Association between depression and activity of daily living with risk of cardiovascular disease

The aim of this study was to investigate the separate and joint association of depressive symptoms and limitation in activity of daily living with cardiovascular diseases. 9120 participants from CHARLS were included. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for cardiovascular disease (CVD), stroke and cardiac events were calculated through Cox proportional hazards models. Depressive symptoms and activities of daily life (ADL)/ instrumental activities of daily life (IADL) status were collected through self-reported questions. During the median 9-years follow-up, a total of 1860 CVD occurred (including 670 stroke and 1316 cardiac event). There is a significant additive and multiplicative interactions of depressive symptoms and ADL/IADL on risk of CVD, stroke and cardiac events. Compared to people without depression and the limitation of ADL, those with both depressive symptoms and limitation in ADL had the highest risk of CVD, stroke and cardiac events, with hazard ratios (95% confidence interval) of 1.38 (1.15–1.65), 1.59 (1.20–2.11) and 1.20 (1.01–1.49), respectively. Similarly, individuals with depressive symptoms and limitation in IADL were also associated with the highest CVD risk. Depressions and limitations in ADL/IADL jointly increased the risk of CVD, stroke and cardiac events.