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September 4, 2024Translational Psychiatry25 citationsOpen Access

Eight-year total, cognitive-affective, and somatic depressive symptoms trajectories and risks of cardiac events

XLXinyi LuCLChunxiao LiuLHLu Hong

Key Result

Persistently high depressive symptom trajectories significantly increased the risk of incident heart disease compared to consistently low symptoms (HR 1.64).

Study Design

Type

Cohort (n=17,787)

Multicenter

Yes

Structured PICO

Do increasing, fluctuating, or persistently high trajectories of depressive symptoms increase the risk of incident heart disease in adults over 50?

P
Population
17,787 adults aged 50 and older without prior heart disease or stroke, followed for 10 years to assess the impact of depressive symptom trajectories on incident heart disease.
E
Exposure
Trajectories of depressive symptoms (decreasing, fluctuating, increasing, and persistently high) assessed using the 8-item CES-D scale, categorized into somatic and cognitive-affective subtypes.
C
Comparator
Consistently low trajectory of depressive symptoms.
O
Outcome
Incident heart disease (self-reported physician-diagnosed conditions including angina, heart attack, congestive heart failure, and other heart problems) over a 10-year follow-up period.hard clinical

Fluctuating, increasing, and persistently high trajectories of depressive symptoms, particularly somatic symptoms, are significantly associated with an increased risk of incident heart disease in older adults.

Main Result

Hazard Ratio: 1.64 (95% CI 1.45–1.84)

p-value: p=<0.001

Limitations

  • Classification of somatic symptoms for the 8-item CES-D may be inconsistent with other literature.
  • Study population was over 50 years of age in the US and UK, which may limit generalizability.
  • Reliance on self-reported questionnaires introduces potential recall bias.
  • Potential effects of unmeasured confounding variables.
  • Observational nature limits the identification of causal relationships.

Abstract

In this study, we analyzed pooled data from two prospective population-based cohorts-the Health Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA)-to explore the association between trajectories of depressive symptoms and the risk of cardiac events. Depressive symptoms were assessed using the 8-item CES-D scale and categorized into somatic and cognitive-affective subtypes. Trajectories were tracked for four surveys from baseline. Heart disease was identified based on self-reported physician-diagnosed conditions. Hazard ratios and 95% confidence intervals were calculated with Cox proportional risk models that adjusted for potential confounders. In total, 17,787 subjects (59.7% female, median age 63 years) were enrolled at baseline. During a 10-year follow-up, 2409 cases of heart disease were identified. Participants with fluctuating (HR = 1.13, 95% CI: 1.06-1.20), increasing (HR = 1.43, 95% CI: 1.25-1.64), and consistently high (HR = 1.64, 95% CI: 1.45-1.84) depressive symptom trajectories exhibited an increased risk of heart disease compared to those with consistently low depressive symptoms, while a decreasing (HR = 1.07, 95% CI: 0.96-1.19) depressive symptom trajectory did not significantly affect the risk of heart disease. Moreover, the association between heart disease and somatic depressive symptoms was found to be stronger than with cognitive-affective symptoms. These findings suggest a significant link between depressive symptom trajectories and heart disease, with particular emphasis on stronger associations with somatic symptoms. It is recommended that the identification and management of depressive symptoms be incorporated into heart disease prevention strategies.

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Cite This Study

Lu et al. (2024) conducted a cohort in Heart disease (n=17,787). Consistently high depressive symptom trajectory vs. Consistently low depressive symptom trajectory was evaluated on Incident heart disease (HR 1.64, 95% CI 1.45-1.84, p=<0.001). Persistently high depressive symptom trajectories significantly increased the risk of incident heart disease compared to consistently low symptoms (HR 1.64).

synapsesocial.com/papers/6a2227c64ae3d5108796fc37https://doi.org/10.1038/s41398-024-03063-y
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