Cardiometabolic Diseases Associated With Elevated Depression Risk

Cardiometabolic diseases have a dose-dependent association with an increased risk for depression, investigators reported in European Psychiatry.

The prospective cohort study enrolled participants from the Swedish Twin Registry to assess the association between cardiometabolic multimorbidity and risk of late-life depression and potential genetic and early-life environmental factors.

A classical cohort study design included all twin individuals in an unmatched analysis, and a matched co-twin analysis involved twin pairs discordant for cardiometabolic diseases and depression.

The population included 40,080 twin individuals (mean age, 60.47±10.69 years; 53.3% women). A total of 5778 participants (14.4%) had 1 or more cardiometabolic diseases, 4809 (12.0%) had 1 cardiometabolic disease and 969 (2.4%) had cardiometabolic multimorbidity.

After a median follow-up of 15.9 years, 1361 (3.4%) individuals developed depression. Based on the Cox analysis models, participants with any cardiometabolic disease (hazard ratio [HR], 1.55; 95% CI, 1.35-1.78), 1 cardiometabolic disease (HR, 1.52; 95% CI, 1.31-1.76), or cardiometabolic multimorbidity (HR, 1.83; 95% CI, 1.29-2.58) had an increased risk for depression, compared with cardiometabolic disease-free participants.

A significant dose-dependent relationship was found between number of comorbid cardiometabolic diseases and depression risk, with depression risk increasing by 43% with each additional comorbid cardiometabolic disease (HR, 1.43; 95% CI, 1.28-1.60).

The risk for depression was increased in cases in which an individual’s initial cardiometabolic disease occurred in midlife (HR, 1.62; 95% CI, 1.34-1.95) vs late life (HR, 1.41; 95% CI, 1.17-1.70). The risk for depression was increased in participants who had a second cardiometabolic disease in midlife (HR, 2.07; 95% CI, 1.07-4.00) vs late life (HR, 1.60; 95% CI, 1.07-2.40).

No significant multiplicative interaction was observed between sex and cardiometabolic diseases for depression risk (P =.309).

In the matched co-twin analysis, the association between cardiometabolic disease and depression in the classical cohort study design continued to be observed in dizygotic twin pairs (HR, 1.63; 95% CI, 1.02-2.59) but not monozygotic twin pairs (HR, 0.90; 95% CI, 0.32-2.51).

Among several limitations, the Swedish database only includes data from inpatient and outpatient clinics, and the number of cases of incident depression in some cardiometabolic disease groups was small.

“Our study highlights active management of CMDs [cardiometabolic diseases] as a potential strategy for prevention of depression and underscores the need for mental health resources for individuals with CMDs, especially those with cardiometabolic multimorbidity,” the researchers wrote.

This article originally appeared on The Cardiology Advisor