Key result
The highest healthy lifestyle score tertile was associated with lower risks of hospitalisation for depression recurrence (HR 0.73; 95% CI 0.69-0.77) and mortality vs the lowest tertile.
Why the study?
Although lifestyle-based treatments are recommended in depression care, the quantitative impact of aggregated healthy lifestyles on depression recurrence and mortality remains unknown.
Does greater adherence to a healthy lifestyle reduce first-time hospitalisation for recurrent depression and mortality in adults with pre-existing depression?
Cohort (n=26,164)
Does greater adherence to a healthy lifestyle reduce first-time hospitalisation for recurrent depression and mortality in adults with pre-existing depression?
Hazard Ratio: 0.73 (95% CI 0.69–0.77)
Greater adherence to a healthy lifestyle is associated with significantly lower risks of hospitalisation for depression recurrence and mortality in adults with pre-existing depression.
Supports lifestyle assessment in depression care; extends observational data but leaves causality and intervention effects open for trials.
BACKGROUND: Although lifestyle-based treatment approaches are recommended as important aspects of depression care, the quantitative influence of aggregated healthy lifestyles on depression recurrence and mortality remains unknown. OBJECTIVE: To investigate the association between healthy lifestyle and the risks of first-time hospitalisation for recurrent depression and mortality. METHODS: 26 164 adults with depression (mean (SD) age, 56.0 (7.9) years) were included from UK Biobank between 2006 and 2010 and followed up until 2022. Depression was defined as a physician's diagnosis in hospital admissions or the use of prescribed antidepressant medication. A weighted healthy lifestyle score (HLS) was calculated based on smoking, alcohol consumption, diet, sleep pattern, physical activity, social health, employment status and greenspace interaction. FINDINGS: Over a 13.3-year follow-up, 9740 cases of first-time hospitalisation due to depression recurrence and 1527 deaths were documented. Compared with the lowest HLS tertile, the highest tertile was associated with a 27% lower risk (HR=0.73, 95% CI 0.69 to 0.77) of first-time hospitalisation for depression recurrence and a 22% (HR=0.78, 95% CI 0.68 to 0.91) lower risk of mortality among adults with depression. Lower risks of first-time hospitalisation for depression recurrence were observed among those who smoked less, drank more alcohol, followed healthier diets and sleep patterns, spent more time employed in current job or had greater exposure to greenspace. CONCLUSION AND IMPLICATIONS: Greater adherence to healthy lifestyle was associated with a lower risk of hospitalisation and mortality among adults with pre-existing depression. Incorporating behaviour modification as an essential part of clinical practice for depressed patients could complement medication-based therapies.
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Cao et al. (2024) conducted a cohort in Pre-existing depression (n=26,164). Highest tertile of healthy lifestyle score (HLS) vs. Lowest HLS tertile was evaluated on First-time hospitalisation for depression recurrence (HR 0.73, 95% CI 0.69-0.77). The highest healthy lifestyle score tertile was associated with lower risks of hospitalisation for depression recurrence (HR 0.73; 95% CI 0.69-0.77) and mortality vs the lowest tertile.
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