Trajectories of depressive symptoms and the risk of cardiovascular, dementia, and pulmonary events in older adults: Evidence from the English Longitudinal Study of Ageing

Abstract

Purpose

This research investigates the relationship between patterns of depressive symptoms over time and the likelihood of developing cardiovascular disease, dementia, and pulmonary conditions.

Methods

We examined 11,577 participants aged 50 and older. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale-8 (CESD-8). Group-based trajectory modeling was employed to categorize patterns of depressive symptoms, while Cox proportional hazards models were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI). Sensitivity analysis for missing data was conducted using multiple imputation and data deletion methods, and the model's timeliness and stability were evaluated through time sensitivity analysis.

Results

Five distinct trajectories of depressive symptoms were identified: consistently low (n = 3353), decreasing (n = 127), increasing (n = 128), fluctuating (n = 7674), and consistently high (n = 295). Compared to the consistently low group, individuals with consistently high depressive symptoms faced significantly elevated risks of cardiovascular disease (HR = 1.65, 95 % CI = 1.38–1.98, P = 0.00), dementia (HR = 2.09, 95 % CI = 1.16–3.79, P = 0.02), and pulmonary diseases (HR = 3.12, 95 % CI = 2.41–4.05, P = 0.00). Fluctuating and increasing trajectories were also associated with higher risks, while the decreasing trajectory correlated with a reduced risk of dementia (HR = 0.77, 95 % CI = 0.62–0.95, P = 0.01).

Conclusion

Long-term patterns of depressive symptoms are strongly linked to the development of cardiovascular disease, dementia, and pulmonary diseases.