The impact of depression and physical multimorbidity on health-related quality of life in China: a national longitudinal quantile regression study.

The co-occurrence of mental and physical chronic conditions is a growing concern and a largely unaddressed challenge in low-and-middle-income countries. This study aimed to investigate the independent and multiplicative effects of depression and physical chronic conditions on health-related quality of life (HRQoL) in China, and how it varies by age and gender. We used two waves of the China Health and Retirement Longitudinal Study (2011, 2015), including 9227 participants aged ≥ 45 years, 12 physical chronic conditions and depressive symptoms. We used mixed-effects linear regression to assess the effects of depression and physical multimorbidity on HRQoL, which was measured using a proxy measure of Physical Component Scores (PCS) and Mental Component Scores (MCS) of the matched SF-36 measure. We found that each increased number of physical chronic conditions, and the presence of depression were independently associated with lower proxy PCS and MCS scores. There were multiplicative effects of depression and physical chronic conditions on PCS (- 0.83 points, 95% CI - 1.06, - 0.60) and MCS scores (- 0.50 points, 95% CI - 0.73, - 0.27). The results showed that HRQoL decreased markedly with multimorbidity and was exacerbated by the presence of co-existing physical and mental chronic conditions.

Evaluating the Effectiveness of the Health Management Program for the Elderly on Health-Related Quality of Life among Elderly People in China: Findings from the China Health and Retirement Longitudinal Study.

The world's rapidly aging population brings serious challenges which could be addressed by changes in behaviour and policy that promote good health in older age. However, these cheap and simple interventions are not available in many countries. China is one of the fastest-ageing countries in the world. The health management programs for the elderly in basic public health services was introduced by the government to promote the health of the elderly in China and address the challenges related to ageing. However, the effectiveness of the program is uncertain. So, we use a propensity score matching difference-in-difference (PSM-DID) model to analyse the causal effect of the health management program for the elderly in basic public health services on the health-related quality of life (HRQoL) of the elderly in China. The result shows that the program has improved the physical health of the elderly but has had no significant impact on mental health. Expanding the program to cover mental health could further benefit the HRQoL of the elderly. The program is a cost-effective approach to tackle the challenges of ageing and is a good example for other developing countries facing the same ageing challenges.