Zi-Ting Huang1, Yan Luo1, Ling Han2, Kaipeng Wang3, Shan-Shan Yao1, He-Xuan Su1, Sumin Chen4, Gui-Ying Cao1, Carson M De Fries3, Zi-Shuo Chen1, Hui-Wen Xu1, Yong-Hua Hu1, Beibei Xu5. 1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China. 2. Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America. 3. Graduate School of Social Work, University of Denver, Denver, Colorado, United States of America. 4. Yancheng Dafeng People's Hospital, Yancheng, Jiangsu, China. 5. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China. Electronic address: xubeibei@bjmu.edu.cn.
Abstract
BACKGROUND: Cardiometabolic diseases (CMDs) are associated with depression. However, it is unclear whether coexisting CMDs may increase the risk of depression. We examined associations between cardiometabolic multimorbidity and depressive symptoms among middle-aged and older Chinese. METHODS: Participants aged ≥45 years were enrolled from the China Health and Retirement Longitudinal Study 2011-2018 (N = 18,002). Cardiometabolic multimorbidity was defined as the coexistence of ≥2 CMDs, including stroke, heart disease, diabetes, hypertension, and dyslipidemia. Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. We used generalized estimating equation models to examine associations between cardiometabolic multimorbidity and depressive symptoms, including the dose effect of disease count and prevalent disease combinations, as well as individual and additive effects of specific CMDs. RESULTS: The prevalence of cardiometabolic multimorbidity was 24.5%. A higher number of CMDs had an additive dose effect on depressive symptoms that persisted consistently in specific CMDs. Stroke only, heart disease only, and diabetes only were each associated with a higher risk of depressive symptoms compared with no CMDs. CMD combinations involving stroke, heart disease, or diabetes were each associated with an increased risk of depressive symptoms compared with the absence of stroke, heart disease, or diabetes. LIMITATION: Self-reported chronic conditions. CONCLUSION: Stroke, heart disease, and diabetes showed individual and additive effects on CMD combinations, whereas hypertension and dyslipidemia only showed associations with depressive symptoms in combinations with other CMDs. These results suggest person-centered healthcare of mental health prevention and treatment for middle-aged and older adults with individual or multiple CMDs.
BACKGROUND: Cardiometabolic diseases (CMDs) are associated with depression. However, it is unclear whether coexisting CMDs may increase the risk of depression. We examined associations between cardiometabolic multimorbidity and depressive symptoms among middle-aged and older Chinese. METHODS: Participants aged ≥45 years were enrolled from the China Health and Retirement Longitudinal Study 2011-2018 (N = 18,002). Cardiometabolic multimorbidity was defined as the coexistence of ≥2 CMDs, including stroke, heart disease, diabetes, hypertension, and dyslipidemia. Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. We used generalized estimating equation models to examine associations between cardiometabolic multimorbidity and depressive symptoms, including the dose effect of disease count and prevalent disease combinations, as well as individual and additive effects of specific CMDs. RESULTS: The prevalence of cardiometabolic multimorbidity was 24.5%. A higher number of CMDs had an additive dose effect on depressive symptoms that persisted consistently in specific CMDs. Stroke only, heart disease only, and diabetes only were each associated with a higher risk of depressive symptoms compared with no CMDs. CMD combinations involving stroke, heart disease, or diabetes were each associated with an increased risk of depressive symptoms compared with the absence of stroke, heart disease, or diabetes. LIMITATION: Self-reported chronic conditions. CONCLUSION: Stroke, heart disease, and diabetes showed individual and additive effects on CMD combinations, whereas hypertension and dyslipidemia only showed associations with depressive symptoms in combinations with other CMDs. These results suggest person-centered healthcare of mental health prevention and treatment for middle-aged and older adults with individual or multiple CMDs.
Authors: Xunjie Cheng; Tianqi Ma; Feiyun Ouyang; Guogang Zhang; Yongping Bai Journal: Int J Environ Res Public Health Date: 2022-04-14 Impact factor: 4.614