Association of mood disorder with cardiometabolic multimorbidity trajectory and life expectancy, a prospective cohort
Jinghua Yin1, Tianqi Ma2, Jinchen Li3
1Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha, China; Department of Pathophysiology, Xiangya Hospital, Central South University, Changsha, China.
Insights
Mood disorders like depression and bipolar significantly increase the risk of developing cardiometabolic multimorbidity (CMM) and mortality. Early intervention for mood disorders is crucial for managing cardiometabolic diseases (CMD).
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Cardiometabolic diseases (CMDs) often co-occur, leading to cardiometabolic multimorbidity (CMM).
- Mood disorders are linked to CMD onset, but their role in progressing from single CMD to CMM is unclear.
Purpose of the Study:
- To investigate the impact of mood disorders on the transition from single CMD to CMM.
- To analyze the association between mood disorders, all-cause mortality, and life expectancy in individuals with CMD.
Main Methods:
- Utilized competing risk regression and flexible parametric proportion-hazard models.
- Analyzed data from 95,351 UK Biobank participants with single CMD.
Main Results:
- Mood disorders, particularly bipolar disorder, significantly increased the hazard of progressing to CMM.
- Depression and bipolar disorder were associated with increased all-cause mortality and reduced life expectancy in CMD patients.
Conclusions:
- Mood disorders confer a greater risk for CMM and mortality outcomes.
- Highlighting the importance of addressing depression and bipolar disorder in CMD progression and management.
Background:
Cardiometabolic diseases (CMDs) including hypertension, coronary heart disease, diabetes and stroke, are always combined with each other, leading to cardiometabolic multimorbidity (CMM). Mood disorder was associated with onset of CMD. However, the impact of mood disorder on the transition from single CMD to CMM was poorly understood.
Methods:
A total of 95,351 participants with single CMD, with median age of 59 (range 40 to 71) years from UK Biobank were enrolled at baseline. Competing risk regression models were used to estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) of association between mood disorder categories and progress from single CMD to CMM. Association of mood disorder with mortality, and life expectancy differences were also calculated by flexible parametric proportion-hazard models.
Results:
Relative associations were observed between mood disorder and the progress from first onset of CMD to CMM. Adjusted HRs for progress to CMM from those with comorbid CMD plus depression or bipolar were increased (depression: 1.23 [1.19 1.27]; bipolar: 1.47 [1.31 1.66]), compared with those with the sole CMD. Mood disorder also had impact on all-cause mortality (depression: 1.17 [1.10 1.24]; bipolar: 2.03 [1.74 2.32]) and reduced life expectancy estimates for those with single CMD.
Limitations:
This cohort primarily comprises White individuals. Covariates only measured at baseline and assumed unchanged during follow-up.
Conclusions:
Mood disorder conferred greater hazard on the CMM and mortality outcome. This study highlighted the importance of depression and bipolar in disease progression, from single CMD, to multimorbidity or mortality.
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