Co-existing depression and visual impairment increased incident cardiovascular disease risk by 56% (HR 1.56, 95% CI 1.40–1.73) in Chinese adults ≥45 years, with depression being the predominant risk factor.
Cohort (n=18,633)
Yes
Does the presence of depression and/or visual impairment increase the risk of incident cardiovascular disease in middle-aged and older adults?
Depression and visual impairment are independently associated with increased incident CVD risk, but their co-occurrence shows an antagonistic interaction where the combined risk does not exceed that of depression alone.
Effect estimate: HR 1.56 for combined depression and visual impairment vs control (95% CI 1.40–1.73)
p-value: p=<0.001
Depression and visual impairment (VI) are prevalent in aging populations and known risk factors for cardiovascular disease (CVD). Their combined impact on CVD incidence remains poorly defined. This study investigated the individual and combined effects of depression and VI on incident CVD in a large Chinese cohort. We included 18,633 participants aged ≥ 45 from the China Health and Retirement Longitudinal Study (2011–2018). Participants were categorized into four groups: control, depression only, VI only, and both. Incident CVD was identified during follow-up. Cox regression was used to estimate hazard ratios (HRs). In the fully adjusted model, all three exposure groups had significantly higher CVD risk than the control group. The highest risk was for depression only (HR: 1.60; 95% CI: 1.36–1.89), followed by co-occurring depression and visual impairment (HR: 1.56; 95% CI: 1.40–1.73), and visual impairment only (HR: 1.25; 95% CI: 1.13–1.38). A significant negative multiplicative interaction was observed (HR for interaction: 0.78; 95% CI: 0.65–0.93; p = 0.006). Depression and VI are independently associated with increased CVD risk. Their co-occurrence shows an antagonistic interaction, with combined risk not exceeding that of depression alone. Screening for depressive symptoms in older adults, especially those with VI, may aid CVD prevention.
Zhou et al. (Mon,) conducted a cohort in Chinese adults aged ≥45 years free of cardiovascular disease at baseline, with assessment of depressive symptoms and visual impairment (n=18,633). Depression (CES-D 10 score ≥10) and/or visual impairment (self-reported fair or poor vision) vs. Control group without depression or visual impairment was evaluated on Incident cardiovascular disease (doctor-diagnosed new-onset heart disease or stroke) (HR 1.56 for combined depression and visual impairment vs control, 95% CI 1.40–1.73, p=<0.001). Co-existing depression and visual impairment increased incident cardiovascular disease risk by 56% (HR 1.56, 95% CI 1.40–1.73) in Chinese adults ≥45 years, with depression being the predominant risk factor.