The relationship between depression and cardiovascular disease in older people: results from a large-scale epidemiological cohort study in Japan.

Abstract

Background: Depression is known to be associated with a greater risk of developing cardiovascular disease (CVD) in middle-aged people. However, it is not certain how depression would influence incident CVD in older people aged ≥ 75 years. We investigated the association between depression and CVD in older people.

Methods: We analyzed 146,085 individuals aged ≥ 75 years including 7581 individuals (5.2%) with depression registered in the DeSC database from April 2014 to November 2022. We excluded those with a prior history of CVD. The incidence of composite CVD events, comprising ischemic heart disease (IHD), heart failure, and stroke was documented. A Cox proportional hazard regression analysis was conducted to estimate hazard ratios (HR) associated with the presence of depression.

Results: The median age was 79 years and 41.0% were men. During the mean follow-up period of 3.4 ± 1.5 years, 39,552 composite CVD events (IHD: n = 10,916; heart failure: n = 26,719; stroke: n = 13,090) were recorded. Multivariable Cox regression analyses showed that older individuals with depression had a greater risk of composite CVD events than those without (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.24-1.34). The HR (95% CI) of depression was 1.26 (1.17-1.37) for IHD, 1.25 (1.19-1.31) for heart failure, and 1.30 (1.21-1.39) for stroke, respectively. While considering the limitations of real-world data, we conducted multiple sensitivity analyses, which confirmed the results of the primary analysis.

Conclusions: The presence of depression was independently associated with a greater risk of developing CVD even in older individuals.