Association of the depressive scores, depressive symptoms, and conversion patterns of depressive symptoms with the risk of new-onset chronic diseases and multimorbidity in the middle-aged and elderly Chinese population

Figures

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  Figure 1. The flowchart of the study design. a. The study design and concept map. b. The screening flowchart for study cohorts. 1Dataset of “Biomarker” in 2013 includes information of participants’ blood pressure, weight, height, etc. 2Dataset of “Health_status_and_function” in 2011 includes records of participants’ CES-D. Abbreviations could be seen in Table 1.

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  Figure 2. Forest plots including HRs(95%CI) for the relationship between new-onset risks of 13 chronic diseases and DS conditions. a. Forest plots for the HRs(95%CIs) of CES-D scores in 2013 for new-onset risks of 13 chronic diseases. b. Forest plots for the HRs(95%CIs) of DS in 2013 for new-onset risks of 13 chronic diseases. c. Forest plots for the HRs(95%CIs) of three conversion patterns of DS (NoDS-DS: newly DS, DS-NoDS: relieved DS, DS-DS: persistent DS) on the new-onset risk of 13 chronic diseases compared with never DS (NoDS-NoDS). Models were all adjusted by age, sex, BMI, SBP, DBP, PP, smoke, drink, IADL, ADL, Naptime, Nighttime, Education, Social Activity, and intellectual Activity. In addition, considering the interrelationships between chronic diseases, we included 11 chronic diseases history as covariates (except for multimorbidity and cohort outcome event disease itself) in our subgroup analysis for each disease cohort to control for the effect of baseline medical history on outcome events when analyzing the risk of CES-D on the new-onset chronic diseases. Specific covariate information for each model is available in Appendix 2c. Abbreviations could be seen in Table 1.

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  Figure 3. The combined graphs of restricted cubic splines with 3 knots to flexibly model the association between 2013 CES-D and HRs (95% CI) for new-onset diseases and distribution density maps of 2013 CES-D in each chronic disease subgroup cohort. a. Heart disease, b. Hypertension, c. Stroke, d. DM/Hglu, e. Digestive disease, f. Cancer, g. Liver disease, h. Kidney disease, I. Lung disease, j. Arth/Rheu, k. Memory disease, l. Asthma, and m. Multimorbidity The vertical axis (left) represents the Hazard ratio for diseases in the restricted cubic splines; the vertical axis (right) represents the 2013 CES-D distribution fraction of the population in density maps. The cutoff refers to the value of 2013 CES-D when hazard ratios for almost all new-onset chronic diseases equal 1. Models were all adjusted by age, sex, BMI, SBP, DBP, PP, smoke, drink, IADL, ADL, Naptime, Nighttime, Education, Social Activity, and intellectual Activity. In addition, considering the interrelationships between chronic diseases, we included 11 chronic diseases history as covariates (except for multimorbidity and cohort outcome event disease itself) in our subgroup analysis for each disease cohort to control for the…

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  Figure 4. Kaplan-Meier plots of cumulative incidence rate to new-onset chronic diseases by DS and NoDS in 2013 in various disease cohorts with the log-rank test. a. Heart disease, b. Hypertension, c. Stroke, d. DM/Hglu, e. Digestive disease, f. Cancer, g. Liver disease, h. Kidney disease, I. Lung disease, j. Arth/Rheu, k. Memory disease, l. Asthma, and m. Multimorbidity. Abbreviations could be seen in Table 1.