Key result
Depressive symptoms linked to ~41% higher risk of mortality, diabetes, stroke, and heart disease.
Why the study?
The role of depression in the development and outcome of cardiometabolic diseases remained to be clarified.
Do depressive symptoms increase the risk of incident cardiometabolic diseases and subsequent all-cause mortality in adults aged ≥50 years?
Cohort (n=78,212)
Yes
Do depressive symptoms increase the risk of incident cardiometabolic diseases and subsequent all-cause mortality in adults aged ≥50 years?
Effect estimate: HR 1.41 (95% CI 1.34 to 1.49)
Depressive symptoms are a significant risk factor for the development of cardiometabolic diseases and subsequent mortality, highlighting the importance of screening and treatment in this population.
Depressive symptoms were associated with higher cardiometabolic and mortality risks in adults ≥50; extends prior observational data but leaves causality and screening benefits open.
BACKGROUND AND PURPOSE: The role of depression in the development and outcome of cardiometabolic diseases remains to be clarified. We aimed to examine the extent to which depressive symptoms affect the transitions from healthy to diabetes, stroke, heart disease and subsequent all-cause mortality in a middle-aged and elderly European population. METHODS: A total of 78 212 individuals aged ≥50 years from the Survey of Health Ageing and Retirement in Europe were included. Participants with any baseline cardiometabolic diseases including diabetes, stroke and heart disease were excluded. Depressive symptoms were measured by the Euro-Depression scale at baseline. Participants were followed up to determine the occurrence of cardiometabolic diseases and all-cause mortality. We used multistate models to estimate the transition-specific HRs and 95% CIs after adjustment of confounders. RESULTS: During 500 711 person-years of follow-up, 4742 participants developed diabetes, 2173 had stroke, 5487 developed heart disease and 7182 died. Depressive symptoms were significantly associated with transitions from healthy to diabetes (HR: 1.12, 95% CI: 1.05 to 1.20), stroke (HR: 1.31, 95% CI: 1.18 to 1.44), heart disease (HR: 1.26, 95% CI: 1.18 to 1.34) and all-cause mortality (HR: 1.41, 95% CI: 1.34 to 1.49). After cardiometabolic diseases, depressive symptoms were associated with the increased risk of all-cause mortality in patients with diabetes (HR: 1.54, 95% CI: 1.25 to 1.89), patients who had stroke (HR: 1.29, 95% CI: 1.03 to 1.61) and patients with heart disease (HR: 1.21, 95% CI: 1.02 to 1.44). CONCLUSIONS: Depressive symptoms increase the risk of diabetes, stroke and heart disease, and affect the risk of mortality after the onset of these cardiometabolic conditions. Screening and treatment of depressive symptoms may have profound implications for the prevention and prognosis of cardiometabolic diseases.
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Qiao et al. (2021) conducted a cohort in Cardiometabolic diseases and all-cause mortality (n=78,212). Depressive symptoms was evaluated on Transitions from healthy to diabetes, stroke, heart disease and all-cause mortality (HR 1.41, 95% CI 1.34 to 1.49). Depressive symptoms significantly increased the risk of transitioning from healthy to all-cause mortality (HR 1.41; 95% CI 1.34-1.49), as well as to diabetes, stroke, and heart disease.
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