Multimorbidity incidence among middle-aged and elderly Chinese women with depression in CHARLS 2020: Interaction of urban–rural differences (STROBE)

In economically less-developed areas, the public is likely to neglect the physical and psychological health of middle-aged and elderly Chinese women by the public. Comorbidities such as multi morbidity and depression are becoming a severe global challenge. This paper aims to explain the impact of depression on multimorbidity in middle-aged and elderly Chinese women with urban-rural differences. In the China Health and Retirement Longitudinal Study 2020, a total of 6317 participants older than 45-year-old were included in this study. First, the Kruskal-Wallis H test and χ² test were used to determine the frequency and correlation between variables, depression, and multimorbidity. Second, logistic regression was used to measure the impact of depression on multimorbidity and identify the confounding factors. Finally, subgroup analysis explained the urban-rural differences. Of the 6317 individuals included, 65.5% of the multimorbidity participants had suffered from minor depression and 82.6% had major depression. Four binary logistic regression models with a good degree of fit were established to indicate that the prevalence of multimorbidity was increased after excluding the confounding factors of residence. In the subgroup analysis, marital status, depression, and self-rated health make sense in urban-rural differences. This study found that depression was more strongly associated with multimorbidity in urban women than in rural ones. In summary, urban women with depression experience multimorbidity with ease. The elderly population (≥60-year-old), unmarried rural women, and urban women with middle school education are more susceptible; in other words, these people might face more serious challenges in China.