Abstract 12083: Symptoms of Depression and All-Cause and Cardiovascular Disease Mortality Among US Adults, NHANES 2005-2018

Abstract

Introduction: Depression is a common mental health disorder among the US population. Depressive symptoms are associated with increased cardiovascular disease (CVD) incidence and mortality rates. Few recent studies have examined the association between depressive symptoms and mortality among US adults. Hypothesis: Depressive symptoms increase all-cause and CVD mortality among US adults. Methods: The present study used the National Health and Nutrition Examination Survey (NHANES) 2005-2018 data with the NHANES 2019 Linked Mortality Files among adults aged ≥20 years. Depressive symptoms were defined by the Patient Health Questionnaire-9 (PHQ-9) scores and categorized into 3 groups: (1) none or minimal (0-4); (2) mild (5-9); and (3) moderate to severe (10-27). Cox proportional hazard models were used to evaluate the association between depressive symptoms and all-cause, CVD, and ischemic heart disease mortality, adjusting for sociodemographic factors, lifestyle factors, and clinical characteristics. Results: Prevalences of none or minimal, mild, and moderate to severe depression were 77.9%, 14.9%, and 7.2%, respectively. For all-cause mortality, hazard ratios were 1.35 (95% confidence interval, 1.06, 1.72) for mild depressive symptoms vs none, and 1.61 (1.24, 2.10) for moderate to severe depressive symptoms vs none. The corresponding hazard ratios were 1.49 (1.11, 2.00) and 1.79 (1.22, 2.62) for CVD mortality, and 0.96 (0.58, 1.60) and 2.21 (1.24, 3.91) for ischemic heart disease mortality. The associations were largely consistent across subgroups. Approximately 11.0%-16.1% of the associations between depression and mortality could be explained by lifestyle factors. Conclusions: Overall, there was a graded and positive association between depressive symptoms and mortality among US adults. Public health and healthcare efforts to improve awareness and treatment of depression and its related risk factors can support a comprehensive strategy to reduce the overall burden of depression nationwide.