Associations between cardiac structure and function and depressive disorder: A centenarian study in China

Abstract

Background: Depressive disorder is a common comorbidity in patients with cardiovascular diseases and is associated with increased hospitalization and death rates. The relationships between cardiac structure and function and depressive disorder remains unclear in the older adults, especially in centenarians. Therefore, this study aimed to explore the possible associations between cardiac structure and function and depressive disorder among centenarians.

Methods: In the China Hainan Centenarian Cohort Study, the 15-item Geriatric Depression Scale scores and echocardiography were used to evaluate depressive disorder and cardiac structure and function, respectively. All information, including epidemiological questionnaires, physical examinations, and blood tests, was obtained following standardized procedures.

Results: A total of 682 centenarians were enrolled in the study (mean age: 102.35 ± 2.72 years). The prevalence of depressive disorder in centenarians is 26.2% (179 older adults), of whom 81.2% (554 older adults) are women. Centenarians with depressive disorder have significantly higher left ventricular ejection fraction (60.02 ± 3.10) and interventricular septum thickness (9.79 ± 1.54). Stepwise multiple linear regression analysis detected positive associations of left ventricular ejection fraction (Bets: 0.093) and interventricular septum thickness (Bets: 0.440) with Geriatric Depression Scale scores. Both left ventricular ejection fraction (odds ratio: 1.081) and interventricular septum thickness (odds ratio: 1.274) were independently associated with depressive disorder in multiple logistic regression analysis (P < 0.05, all).

Conclusions: The prevalence of depressive disorder remains very high, and associations were found between left ventricular ejection fraction, interventricular septum thickness, and depressive disorder in Chinese centenarians. Future studies should focus on their temporal relationships to improve cardiac structure and function, prevent depressive disorder, and achieve healthy aging by coordinating their relationships.

Keywords: Centenarians; Depressive disorder; Geriatric depression scale; Interventricular septum thickness; Left ventricular ejection fraction.

Fig. 1

Information of the China Hainan Centenarian Cohort Study (CHCCS) and flowchart of participant selection based on inclusion and exclusion criteria in this study (CONSORT 2010 Flow Diagram).

Fig. 2

Left ventricular ejection fraction (LVEF) of centenarians with and without depressive disorder (A); Interventricular septum thickness (IVST) of centenarians with and without depressive disorder (B); LVEF of centenarians with depressive disorder in echocardiography (C); LVEF of centenarians without depressive disorder in echocardiography (D); IVST of centenarians with depressive disorder in apical four-chamber view of echocardiography (E); IVST of centenarians without depressive disorder in apical four-chamber view of echocardiography (F); IVST of centenarians with depressive disorder in left ventricular long-axis view of echocardiography (G); IVST of centenarians without depressive disorder in left ventricular long-axis view of echocardiography (H).

Fig. 3

Stepwise multiple linear regression analysis based on the GDS-15 scores. Note: adjusted for age, sex, BMI, smoking, drinking, CI, physical disability, hemoglobin, hyperlipidemia, diabetes mellitus, hypertension, renal disease, LVEF, aortic diameter, left ventricular end-diastolic diameter, IVST, LVPWT, left atrial end-systolic diameter, right ventricular end-diastolic diameter, right atrial end-systolic diameter, and pulmonary artery diameter. Abbreviations: GDS-15: Geriatric Depression Scale; BMI, body mass index; CI, cognitive impairment; LVEF, left ventricular ejection fraction; IVST, interventricular septum thickness; LVPWT, left ventricular posterior wall thickness.