Associations between depression and risk of cardiometabolic multimorbidity among middle-aged and older Chinese adults

Numerous studies have performed the association between depression and increased risk of cardiometabolic diseases (CMDs). However, there is limited understanding regarding the impact of the depression on cardiometabolic multimorbidity (CMM), particularly the various combinations of CMM. The purpose of this study was to explore the association between depression and CMM. We followed 9746 adults in the China Health and Retirement Longitudinal Study from 2012 to 2020. CMM was defined as the coexistence of ≥ 2 CMDs, including diabetes, heart disease, and stroke. Depression was assessed by the scale of the Center for Epidemiologic Studies Depression Scale-10 (CESD-10). We used Cox proportional hazards regression models and restricted cubic spline regression models to examine associations between depression and CMM. During the 8 years of follow-up, 779 incident CMM cases (8.0%) were identified. Depression was independently associated with CMM after adjusting for age, sex, residence, marital status, educational level, smoking status, and drinking status (adjusted hazard ratio, 1.64; 95% CI, 1.15-2.13). Prevalent CMM combinations were associated with a higher risk of depression when compared with no CMM, except for CMM combinations of "Diabetes + Stroke". Depression was significantly associated with excessive risk of CMM among middle-aged and older Chinese adults. These results suggest intervention targeting at individuals with depression might have substantial benefit in minimizing the risk of CMM.