Increased depressive symptoms were associated with a significantly higher risk of all-cause mortality (HR 3.26) specifically among subjects with normal weight (BMI < 25.0 kg/m2), but not among those with overweight or obesity.
Cohort (n=2,509)
Yes
Do increased depressive symptoms increase all-cause mortality in middle-aged subjects with elevated cardiovascular risk across different BMI categories?
Increased depressive symptoms are associated with a significantly higher risk of all-cause mortality specifically among normal-weight individuals with elevated cardiovascular risk, but not among those with overweight or obesity.
Hazard Ratio: 3.26 (95% CI 1.83–5.82)
Absolute Event Rate: 21.5% vs 6%
Abstract Background/Objective Pre-existing diseases have been found to affect the relationship between body mass index (BMI) and mortality. However, psychiatric disorders common in general population have not been previously addressed. The aim of this study was to assess the relationship of depressive symptoms and BMI with all-cause mortality. Methods A prospective cohort study in Finnish primary care setting was conducted. A population survey identified 3072 middle-aged subjects who had elevated cardiovascular risk. Subjects who attended clinical examination and completed Beck’s Depression Inventory (BDI) ( n = 2509) were included in this analysis. Effect of depressive symptoms and BMI on all-cause mortality after 14 years follow-up was estimated in models adjusted for age, sex, education years, current smoking, alcohol use, physical activity, total cholesterol, systolic blood pressure, and glucose disorders. Results When subjects with and without increased depressive symptoms were compared, the fully adjusted hazard ratios (HR) for all-cause mortality in the BMI categories (<25.0, 25.0–29.9, 30.0–34.9, ≥35.0 kg/m 2 ) were 3.26 (95% CI 1.83 to 5.82), 1.31 (95% CI 0.83 to 2.06), 1.27 (95% CI 0.76 to 2.11), and 1.25 (95% CI 0.63 to 2.48), respectively. The lowest risk of death was among non-depressive subjects who had BMI < 25.0 kg/m 2 . Conclusions Effect of increased depressive symptoms on all-cause mortality risk seems to vary with BMI. Elevated mortality risk is especially apparent among depressive subjects with normal weight. Among individuals with overweight and obesity, increased depressive symptoms seem not to further increase all-cause mortality.
Rantanen et al. (2023) conducted a cohort in Elevated cardiovascular risk (n=2,509). Increased depressive symptoms (BDI ≥ 10) vs. No increased depressive symptoms (BDI < 10) was evaluated on All-cause mortality in subjects with BMI < 25.0 kg/m2 (HR 3.26, 95% CI 1.83 to 5.82). Increased depressive symptoms were associated with a significantly higher risk of all-cause mortality (HR 3.26) specifically among subjects with normal weight (BMI < 25.0 kg/m2), but not among those with overweight or obesity.