Lifetime depression and age-related changes in body composition, cardiovascular function, grip strength and lung function: sex-specific analyses in the UK Biobank

Abstract

Individuals with depression, on average, die prematurely, have high levels of physical comorbidities and may experience accelerated biological ageing. A greater understanding of age-related changes in physiology could provide novel biological insights that may help inform strategies to mitigate excess mortality in depression. We used generalised additive models to examine age-related changes in 15 cardiovascular, body composition, grip strength and lung function measures, comparing males and females with a lifetime history of depression to healthy controls. The main dataset included 342,393 adults (mean age = 55.87 years, SD = 8.09; 52.61% females). We found statistically significant case-control differences for most physiological measures. There was some evidence that age-related changes in body composition, cardiovascular function, lung function and heel bone mineral density followed different trajectories in depression. These differences did not uniformly narrow or widen with age and differed by sex. For example, BMI in female cases was 1.1 kg/m² higher at age 40 and this difference narrowed to 0.4 kg/m² at age 70. In males, systolic blood pressure was 1 mmHg lower in depression cases at age 45 and this difference widened to 2.5 mmHg at age 65. These findings suggest that targeted screening for physiological function in middle-aged and older adults with depression is warranted to potentially mitigate excess mortality.

Keywords: aging; body composition; cardiovascular function; depression; grip strength.

Figure 1

Flowchart of study population. The main dataset included hand-grip strength, blood pressure, pulse rate and measures of body composition.

Figure 2

Generalised additive models of age-related changes in physiological measures in females with lifetime depression and healthy controls. The solid lines represent physiological measures against smoothing functions of age. The shaded areas correspond to approximate 95% confidence intervals (± 2 × standard error). FEV₁, forced expiratory volume in one second; FVC, forced vital capacity.

Figure 3

Generalised additive models of age-related changes in physiological measures in males with lifetime depression and healthy controls. The solid lines represent physiological measures against smoothing functions of age. The shaded areas correspond to approximate 95% confidence intervals (± 2 × standard error). FEV₁, forced expiratory volume in one second; FVC, forced vital capacity.

Figure 4

Difference smooths comparing age-related changes in physiological measures of females with lifetime depression to healthy controls. The shaded areas correspond to approximate 95% confidence intervals (± 2 × standard error). Negative values on the y-axes correspond to lower values in females with lifetime depression compared to healthy controls. The horizontal lines represent no difference between female cases and controls. FEV₁, forced expiratory volume in one second; FVC, forced vital capacity; Bonf, Bonferroni; BH, Benjamini and Hochberg.

Figure 5

Difference smooths comparing age-related changes in physiological measures of males with lifetime depression to healthy controls. The shaded areas correspond to approximate 95% confidence intervals (± 2 × standard error). Negative values on the y-axes correspond to lower values in males with lifetime depression compared to healthy controls. The horizontal lines represent no difference between male cases and controls. FEV₁, forced expiratory volume in one second; FVC, forced vital capacity; Bonf, Bonferroni; BH, Benjamini and Hochberg.