Linking cardiometabolic multimorbidity to depressive symptoms in the oldest-old: results from a cross-sectional study in Germany

Background Depression often accompanies cardiometabolic multimorbidity (CMM), but it remains unclear whether this association persists in very old people. Hence, we examined the link between CMM and depressive symptoms in an oldest-old population. Methods Using cross-sectional data from a representa...

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Published in:BMC public health Vol. 25; no. 1; pp. 1720 - 10
Main Authors: Maschke, Verena, Lohner, Valerie, Mons, Ute
Format: Journal Article
Language:English
Published: London BioMed Central 09.05.2025
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Age
Age groups
Aged, 80 and over
Biostatistics
Cardiometabolic multimorbidity
Cardiovascular Diseases - epidemiology
Care and treatment
Cerebral infarction
Chronic illnesses
Comorbidity
Congestive heart failure
Cross-Sectional Studies
Depression
Depression - epidemiology
Depression, Mental
Diabetes
Diabetes mellitus
Diagnosis
Environmental Health
Epidemiology
Female
Geriatric psychiatry
Germany - epidemiology
Heart failure
Humans
Hypertension
Kidney diseases
Liver cancer
Liver diseases
Longitudinal studies
Lung cancer
Lung diseases
Male
Medicine
Medicine & Public Health
Mental depression
Metabolic disorders
Multimorbidity
Myocardial infarction
Obesity
Older people
Practice
Psychocardiology
Psychogeriatrics
Public Health
Regression analysis
Regression models
Risk factors
Signs and symptoms
Stroke
Vaccine
Womens health
Germany
Depression
Psychogeriatrics
Cardiometabolic multimorbidity
Psychocardiology
ISSN:1471-2458, 1471-2458
Online Access:Get full text
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Summary:Background Depression often accompanies cardiometabolic multimorbidity (CMM), but it remains unclear whether this association persists in very old people. Hence, we examined the link between CMM and depressive symptoms in an oldest-old population. Methods Using cross-sectional data from a representative sample of individuals aged 80 years and older in North Rhine-Westphalia, Germany ( N  = 1,863), we constructed an additive disease index covering seven cardiometabolic diseases (CMDs): myocardial infarction, heart failure, hypertension, stroke, diabetes mellitus, kidney disease, and obesity. Depressive symptoms were assessed using the short form of the Depression in Old Age Scale (0 to 4 points). We employed multivariable linear regression models to study associations of CMD index (0, 1, 2, ≥ 3 CMDs) and CMD count (0 to 7 diseases) with depressive symptoms, adjusting for age, sex, socio-economic index, respiratory and pulmonary disease, cancer, and liver disease. Results Participants had a mean depressive symptom score of 0.94, and 44% reported two or more CMDs. Heart failure, hypertension, stroke, and obesity were each individually associated with more depressive symptoms. Participants with two (β = 0.30; 95%-CI: 0.12–0.48), and three or more CMDs (β = 0.40; 95%-CI: 0.18–0.62) showed higher depressive symptoms compared to those with no CMD, i.e., each additional CMD was associated with a 0.30-unit or 0.40-unit increase in depressive symptoms, respectively. We observed an additive dose–response association between CMD count and depressive symptoms (β = 0.16; 95%-CI: 0.09–0.23), slightly more pronounced for women (β = 0.19; 95%-CI: 0.10–0.29) than for men (β = 0.10, 95%-CI: 0.02–0.19). Conclusions Individuals with CMM showed increased depressive symptomatology, indicating the need to address both physical and mental health in oldest-old individuals with high CMD burden. However, the cross-sectional study design prevents conclusions about causality and warrants further longitudinal studies.
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ISSN:1471-2458
1471-2458
DOI:10.1186/s12889-025-22964-1