The longitudinal association between physical health and depressive symptoms over eight years: Evidence from the health and retirement study.

In a recent paper published in the J Affect Disord, Li et al. found a bidirectional association between physical health and depressive symptoms in the elderly (
Li et al., 2024
).

Given the expanding global population of older adults, the potential relationship between compromised physical health (PH) and depressive symptoms (DS) becomes increasingly pronounced and severe. Li et al. evaluated change in PH or DS, to the extent possible, and believe that initial level of PH was related to the initial level of DS, and the initial level of PH could predict the trajectory of DS. In addition, the bidirectional association between PH and DS was further demonstrated by the two-level logistic models. However, we still need to point out two other extremely important factors that were not evaluated in the patients of this study. Currently, a large number of clinical studies support that medication can induce or worsening depression and depression-like behaviors in the aged, which include isotretinoin, ribavirin, rimonabant, ethionamide, cycloserine, leuprolide, goserelin, cannabis, and so on (
Baldacara et al., 2023
). However, in this study, medication induce or worsening depression and depression-like behaviors were not considered or compared in the baseline. Additionally, some clinical variables (income, religion), the key factors influencing the incidence of depressive symptoms, were not accounted for or compared at baseline, despite the PH and DS scores of participants increase with age.

PH is an important factor affecting DS, and there is a mutually promoting relationship between them. However, it is also necessary to consider the self-management and some special clinical variables of all participants. Therefore, it is crucial to not only focus on physical health, but also on the medication-induced depression and clinical variables (income, religion). While we acknowledge the findings of Li et al., and we believe that it would be beneficial to include more details designed to support a bidirectional association between PH and DS in the elderly.