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Time-dependent depressive symptoms and risk of cardiovascular and all-cause mortality among the Chinese elderly: The Beijing Longitudinal Study of Aging.

Haibin Li,Nicholas Van Halm-Lutterodt,D. Zheng,Yue Liu,Jin Guo,W. Feng,Xia Li,Anxin Wang,Xiangtong Liu,L. Tao,C. Hou,Yanxia Luo,Feng Zhang,Xinghua Yang,Qi Gao,Wei Wang,Zhe Tang,Xiuhua Guo

Published 2018 in Journal of Cardiology

ABSTRACT

BACKGROUND Depressive symptoms tend to fluctuate over time. Data on the relationship between time-dependent depressive symptoms and the risk of cardiovascular and all-cause mortality among the elderly in China are lacking. METHODS AND RESULTS A prospective cohort of 1999 subjects aged ≥55 years were enrolled in the Beijing Longitudinal Study of Aging since 1992. Depressive symptoms were assessed at baseline (0 years) and after 2, 5, 8, and 12 years, defined as a score of ≥16 on the 20-item Center for Epidemiological Studies Depression Scale. Mortality status was obtained from the local death registry until December 31st, 2012. Hazard ratio (HR) for all-cause mortality and sub-distribution HR (SHR) for cardiovascular mortality were respectively deduced from time-dependent Cox and competing risk models. During 19,658 person-years of follow-up, 1127 (55.65%) deaths were recorded, of which 483 (23.85%) were attributable to cardiovascular inclinations. Baseline depressive symptoms were neither associated with all-cause mortality (adjusted HR: 1.12, 95% confident interval, CI: 0.94-1.33) nor cardiovascular mortality (adjusted SHR: 1.10, 95% CI: 0.82-1.46) after adjustment of potential cardiac-risk factors. When depressive symptoms were used as time-dependent variable updated from 1992 to 2004, the associations were significant for both all-cause mortality (adjusted HR: 1.48, 95% CI: 1.26-1.73) and cardiovascular mortality (adjusted SHR: 1.40, 95% CI: 1.08-1.82) in the full adjusted model. CONCLUSIONS Time-dependent depressive symptoms increased the risk of all-cause and cardiovascular mortality among the elderly in China.

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