慢性身体疾病会增加随后抑郁症状的风险，但我们很少了解与此相关的机制，或者可以解决这种状况的干预措施。本研究旨在调查孤独感是否可以解释慢性疾病和随后抑郁症状之间的关联。我们使用了英国长寿研究数据，一项50岁以上成年人的前瞻性研究。我们将慢性疾病（第二波）包括关节炎、癌症、糖尿病、心血管疾病、中风和慢性阻塞性肺疾病作为曝露因素。用短版加州大学洛杉矶分校孤独量表（第三波）的孤独感分数作为中介变量。心理流行病学抑郁量表（第四波）用于测量抑郁症状得分（结果）。我们使用单因素和多因素回归模型检查了慢性身体疾病与孤独感和抑郁症状的关联。完全调整后的模型共包括2436名参与者和抑郁症状结果的2052名参与者。慢性身体疾病与随后的抑郁症状得分提高了21%（发病率比=1.21，95%置信区间=1.03-1.42）。我们没有发现慢性身体疾病与孤独感之间的关联，因此没有进行中介分析。我们的结果可能是由更普遍的慢性疾病，如心血管疾病，导致的。慢性身体疾病会增加老年人抑郁症状的风险。然而，我们没有发现慢性身体疾病与随后孤独感的增加有关。因此，针对孤独感来减少慢性身体疾病老年人的抑郁症状的干预措施可能是不足够的。 版权所有 © 2023 Elsevier B.V.发行

Chronic physical illness increases the risk of subsequent depressive symptoms, but we know little about the mechanisms underlying this association that interventions can target. We investigated whether loneliness might explain associations between chronic illness and subsequent depressive symptoms.We used English Longitudinal Study of Ageing data, a prospective cohort of adults over 50. Our exposure was chronic illnesses (wave two) including arthritis, cancer, diabetes, cardiovascular disease, stroke, and chronic obstructive pulmonary disease. Loneliness scores were a mediator on the short University of California, Los Angeles Loneliness Scale at wave three. Depressive symptom scores (outcome) were measured using the Centre for Epidemiologic Studies Depression Scale (wave four). We examined associations of chronic physical illness with loneliness and depressive symptoms in univariable and multivariable regression models.Fully-adjusted models included 2436 participants with the depression outcome and 2052 participants with the loneliness outcome. Chronic physical illness was associated with 21 % (incident rate ratio = 1.21, 95%CI = 1.03-1.42) higher depression scores at follow-up. We found no evidence of an association between chronic physical illness and loneliness and therefore did not proceed to analyses of mediation.More prevalent chronic illnesses could have driven our results, such as cardiovascular disease.Chronic physical illnesses increase the risk of depressive symptoms in older adults. However, we did not find any that chronic physical illnesses were associated with an increased risk of subsequent loneliness. Therefore, interventions targeting loneliness to reduce depression in older adults with chronic physical illness may be insufficient.Copyright © 2023. Published by Elsevier B.V.