Haibin Li1, Nicholas Van Halm-Lutterodt2, Deqiang Zheng1, Yue Liu1, Jin Guo3, Wei Feng1, Xia Li4, Anxin Wang1, Xiangtong Liu1, Lixin Tao1, Chengbei Hou1, Yanxia Luo1, Feng Zhang1, Xinghua Yang1, Qi Gao1, Wei Wang5, Zhe Tang6, Xiuhua Guo7. 1. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China. 2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 3. Greenwood Medical Company, Melbourne, Victoria, Australia. 4. Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia. 5. Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Perth, Western Australia, Australia. 6. Beijing Geriatric Healthcare Center, Xuan Wu Hospital, Capital Medical University, Beijing, China. Electronic address: tangzhe@medmail.com.cn. 7. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China. Electronic address: statguo@ccmu.edu.cn.
Abstract
BACKGROUND: Depressive symptoms tend to fluctuate over time. Data on the relationship between time-dependent depressive symptoms and the risk of cardiovascular and all-cause mortality among the elderly in China are lacking. METHODS AND RESULTS: A prospective cohort of 1999 subjects aged ≥55 years were enrolled in the Beijing Longitudinal Study of Aging since 1992. Depressive symptoms were assessed at baseline (0 years) and after 2, 5, 8, and 12 years, defined as a score of ≥16 on the 20-item Center for Epidemiological Studies Depression Scale. Mortality status was obtained from the local death registry until December 31st, 2012. Hazard ratio (HR) for all-cause mortality and sub-distribution HR (SHR) for cardiovascular mortality were respectively deduced from time-dependent Cox and competing risk models. During 19,658 person-years of follow-up, 1127 (55.65%) deaths were recorded, of which 483 (23.85%) were attributable to cardiovascular inclinations. Baseline depressive symptoms were neither associated with all-cause mortality (adjusted HR: 1.12, 95% confident interval, CI: 0.94-1.33) nor cardiovascular mortality (adjusted SHR: 1.10, 95% CI: 0.82-1.46) after adjustment of potential cardiac-risk factors. When depressive symptoms were used as time-dependent variable updated from 1992 to 2004, the associations were significant for both all-cause mortality (adjusted HR: 1.48, 95% CI: 1.26-1.73) and cardiovascular mortality (adjusted SHR: 1.40, 95% CI: 1.08-1.82) in the full adjusted model. CONCLUSIONS: Time-dependent depressive symptoms increased the risk of all-cause and cardiovascular mortality among the elderly in China.
BACKGROUND:Depressive symptoms tend to fluctuate over time. Data on the relationship between time-dependent depressive symptoms and the risk of cardiovascular and all-cause mortality among the elderly in China are lacking. METHODS AND RESULTS: A prospective cohort of 1999 subjects aged ≥55 years were enrolled in the Beijing Longitudinal Study of Aging since 1992. Depressive symptoms were assessed at baseline (0 years) and after 2, 5, 8, and 12 years, defined as a score of ≥16 on the 20-item Center for Epidemiological Studies Depression Scale. Mortality status was obtained from the local death registry until December 31st, 2012. Hazard ratio (HR) for all-cause mortality and sub-distribution HR (SHR) for cardiovascular mortality were respectively deduced from time-dependent Cox and competing risk models. During 19,658 person-years of follow-up, 1127 (55.65%) deaths were recorded, of which 483 (23.85%) were attributable to cardiovascular inclinations. Baseline depressive symptoms were neither associated with all-cause mortality (adjusted HR: 1.12, 95% confident interval, CI: 0.94-1.33) nor cardiovascular mortality (adjusted SHR: 1.10, 95% CI: 0.82-1.46) after adjustment of potential cardiac-risk factors. When depressive symptoms were used as time-dependent variable updated from 1992 to 2004, the associations were significant for both all-cause mortality (adjusted HR: 1.48, 95% CI: 1.26-1.73) and cardiovascular mortality (adjusted SHR: 1.40, 95% CI: 1.08-1.82) in the full adjusted model. CONCLUSIONS: Time-dependent depressive symptoms increased the risk of all-cause and cardiovascular mortality among the elderly in China.