Depressive symptoms and risk of incident cardiometabolic multimorbidity in community-dwelling older adults: The China Health and Retirement Longitudinal Study

Depressive symptoms are associated with an increased risk of developing cardiometabolic diseases (CMDs). However, the relationship between depressive symptoms and cardiometabolic multimorbidity (CMM) remains unclear. Therefore, we aimed to examine whether depressive symptoms were associated with an increased risk of incident CMM in middle-aged and older Chinese adults. This prospective cohort study included 6663 participants who were free of CMM at baseline from the China Health and Retirement Longitudinal Study. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale-10 (CESD-10). Incident CMM refers to the coexistence of ≥2 CMDs (heart disease, stroke, or diabetes). Multivariable logistic regressions and restricted cubic splines were performed to assess the association between depressive symptoms and incident CMM. The median CESD-10 score at baseline was 7 (IQR: 3 to 12). Over 4 years of follow-up, 309 participants (4.6 %) developed CMM. After adjusting for sociodemographic, behavioral, and traditional clinical risk factors, a higher frequency of depressive symptoms was associated with an increased risk of incident CMM (per 9-point higher CESD-10 score OR: 1.73; 95 % CI: 1.48–2.03). The association between the CESD-10 score and incident CMM was more obvious in women (OR: 2.02; 95 % CI: 1.63–2.51) than in men (OR: 1.16; 95 % CI: 0.86–1.56) (P interaction = 0.005). Heart diseases and stroke were determined based on self-reported physician diagnoses. A higher frequency of depressive symptoms at baseline increased the risk of incident CMM within four years among middle-aged and older individuals in China.