| ObjectivesThis study explored and compared the influence of chronic diseases on incidence of depression in Chinese and European populations,in order to provide reference data for the prevention and treatment of depression and the reduction of the disease burden caused by depression.Study design and methodsThis study used data from the China Health and Retirement Longitudinal Study(CHARLS)and the Survey of Health,Aging,and Retirement in Europe(SHARE).Depression was evaluated using the 10 items Center for Epidemiological Studies Depression Scale(CES-D10)in CHARLS and Europe-Depression(Euro-D)in SHARE.Each item in CES-D10 was scored 0-3,and the total score ranges from 0 to 30.Euro-D includes 12 items in total,with 0 or 1 score for each item,with a total score of 12.Depression was defined by a score of 10 or more in the CES-D10 scale and 4 or more in the Euro-D.Chronic diseases were defined by inquiring about previous doctors’diagnoses,13 chronic diseases were included in CHARLS and 17 chronic diseases were included in SHARE.In the analytical sample,6,132 and 17,054 participants were included in CHARLS and SHARE,respectively.Participants>=50 years old without depression in CHARLS and SHARE were followed-up for an average of 3.40 and 3.28 years,respectively,to explore the associations of baseline chronic diseases with incident depression using Logistic regression models.The association was first examined in the two databases respectively,then in the pooled database,if the results were similar from the two individual databases.Results1.The relationship between baseline chronic disease and incident depression among middle-aged and older adults in ChinaDuring a 4-year follow-up,1788 of 6,132 individuals(29.16%,86/1,000 personyears)developed depression.People with chronic disease had a higher risk of developing depression(OR=1.35,95%CI:1.18-1.53)in the model adjusting for age,gender,education,living status,smoke,drink,BMI,and follow-up time.Further,the risk of depression increased with the increase in the number of chronic diseases(Ptrend<0.001).In addition,arthritis was significantly associated with an increased risk of depression(OR=1.38,95%CI:1.20-1.58)among the 13 chronic diseases.2.The relationship between baseline chronic disease and incident depression among middle-aged and older adults in EuropeDuring a 4-year follow-up,4,230 of 17,054 individuals(24.80%,76/1,000 personyears)developed depression.People with chronic disease had a higher risk of developing depression(OR=1.73,95%CI:1.57-1.90)in the model adjusting for age,gender,education,living status,smoke,drink,BMI,and follow-up time.Further,the risk of depression increased with the increase in the number of chronic diseases(Ptrend<0.001).In addition,among the 17 chronic diseases,diabetes/high blood sugar(OR=1.68,95%CI:1.28-2.20),arthritis(OR=1.60,95%CI:(1.28-2.00),stomach/duodenal ulcer/peptic ulcer(OR=1.78,95%CI:1.26-2.51),cataract(OR=1.40,95%CI:1.03-1.90),and other fractures(OR=1.59,95%CI:1.23-2.05)were significantly associated with increased risk of depression.3.The relationship between baseline chronic disease and incident depression among middle-aged and older adults in the total populationAfter pooling the two databases,6,018 of 23,186 individuals(25.96%,78/1,000 person-years)developed depression during a 4-year follow-up.People with chronic disease still had a higher risk of developing depression(OR=1.57,95%CI:1.46-1.69)in the model adjusting for age,gender,education,living status,smoke,drink,BMI,and follow-up time.Further,the risk of depression increased with the increase in the number of chronic diseases(P-trend<0.001).ConclusionsPeople with chronic diseases have a higher risk of developing depression,and the risk of depression increases with the increase in the number of chronic diseases in China and Europe.A higher risk of depression is also associated with some specific diseases:arthritis,peptic ulcer,diabetes or high blood sugar,cataracts and other fractures all significantly increase the risk of depression. |
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