Cargando…

Observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the REGARDS study

OBJECTIVE: To assess the association between time-varying depressive symptoms with all-cause and cause-specific mortality. DESIGN: The REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a national, population-based longitudinal study conducted from 2003 to 2007. SETTING: General co...

Descripción completa

Detalles Bibliográficos
Autores principales: Moise, Nathalie, Khodneva, Yulia, Jannat-Khah, Deanna Pereira, Richman, Joshua, Davidson, Karina W, Kronish, Ian M, Shaffer, Jonathan, Safford, Monika M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5780736/
https://www.ncbi.nlm.nih.gov/pubmed/29306879
http://dx.doi.org/10.1136/bmjopen-2017-017385
_version_ 1783294797851656192
author Moise, Nathalie
Khodneva, Yulia
Jannat-Khah, Deanna Pereira
Richman, Joshua
Davidson, Karina W
Kronish, Ian M
Shaffer, Jonathan
Safford, Monika M
author_facet Moise, Nathalie
Khodneva, Yulia
Jannat-Khah, Deanna Pereira
Richman, Joshua
Davidson, Karina W
Kronish, Ian M
Shaffer, Jonathan
Safford, Monika M
author_sort Moise, Nathalie
collection PubMed
description OBJECTIVE: To assess the association between time-varying depressive symptoms with all-cause and cause-specific mortality. DESIGN: The REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a national, population-based longitudinal study conducted from 2003 to 2007. SETTING: General continental US communities. PARTICIPANTS: 29 491 black and white US adults ≥45 years randomly sampled within race–sex–geographical strata. EXPOSURE: Elevated depressive symptoms (Centre for Epidemiologic Studies Depression (CES-D) 4≥4) measured at baseline and on average 5 and 7 years later. MAIN OUTCOME MEASURES: Cox proportional hazard regression models assessed cancer, non-cardiovascular (cardiovascular disease (CVD)), CVD and all-cause mortality. RESULTS: The average age was 64.9 years; 55% were women; 41% black; 11.0% had elevated depressive symptoms; 54% had poor, fair or good health. Time-varying depressive symptoms were significantly associated with non-CVD (adjusted HR (aHR)=1.29, 95% CI 1.16 to 1.44) and all-cause (aHR=1.24, 95% CI 1.14 to 1.39), but not cancer (aHR=1.15, 95% CI 0.96 to 1.38) or CVD (aHR=1.13, 95% CI 0.98 to 1.32) death adjusting for demographics, chronic clinical diseases, behavioural risk factors and physiological factors. Depressive symptoms were related to all-cause (aHR=1.48, 95% CI 1.27 to 1.78), CVD (aHR=1.37, 95% CI 0.99 to 1.91), non-CVD (aHR=1.54, 95% CI 1.24 to 1.92) and cancer (aHR=1.36, 95% CI 0.97 to 1.91) death in those who reported excellent or very good health. The analyses of the association between one measure of baseline depressive symptoms and mortality analyses yielded similar results. CONCLUSIONS: Time-varying depressive symptoms confer an increased risk for all-cause mortality, CVD, non-CVD death and cancer death, particularly in those with excellent or very good health. These findings may have implications for timely treatment, regardless of health status.
format Online
Article
Text
id pubmed-5780736
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-57807362018-01-31 Observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the REGARDS study Moise, Nathalie Khodneva, Yulia Jannat-Khah, Deanna Pereira Richman, Joshua Davidson, Karina W Kronish, Ian M Shaffer, Jonathan Safford, Monika M BMJ Open Mental Health OBJECTIVE: To assess the association between time-varying depressive symptoms with all-cause and cause-specific mortality. DESIGN: The REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a national, population-based longitudinal study conducted from 2003 to 2007. SETTING: General continental US communities. PARTICIPANTS: 29 491 black and white US adults ≥45 years randomly sampled within race–sex–geographical strata. EXPOSURE: Elevated depressive symptoms (Centre for Epidemiologic Studies Depression (CES-D) 4≥4) measured