Maschke Verena, Lohner Valerie, Mons Ute
Department of Cardiology, Faculty of Medicine and University Hospital Cologne, Cardiovascular Epidemiology of Aging, University of Cologne, Kerpener Straße 62, Cologne, 50937, Germany.
BMC Public Health. 2025 May 9;25(1):1720. doi: 10.1186/s12889-025-22964-1.
Depression often accompanies cardiometabolic multimorbidity (CMM), but it remains unclear whether this association persists in very old people. Hence, we examined the link between CMM and depressive symptoms in an oldest-old population.
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 mellitus, kidney disease, and obesity. Depressive symptoms were assessed using the short form of the Depression in Old Age Scale (0 to 4 points). We employed multivariable linear regression models to study associations of CMD index (0, 1, 2, ≥ 3 CMDs) and CMD count (0 to 7 diseases) with depressive symptoms, adjusting for age, sex, socio-economic index, respiratory and pulmonary disease, cancer, and liver disease.
Participants had a mean depressive symptom score of 0.94, and 44% reported two or more CMDs. Heart failure, hypertension, stroke, and obesity were each individually associated with more depressive symptoms. Participants with two (β = 0.30; 95%-CI: 0.12-0.48), and three or more CMDs (β = 0.40; 95%-CI: 0.18-0.62) showed higher depressive symptoms compared to those with no CMD, i.e., each additional CMD was associated with a 0.30-unit or 0.40-unit increase in depressive symptoms, respectively. We observed an additive dose-response association between CMD count and depressive symptoms (β = 0.16; 95%-CI: 0.09-0.23), 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).
Individuals with CMM showed increased depressive symptomatology, indicating the need to address both physical and mental health in oldest-old individuals with high CMD burden. However, the cross-sectional study design prevents conclusions about causality and warrants further longitudinal studies.
抑郁症常与心脏代谢多病症（CMM）并存，但在高龄人群中这种关联是否持续尚不清楚。因此，我们在高龄人群中研究了CMM与抑郁症状之间的联系。
利用来自德国北莱茵-威斯特法伦州80岁及以上个体的代表性样本的横断面数据（N = 1863），我们构建了一个涵盖七种心脏代谢疾病（CMD）的累加疾病指数：心肌梗死、心力衰竭、高血压、中风、糖尿病、肾脏疾病和肥胖症。使用老年抑郁量表简表（0至4分）评估抑郁症状。我们采用多变量线性回归模型研究CMD指数（0、1、2、≥3种CMD）和CMD计数（0至7种疾病）与抑郁症状之间的关联，并对年龄、性别、社会经济指数、呼吸和肺部疾病、癌症以及肝脏疾病进行了调整。
参与者的平均抑郁症状评分为0.94，44%的人报告患有两种或更多种CMD。心力衰竭、高血压、中风和肥胖症各自都与更多的抑郁症状相关。与无CMD的参与者相比，患有两种CMD（β = 0.30；95%可信区间：0.12 - 0.48）以及三种或更多种CMD（β = 0.40；95%可信区间：0.18 - 0.62）的参与者表现出更高的抑郁症状，即每增加一种CMD分别与抑郁症状增加0.30单位或0.40单位相关。我们观察到CMD计数与抑郁症状之间存在累加剂量反应关联（β = 0.16；95%可信区间：0.09 - 0.23），女性（β = 0.19；95%可信区间：0.10 - 0.29）比男性（β = 0.10，95%可信区间：0.02 - 0.19）更为明显。
患有CMM的个体表现出抑郁症状增加，这表明对于CMD负担高的高龄个体，需要同时关注其身心健康。然而，横断面研究设计无法得出因果关系的结论，需要进一步进行纵向研究。
