Abstract
BACKGROUND: Speech impairments significantly affect communication and are associated with social and psychological difficulties, particularly among adults aged 45 years and older. This study examines the relationship between speech impairments and depression using data from the China Health and Retirement Longitudinal Study (CHARLS). METHODS: A total of 67,014 participants aged 45 years and older were included in the analysis. The baseline characteristics of participants with and without speech impairments were compared using chi-square tests. Multivariable logistic and linear regression models were employed to assess the association between speech impairments and depression. Sensitivity and subgroup analyses were performed to explore variations across different demographic and lifestyle characteristics. RESULTS: Participants with speech impairments exhibited a significantly greater likelihood of depression, with adjusted odds ratios (Model II: OR = 2.16, 95% CI: 1.56-2.97, p < 0.0001) and higher depression scores (Model II: β = 3.03, 95% CI: 2.24-3.81, p < 0.0001) after controlling for confounders. Sensitivity analysis confirmed the robustness of these findings. Subgroup analysis revealed consistent associations across all the examined subgroups, with a statistically significant interaction between speech impairments and place of residence (p for interaction = 0.02), indicating a stronger association in urban residents. CONCLUSION: Speech impairments are strongly associated with a greater likelihood of depression in middle-aged and elderly Chinese adults. This finding underscores the importance of targeted mental health interventions and support for this population, particularly in urban settings. CLINICAL TRIAL NUMBER: Not applicable.