at baseline and on average 5 and 7 years later. MAIN OUTCOME MEASURES: Cox proportional hazard regression models assessed cancer, non-cardiovascular (cardiovascular disease (CVD)), CVD and all-cause mortality. RESULTS: The average age was 64.9 years; 55% were women; 41% black; 11.0% had elevated depressive symptoms; 54% had poor, fair or good health. Time-varying depressive symptoms were significantly associated with non-CVD (adjusted HR (aHR)=1.29, 95% CI 1.16 to 1.44) and all-cause (aHR=1.24, 95% CI 1.14 to 1.39), but not cancer (aHR=1.15, 95% CI 0.96 to 1.38) or CVD (aHR=1.13, 95% CI 0.98 to 1.32) death adjusting for demographics, chronic clinical diseases, behavioural risk factors and physiological factors. Depressive symptoms were related to all-cause (aHR=1.48, 95% CI 1.27 to 1.78), CVD (aHR=1.37, 95% CI 0.99 to 1.91), non-CVD (aHR=1.54, 95% CI 1.24 to 1.92) and cancer (aHR=1.36, 95% CI 0.97 to 1.91) death in those who reported excellent or very good health. The analyses of the association between one measure of baseline depressive symptoms and mortality analyses yielded similar results. CONCLUSIONS: Time-varying depressive symptoms confer an increased risk for all-cause mortality, CVD, non-CVD death and cancer death, particularly in those with excellent or very good health. These findings may have implications for timely treatment, regardless of health status. BMJ Publishing Group 2018-01-05 /pmc/articles/PMC5780736/ /pubmed/29306879 http://dx.doi.org/10.1136/bmjopen-2017-017385 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Mental Health
Moise, Nathalie
Khodneva, Yulia
Jannat-Khah, Deanna Pereira
Richman, Joshua
Davidson, Karina W
Kronish, Ian M
Shaffer, Jonathan
Safford, Monika M
Observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the REGARDS study
title Observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the REGARDS study
title_full Observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the REGARDS study
title_fullStr Observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the REGARDS study
title_full_unstemmed Observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the REGARDS study
title_short Observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the REGARDS study
title_sort observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the regards study
topic Mental Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5780736/
https://www.ncbi.nlm.nih.gov/pubmed/29306879
http://dx.doi.org/10.1136/bmjopen-2017-017385
work_keys_str_mv AT moisenathalie observationalstudyofthedifferentialimpactoftimevaryingdepressivesymptomsonallcauseandcausespecificmortalitybyhealthstatusincommunitydwellingadultstheregardsstudy
AT khodnevayulia observationalstudyofthedifferentialimpactoftimevaryingdepressivesymptomsonallcauseandcausespecificmortalitybyhealthstatusincommunitydwellingadultstheregardsstudy
AT jannatkhahdeannapereira observationalstudyofthedifferentialimpactoftimevaryingdepressivesymptomsonallcauseandcausespecificmortalitybyhealthstatusincommunitydwellingadultstheregardsstudy
AT richmanjoshua observationalstudyofthedifferentialimpactoftimevaryingdepressivesymptomsonallcauseandcausespecificmortalitybyhealthstatusincommunitydwellingadultstheregardsstudy
AT davidsonkarinaw observationalstudyofthedifferentialimpactoftimevaryingdepressivesymptomsonallcauseandcausespecificmortalitybyhealthstatusincommunitydwellingadultstheregardsstudy
AT kronishianm observationalstudyofthedifferentialimpactoftimevaryingdepressivesymptomsonallcauseandcausespecificmortalitybyhealthstatusincommunitydwellingadultstheregardsstudy
AT shafferjonathan observationalstudyofthedifferentialimpactoftimevaryingdepressivesymptomsonallcauseandcausespecificmortalitybyhealthstatusincommunitydwellingadultstheregardsstudy
AT saffordmonikam observationalstudyofthedifferentialimpactoftimevaryingdepressivesymptomsonallcauseandcausespecificmortalitybyhealthstatusincommunitydwellingadultstheregardsstudy