Recovery from depression reduced incident CVD risk (CHARLS HR 0.64; SHARE HR 0.45), while progression to moderate/severe depression increased risk (CHARLS HR 1.61; SHARE HR 2.18).
Does a change in depression status affect the risk of incident cardiovascular disease in older adults?
Changes in depression status over time are significantly associated with the risk of incident cardiovascular disease, highlighting the importance of dynamic depression monitoring in cardiovascular risk assessment.
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Abstract Background and Aims Previous studies have identified depression as a significant risk factor for cardiovascular disease (CVD). However, these studies primarily focused on baseline depression status without considering changes in depression during follow-up. This study aims to investigate the associations between changes in depression status and the incidence of CVD. Methods This research utilized data from two prospective cohorts: the China Health and Retirement Longitudinal Study (CHARLS) and the Survey of Health, Ageing and Retirement in Europe (SHARE). Depression was assessed using the 10-item Center for Epidemiological Studies Depression (CES-D-10) scale in CHARLS and the 12-item European Depression (EURO-D) scale in SHARE. Changes in depression status were evaluated based on the depression status at baseline and at the second survey, conducted two years later. Cardiovascular disease was determined through self-reported physician diagnoses of heart disease (including angina, heart attack, congestive heart failure, and other heart problems) or stroke. Cox proportional hazard models were employed to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) after adjusting for potential confounders. Results A total of 8,511 participants from CHARLS (female: 47.2%, mean age: 57.8 years) and 6,447 from SHARE (female: 61.4%, mean age: 67.6 years) were included based on the established inclusion and exclusion criteria. The median follow-up period was 7.0 years for both CHARLS and SHARE. In multivariate Cox regression models, participants with stable no depression status had lower risks of incident CVD compared to those who progressed to moderate/severe depression (CHARLS, HR = 1.61, 95% CI: 1.14-2.27; SHARE, HR = 2.18, 95% CI: 1.29-3.68). Conversely, participants who recovered from moderate/severe depression to no depression status exhibited decreased risks of incident CVD (CHARLS, HR = 0.64, 95% CI: 0.44-0.93; SHARE, HR = 0.45, 95% CI: 0.20-1.01). Additionally, after adjusting for confounders, participants in the upper tertile of total depression scores demonstrated significantly higher risks of incident CVD compared to those in the lower tertile (CHARLS, HR = 1.55, 95% CI: 1.33-1.80; SHARE, HR = 1.40, 95% CI: 1.12-1.75). For participants in the upper tertile of change in depression scores (defined as the depression score at the second wave minus that at the first wave), there was a significantly increased risk of incident CVD in CHARLS (HR = 1.45, 95% CI: 1.21–1.73), but not in SHARE (HR = 1.15, 95% CI: 0.89-1.49). No significant interactions were observed in subgroups classified by age and gender. Conclusions Changes in depression status are associated with varying risks of incident CVD. An increase in depression status is linked to higher risks of incident CVD, while recovery from depression correlates with reduced risks.
Wu et al. (Sat,) reported a other. Recovery from depression reduced incident CVD risk (CHARLS HR 0.64; SHARE HR 0.45), while progression to moderate/severe depression increased risk (CHARLS HR 1.61; SHARE HR 2.18).