Longitudinal changes in depressive symptoms and risks of cardiovascular disease and all-cause mortality: A nationwide population-based cohort study

Document Type

Journal Article

Publication Title

The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences

Volume

75

Issue

11

First Page

2200

Last Page

2206

Publisher

Oxford Academic

School

School of Medical and Health Sciences

RAS ID

35318

Funders

National Natural Science Foundation of China

Comments

Li, H., Qian, F., Hou, C., Li, X., Gao, Q., Luo, Y., ... Guo, X. (2020). Longitudinal changes in depressive symptoms and risks of cardiovascular disease and all-cause mortality: A nationwide population-based cohort study. The Journals of Gerontology: Series A, 75(11), 2200-2206. https://doi.org/10.1093/gerona/glz228

Abstract

© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. BACKGROUND: There remains a relative paucity of evidence for the association between changes in depressive symptoms with cardiovascular disease (CVD) and mortality. This study aimed to evaluate the association of change in depressive symptoms and incident CVD and mortality in a large prospective cohort of middle-aged and older adults. METHODS: A total of 6,810 participants free of CVD in the China Health and Retirement Longitudinal Study with two assessments of depressive symptoms at wave 1 (2011-2012) and wave 2 (2013-2014) were included. Elevated depressive symptoms were defined as a score of ≥12 on the 10-item Center for Epidemiologic Studies Depression scale. We used a modified Poisson regression to examine the association of changes in depressive symptoms (never, onset, remitted, and persistent) and incident CVD (a composite endpoint of heart disease or stroke) and mortality at wave 3 (2015-2016). RESULTS: During follow-up, 457 CVDs and 148 deaths occurred. Multivariable analyses revealed that persistent depressive symptoms were associated with an elevated risk of CVD (risk ratio = 1.77, 95% confidence interval = 1.38-2.26) and mortality (risk ratio = 1.63, 95% confidence interval = 1.01-2.64) compared with participants without any depressive symptoms. New-onset depressive symptoms increased the mortality risk (risk ratio = 2.37, 95% confidence interval = 1.52-3.69), but not CVD (risk ratio = 1.15, 95% confidence interval = 0.84-1.58). Remitted depressive symptoms were associated with a 35% and 13% excess risk of CVD and mortality, respectively. CONCLUSION: Persistent and remitted depressive symptoms were associated with an increased risk of CVD. New-onset depressive symptoms predicted elevated mortality risk.

DOI

10.1093/gerona/glz228

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