Long-term Cumulative Depressive Symptoms and Incident Cardiovascular Disease in Middle-aged and Older Population: Two...

Elevated depressive symptoms are well-documented among geriatric adults with cardiovascular disease (CVD); however, few studies have accounted for long-term cumulative depressive symptom exposure. This study determined the relationship between cumulative depressive symptoms and CVD.

Individual participant data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) and Health and Retirement Study (HRS). Eligible participants had access to assessment information on depressive symptoms and had no history of CVD at baseline. Long-term cumulative depressive symptoms were estimated by calculating the area under the curve based on the Center for Epidemiological Studies Depression Scale.

Herein, 8,861 participants from CHARLS (mean age: 58.58 years; male: 48.6%) and 7,284 from HRS (60.94 years; 35.0%) were enrolled. The median follow-up period was 5 years for the CHARLS and 10 years for the HRS. Compared with the first quartile of cumulative depressive symptoms, the HRs (95% CI) in the fourth quartile were 1.73 (1.48, 2.02) for predicting CVD ( P < 0.001), 1.83 (1.52, 2.19) for heart disease ( P < 0.001), 1.53 (95% CI: 1.17, 1.99) for stroke ( P = 0.002) in CHARLS. For HRS, the HRs (95% CI) were 1.41 (95% CI: 1.27, 1.57; P < 0.001), 1.42 (95% CI: 1.26, 1.59; P < 0.001), and 1.30 (95% CI: 1.06, 1.58; P = 0.010) respectively. Strong dose-response relationships were observed, with similar results for the two cohorts.

Long-term cumulative depressive symptoms were significantly associated with incident CVD in middle-aged and older adults, providing insights into controlling long-term depressive symptoms to improve this cohort's health.