESD-10) scale. Somatic conditions were assessed by pain, falls, chronic diseases, multimorbidity, activities of daily living (ADL), and instrumental activities of daily living (IADL). Weibull regression and mediation analysis were used to explore the bidirectional associations between depressive symptoms and somatic conditions after ACEs. 4 or more (vs. 0) ACEs were associated with new-onset pain, falls, chronic diseases, multimorbidity, ADL limitations, and IADL limitations, with HRs (95% CIs) of 1.57 (1.37–1.79), 1.84 (1.55–2.18), 1.43 (1.19–1.72), 1.55 (1.32–1.83), 1.85 (1.54–2.23), and 1.46 (1.24–1.71), all of which were mediated by depressive symptoms by 12.3%, 8.6%, 9.6%, 11.9%, 15.3%, and 22.5%, respectively. 4 or more (vs. 0) ACEs were also associated with about 1.90-time higher risk of new-onset depressive symptoms. However, only pain, chronic diseases, and multimorbidity mediated the association by 4.1%, 3.3%, and 2.2%. All the above associations were more pronounced in women than men. ACEs tend to induce depressive symptoms before somatic conditions assessed by pain, falls, chronic diseases, multimorbidity, and functional limitations rather than vice versa. Future strategies should focus first on mental health in older Chinese to lessen the burden attributed to ACEs to the greatest extent. • More than 30% of Chinese aged ≥45 had 4 or more adverse childhood experiences (ACEs). • Mental and somatic conditions are bidirectionally associated after exposure to ACEs. • ACEs tend to induce depressive symptoms first rather than somatic conditions. • These bidirectional associations and mediating roles are more pronounced in women. [ABSTRACT FROM AUTHOR]

Hearing impairment is a common geriatric health problem and chronic stressor, and it is associated with poor cognitive outcomes. However, little is known about the impact of hearing impairment in married couples, particularly its potential spillover effects on the cognitive health among spouses of individuals with impairment. Drawing on a stress-proliferation perspective, we used actor–partner interdependence models to examine (1) whether an individual's hearing impairment influences their spouse's cognitive function; and (2) whether AL, symptoms of depression, and social participation serve as mediators for such an association. We utilized data from the 2015 (baseline) and 2018 (3-year follow-up) waves of the China Health and Retirement Longitudinal Study. 4434 couples were included at baseline, and 2190 couples remained after the 3-year follow-up. Hearing impairment among married women was associated with negative impacts on their spouses' cognitive function. Symptoms of depression and social participation may have served as potential mediators in this relationship. For married men, there was no statistically significant association between hearing impairment and spouses' cognitive function. Our findings suggest that hearing impairment among one spouse can lead to negative impacts on the other, but that this effect may depend on gender. Early diagnosis and couple-based interventions for hearing impairment are important for the cognitive health of both hearing-impaired individuals and their spouses. • We examined the impacts of hearing impairment on cognitive function in married couples. • Married women's hearing impairment negatively affected their husbands' cognitive function and psychosocial well-being. • Married men's hearing impairment was not associated with changes in their wives' cognitive function. • Couple-based interventions for hearing impairment may be beneficial to the health of both spouses. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) are associated with depression in later life. This study aimed to measure the impact of ACEs on life expectancy with depression (DLE) and to assess how educational attainment affected expectations. The study used data on 5597 participants from the English Longitudinal Study of Aging (2006–2013). Depression was assessed through the eight-item short version of the Centre for Epidemiologic Studies Depression. We used discrete-multistate life table models to estimate total life expectancy and life expectancy with depression. Older adults with ACEs had longer DLE and a higher proportion of remaining life with depression compared with those without ACEs. For example, men aged 60 years with ACEs could expect to live 5.2 (95 % confidence interval (CI): 4.2, 6.2) years with depression compared with 2.8 (95 % CI: 2.3, 3.3) years for men without ACEs. Women aged 60 years who reported ACEs could expect to live 9.4 (95 % CI: 7.6, 11.1) years with depression compared with 6.0 (95 % CI: 5.1, 7.0) years for women without ACEs. With a high level of educational attainment, older adults from younger cohorts with ACEs lived fewer depression years and spent a higher proportion of their life being free of depression than adults with ACEs and had a low level of educational attainment. Our results indicated that ACEs may increase years of life with depression among U.K. adults. Meanwhile, high educational attainment could mitigate the mental health burden associated with ACEs. • ACEs victims had longer years living with depression versus those without ACEs. • Women suffered from longer life expectancy with depression after experiencing ACEs. • Higher educational attainment could mitigate the health consequences of ACEs. • Younger ACEs victims may receive more health benefit from education. [ABSTRACT FROM AUTHOR]