Baseline Mental Disorders and Longitudinal Changes in Blood Pressure and Metabolic Measures Among Community-Dwelling Older Adults in Shanghai: A Retrospective Longitudinal Study

Abstract Background To assess whether mental disorder status at baseline was associated with changes in blood pressure, body mass index (BMI), and fasting blood glucose among older adults in a community in Shanghai, China. Methods We conducted a retrospective longitudinal study using health examination data collected at a community health service center in Shanghai between 2019 and 2025. Participants were aged 60 years or older at baseline, had available information on baseline mental disorder status, and had at least 3 valid measurements of the outcome under study. Linear mixed-effects models were used to estimate baseline differences and annual changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI, and fasting blood glucose according to baseline mental disorder status. Generalized estimating equations were used for sensitivity analyses. Results The blood pressure, BMI, and fasting blood glucose analyses included 2429, 2801, and 2650 participants, respectively. Participants in the blood pressure analysis had a mean (SD) age of 70.34 (5.19) years; 161 (6.6%) had a mental disorder at baseline. After multivariable adjustment, participants with a mental disorder had lower model-estimated baseline SBP (β, − 3.420 mm Hg; 95% CI, − 5.900 to − 0.932; P = .007) and DBP (β, − 3.290 mm Hg; 95% CI, − 4.710 to − 1.860; P < .001) than those without an identified mental disorder. The annual change in SBP did not differ significantly between the groups. The annual change in DBP was 0.445 mm Hg/y greater in participants with a mental disorder (β for the group-by-time interaction, 0.445; 95% CI, 0.151–0.738; P = .003). No significant between-group differences were observed in annual changes in BMI or fasting blood glucose. Conclusions In this community-based sample of older adults, mental disorder status at baseline was associated with lower model-estimated baseline SBP and DBP and a greater annual increase in DBP. It was not significantly associated with annual changes in SBP, BMI, or fasting blood glucose. These findings should be interpreted in light of the observational design, the small number of participants with mental disorders, and the use of data from a single community.