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Bidirectional Associations Between Cardiometabolic Multimorbidity and Depression and Mediation of Lifestyles: A

Yaguan Zhou1,2, Mika Kivimäki3, Carmen C W Lim4,5

  • 1School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

JACC. Asia
|October 7, 2024
PubMed

Insights

Cardiometabolic multimorbidity (CMM) and depression share a two-way relationship, increasing the risk of developing the other condition. Lifestyle factors like physical activity and alcohol consumption partially mediate these associations.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Cardiometabolic multimorbidity (CMM) and depression are significant global health issues.
  • The onset of one condition can increase the likelihood of developing the other, indicating a potential bidirectional link.

Purpose of the Study:

  • To investigate the reciprocal associations between CMM and depression in middle-aged and older adults.
  • To explore the mediating roles of lifestyle factors in the relationship between CMM and depression.

Main Methods:

  • A multicohort study utilizing harmonized data from five prospective cohorts across China, South Korea, the US, UK, and Europe.
  • Assessment of cardiometabolic diseases (diabetes, heart disease, stroke) and depression at baseline and follow-up (7-8 years).
  • Analysis of lifestyle factors (physical activity, alcohol, smoking) as potential mediators in bidirectional CMM-depression models.

Main Results:

  • Participants with CMM had a significantly higher risk of developing depression (HR: 1.52), and those with depression had a higher risk of developing CMM (HR: 1.31).
  • Physical activity and alcohol consumption mediated 7.5% and 6.9% of the CMM-to-depression link, and 12.0% and 7.1% of the depression-to-CMM link, respectively.
  • The bidirectional associations were stronger in Western countries compared to Asian countries.

Conclusions:

  • CMM and depression exhibit a significant bidirectional relationship.
  • Lifestyle factors play a mediating role in both directions of the association, with a more substantial impact in the depression-to-CMM pathway.
Abstract

Keywords:
cardiovascular diseasesdiabeteslifestyle modificationsmental healthreciprocal relationship

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