Independent and combined effects of depressive symptoms and cardiometabolic risk factors on dementia incidence: a cross-country comparison in England, the United States and China

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2025-05-08 DOI:10.1016/j.archger.2025.105889

Panagiota Kontari , Chris Fife-Schaw , Kimberley Smith

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引用次数: 0

Abstract

Background

Depression and cardiometabolic conditions are suggested as modifiable risk factors for dementia, yet their combined impact remains unclear. This study assessed the independent and combined effects of depressive symptoms and cardiometabolic conditions on dementia incidence in England, the US and China.

Methods

The sample comprised 4472 participants aged 50 and older from the English Longitudinal Study of Ageing (ELSA), 5021 from Health and Retirement Study (HRS), and 8925 from China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were assessed using the Center for Epidemiological Studies-Depression scale. Cardiometabolic factors included central obesity, low high‐density-lipoprotein (HDL) cholesterol, systolic and diastolic blood pressure (BP), hyperglycemia, diabetes, and inflammation. Dementia incidence was estimated using confounder-adjusted Cox proportional hazards regressions, and pooled estimates were obtained using random-effects meta-analysis.

Results

A total of 1218 individuals developed dementia over a median of 6.8–12.2 years. Depressive symptoms (ELSA: HR = 1.47 [95 % CI = 1.09–2.00]; HRS: HR = 1.68 [95 % CI = 1.33–2.13]; CHARLS: HR = 1.35 [95 % CI = 1.12–1.64]) and elevated systolic BP (ELSA: HR = 1.51 [95 % CI = 1.17–1.95]; HRS: HR = 1.48 [95 % CI = 1.24–1.79]; CHARLS: HR = 1.26 [95 % CI = 1.05–1.52]) were linked to dementia risk in all countries. While cardiometabolic multimorbidity (≥2 conditions) was not associated with dementia risk, those with the highest cardiometabolic index (≥4 conditions) had a greater risk of dementia in all samples (ELSA: HR = 1.82 [95 % CI = 1.01–3.26]; HRS: HR = 1.85 [95 % CI = 1.02–3.35]; CHARLS: HR = 1.65 [95 % CI = 1.18–2.30]).

Conclusion

Depressive symptoms are independently linked to dementia risk, while having multiple cardiometabolic conditions further increases this risk, especially when co-occurring with depressive symptoms in both Western and Chinese populations.

查看原文本刊更多论文

抑郁症状和心血管代谢危险因素对痴呆发病率的独立和联合影响：英国、美国和中国的跨国比较

背景：抑郁症和心脏代谢疾病被认为是痴呆的可改变的危险因素，但它们的综合影响尚不清楚。本研究评估了英国、美国和中国的抑郁症状和心脏代谢状况对痴呆发病率的独立和联合影响。方法采用英国老龄化纵向研究（ELSA）的4472名、健康与退休研究（HRS）的5021名和中国健康与退休纵向研究（CHARLS）的8925名50岁及以上的参与者作为样本。使用流行病学研究中心抑郁量表评估抑郁症状。心脏代谢因素包括中枢性肥胖、低高密度脂蛋白（HDL）胆固醇、收缩压和舒张压（BP）、高血糖、糖尿病和炎症。使用混杂校正Cox比例风险回归估计痴呆发病率，并使用随机效应荟萃分析获得汇总估计值。结果共有1218人在6.8-12.2年的中位数期间患上痴呆。抑郁症状(ELSA: HR = 1.47 [95% CI = 1.09-2.00]；hr: hr = 1.68 [95% ci = 1.33-2.13]；CHARLS: HR = 1.35 [95% CI = 1.12-1.64])和收缩压升高(ELSA: HR = 1.51 [95% CI = 1.17-1.95]；hr: hr = 1.48 [95% ci = 1.24-1.79]；CHARLS: HR = 1.26 [95% CI = 1.05-1.52])与痴呆风险相关。虽然心脏代谢多病（≥2种情况）与痴呆风险无关，但在所有样本中，心脏代谢指数最高（≥4种情况）的患者患痴呆的风险更高(ELSA: HR = 1.82 [95% CI = 1.01-3.26]；Hrs: hr = 1.85 [95% ci = 1.02-3.35]；Charls: hr = 1.65 [95% ci = 1.18-2.30])。抑郁症状与痴呆风险独立相关，而患有多种心脏代谢疾病进一步增加了这种风险，特别是在西方和中国人群中与抑郁症状同时发生时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.