Role of depressive symptoms in cardiometabolic diseases and subsequent transitions to all-cause mortality:an application of multistate models in a prospective cohort study

作     者：Yanan Qiao Siyuan Liu Guochen Li Yanqiang Lu Ying Wu Yi Ding Chaofu Ke 

作者机构：Department of Epidemiology and BiostatisticsSoochow University Medical College School of Public HealthSuzhouJiangsuChina Department of BiostatisticsSchool of Public HealthSouthern Medical UniversityGuangzhouGuangdongChina Department of Preventive MedicineCollege of Clinical MedicineSuzhou Vocational Health CollegeSuzhouJiangsuChina 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)

年 卷 期：2021年第6卷第4期

页      面：511-518,I0003,I0004页

核心收录：

学科分类：1002[医学-临床医学] 100205[医学-精神病与精神卫生学] 10[医学] 

基　　金：The development of the Harmonized SHARE was funded by the National Institute on Aging(R01 AG030153,RC2 AG036619,R03 AG043052) This work was supported by National Natural Science Foundation of China(81703316) Natural Science Foundation of Jiangsu Province(BK20170350) a project Funded by Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)and Natural Science Research Projects of Colleges and Universities in Jiangsu Province(20KJB330004). 

主　　题：diseases symptoms mortality 

摘      要：Background and purpose The role of depression in the development and outcome of cardiometabolic diseases remains to be clarified.We aimed to examine the extent to which depressive symptoms affect the transitions from healthy to diabetes,stroke,heart disease and subsequent all-cause mortality in a middle-aged and elderly European population.Methods A total of 78212 individuals aged≥50 years from the Survey of Health Ageing and Retirement in Europe were included.Participants with any baseline cardiometabolic diseases including diabetes,stroke and heart disease were excluded.Depressive symptoms were measured by the Euro-Depression scale at baseline.Participants were followed up to determine the occurrence of cardiometabolic diseases and all-cause mortality.We used multistate models to estimate the transition-specific HRs and 95%CIs after adjustment of confounders.Results During 500711 person-years of follow-up,4742 participants developed diabetes,2173 had stroke,5487 developed heart disease and 7182 died.Depressive symptoms were significantly associated with transitions from healthy to diabetes(HR:1.12,95%CI:1.05 to 1.20),stroke(HR:1.31,95%CI:1.18 to 1.44),heart disease(HR:1.26,95%CI:1.18 to 1.34)and all-cause mortality(HR:1.41,95%CI:1.34 to 1.49).After cardiometabolic diseases,depressive symptoms were associated with the increased risk of all-cause mortality in patients with diabetes(HR:1.54,95%CI:1.25 to 1.89),patients who had stroke(HR:1.29,95%CI:1.03 to 1.61)and patients with heart disease(HR:1.21,95%CI:1.02 to 1.44).Conclusions Depressive symptoms increase the risk of diabetes,stroke and heart disease,and affect the risk of mortality after the onset of these cardiometabolic conditions.Screening and treatment of depressive symptoms may have profound implications for the prevention and prognosis of cardiometabolic diseases.