Association of Dietary Diversity Trajectories With Depressive Symptoms in Chinese Older Adults: Findings From a Nationwide Population-Based Study.

Objective: Dietary diversity has been found to be related to depressive symptoms. However, the relationship between the trajectory of dietary diversity score (DDS) and depressive symptoms in Chinese older adults remains unclear. Methods: The longitudinal dataset of Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2011 to 2018 was used to identify the DDS trajectory among older adults over 65 years old by latent class growth analysis. DDS and depressive symptoms were measured using the food frequency questionnaire and the Center for Epidemiologic Studies Depression Scale-10, respectively. The logistic regression model was used to explore the association between the DDS trajectory and depressive symptoms measured in 2018, and network analysis was used to explore the inter-relationships of depressive symptoms. Results: A total of 1549 participants were included. This study identified two different DDS trajectories: "persistent high DDS trajectory" and "low but slowly rising DDS trajectory." After adjusting the covariates, participants with a low but slowly rising DDS trajectory had a higher risk of having depressive symptoms (odds ratio [OR] [95% confidence interval [CI]]: 1.71 [1.34-2.18], p<0.001). Comparisons of network structures of depressive symptoms in different DDS trajectories showed that local difference was found in edge CESD2-CESD6 (difficulty with concentrating-feeling nervous/fearful), and the central symptom in both groups was CESD3 "feeling blue/depressed." Conclusion: Maintaining high dietary diversity is associated with a lower risk of depressive symptoms among Chinese older adults. Educational campaigns highlighting the importance of dietary diversity could be implemented for this population to lower depression risk and promote healthy aging.