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January 22, 2026International Journal of Surgery0 citationsOpen Access

Association of spousal cardio-pulmo-metabo-disease and sensory impairment with incident depression in middle-aged and older adults: a prospective multi-cohort study

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XHXiaomei HuYLY. LiuYFYixiao Fu

Key Result

Spousal cardio-pulmo-metabo-disease and sensory impairments were associated with increased depression risk, with HR of 1.10 and 1.18 per condition increment, respectively.

Key Points

  • This study investigates how spousal chronic diseases and sensory impairments impact the risk of depression in middle-aged and older adults.
  • Utilized pooled data from four longitudinal cohort studies: HRS, SHARE, ELSA, KLoSA.
  • Defined spousal cardio-pulmo-metabo-disease (CPMD) and sensory impairments based on self-reports.
  • Excluded participants with depressive symptoms at baseline.
  • Assessed incident depression using CES-D or EURO-D and applied Cox proportional hazard models.
  • Spousal CPMD showed a progressive association with higher depression risk (HR per disease increment: 1.10).
  • Spousal sensory impairments correlated with increased risk (HR per impairment increment: 1.18).
  • Combined effects of CPMD and sensory impairments significantly affected age at onset of depression.
  • Participants with spouses who had persistent conditions had a higher depression risk.

Structured PICO

Does spousal cardio-pulmo-metabo-disease and sensory impairment increase the risk of incident depression in middle-aged and older adults?

P
Population
Middle-aged and older adults without depressive symptoms at baseline, drawn from four nationally representative longitudinal cohorts (HRS, SHARE, ELSA, and KLoSA).
I
Intervention
Presence of spousal cardio-pulmo-metabo-disease (self-reported cardiovascular disease, chronic lung disease, and diabetes) and/or spousal sensory impairments (hearing and vision).
C
Comparator
Spouses without cardio-pulmo-metabo-disease or sensory impairments.
O
Outcome
Incident depression assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) or EURO-D.patient reported

Spousal cardio-pulmo-metabo-disease and sensory impairments independently and cumulatively increase the risk of incident depression in middle-aged and older adults.

Abstract

Background: Depression in middle-aged and older adults is increasingly recognized as being influenced by spousal health conditions, yet the specific impact of spousal chronic diseases and sensory impairments remains underexplored. This study aimed to investigate the independent and combined effects of spousal cardio-pulmo-metabo-disease (CPMD) and sensory impairments on (1) incident depression, (2) age at onset of depression, and (3) changes in these conditions with depression onset. Materials and methods: This pooled multi-cohort study utilized data from four nationally representative longitudinal cohort studies: the Health and Retirement Study (HRS), the Survey of Health, Ageing and Retirement in Europe (SHARE), the English Longitudinal Study of Ageing (ELSA), and the Korean Longitudinal Study of Ageing (KLoSA). Spousal CPMD was defined as the self-reported presence of cardiovascular disease, chronic lung disease, and diabetes, and categorized as none, single, or multimorbidity. Spousal sensory impairments were defined based on self-rated hearing and vision, harmonized into “optimal,” “adequate,” or “impaired,” and further classified as none, single (hearing or vision), or dual impairments (both hearing and vision). We excluded participants with depressive symptoms at baseline. Incident depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) or EURO-D. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) after adjusting for potential confounders. Results: After adjusting for covariates, spousal CPMD was progressively associated with higher depression risk (HR per one disease increment: 1.10, 95% CI: 1.06–1.14). Similarly, graded increases in risk were observed for spousal sensory impairments (HR per one impairment increment: 1.18, 95% CI: 1.14–1.22). Their combined effects were significantly associated with age at onset of depression across all age groups. Participants whose spouses had persistent CPMD or sensory impairments had a significantly higher risk of depression compared to those whose spouses remained free of these conditions. Conclusion: Holistically addressing spousal CPMD and sensory impairments can reduce depression risk and improve quality of life in aging populations.

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Cite This Study

Hu et al. (2026) studied this question. Spousal cardio-pulmo-metabo-disease and sensory impairments were associated with increased depression risk, with HR of 1.10 and 1.18 per condition increment, respectively.

synapsesocial.com/papers/6971bdcf642b1836717e2768https://doi.org/10.1097/js9.0000000000004861
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