Abstract:

Objective: Based on the data from the China Health and Retirement Longitudinal Study (CHARLS), to explore the association between tuberculosis (TB) history and depressive status in middle-aged and elderly adults, as well as the potential influencing factors. Methods: A cross-sectional study design was used, a total of 15273 middle-aged and elderly individuals aged 45 years or order were included in this study and divided into two groups: depression group and non-depression group. Multiple imputation was used to process the missing data, and the association between TB history and depressive status was evaluated through multi-stage adjusted logistic regression model and subgroup analysis. The important factors affecting depressive status were visualized through nomogram. Results: Among 15273 middle-aged and elderly individuals, 5658 (37.05%) were in the depression group and 9615 (62.95%) were in the non-depression group. The proportion of patients with a history of TB in the depression group (0.90%, 51/5658) was higher than that in the non-depression group (0.52%, 50/9615) with a statistically significant difference (χ²=7.316, P=0.007). After adjustment of multiple model, TB history remained significantly related to depression (Model 3: OR=1.61, 95%CI: 1.05-2.46). Subgroup analysis showed that although the correlation strength between TB and depression had a higher trend in women (OR=2.06, 95%CI: 1.11-3.95) and younger groups (OR=2.18, 95%CI: 1.32-3.64), the interaction test did not show significant effect on gender (OR=0.51, 95%CI: 0.23-1.14, P_interaction=0.714) or age (OR=0.51, 95%CI: 0.23-1.14, P_interaction=0.102). The nomogram analysis indicated that the history of TB (risk score=5.150) had a greater impact on depression than the elderly (risk score=0.790), smoking (risk score for former smokers=0.910, risk score for current smokers=1.240) and high physical activity (risk score=0.180). Sensitivity analysis showed that the main results before and after interpolation were consistent, supporting the robustness of the conclusion. Conclusion: TB history is significantly associated with the depressive status of Chinese middle-aged and older people, and is not affected by gender or age. TB infection may have a long-term negative impact on mental health. It is suggested that depression screening and intervention measures should be included into the routine follow-up care for patients with TB.

Key words: Tuberculosis, Depression, Logistic models, Research