Article
Linking cardiometabolic multimorbidity to depressive symptoms in oldest-old people: results from a cross-sectional study in Germany
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Authors
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Verena Maschke
- Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Valerie Lohner
- Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Ute Mons
- Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| Published: | September 6, 2024 |
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Outline
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Background: Depression is often associated with the presence of cardiometabolic multimorbidity (CMM). However, it remains unclear whether this association persists in the very old population. Hence, we examined the link between CMM and depressive symptoms in the oldest-old population.
Methods: Using cross-sectional data from a representative sample of individuals aged 80 years and older in North Rhine-Westphalia, Germany (N=1,863), we constructed an additive disease index covering seven cardiometabolic diseases (CMDs): myocardial infarction, heart failure, hypertension, stroke, diabetes, kidney disease, and obesity. Depressive symptoms were assessed using the short form of the Depression in Old Age Scale (ranging from 0 to 4 points). We employed a multivariable linear regression model to study associations between disease index categories (0, 1, 2, ≥3 CMDs) and depressive symptoms, and report beta coefficients (β) with 95% confidence intervals (CIs).
Results: The study population was evenly distributed across age groups (80-84, 85-89, and 90 years and older), with 50.2% being women. Participants exhibited mean depressive symptoms of 0.94, and 44.0% presented with two or more CMDs. Heart failure, hypertension, stroke, and obesity were each individually associated with heightened depressive symptoms. An increase in depressive symptoms was observed in participants with two CMDs (β=0.30; 95% CI: 0.12-0.48) and three or more (β=0.40; 95% CI: 0.18-0.62), in reference to those with no CMD. Moreover, we observed a significant, additive dose-response association between an increase in CMD count and depressive symptoms (β=0.16; 95% CI: 0.09-0.23). This association tended to be slightly more pronounced for women (β=0.19; 95% CI: 0.10-0.29) than for men (β=0.10; 95% CI: 0.02-0.19).
Conclusion: A higher number of CMDs was associated with increased depressive symptomatology, indicating the need to address both physical and mental health in oldest-old individuals with high CMD burden.
The authors declare that they have no competing interests.
The authors declare that a positive ethics committee vote has been obtained.
