Body Mass Index, Blood Pressure, and Risk of Depression in the Elderly: A Marginal Structural Model

Abstract

The authors' objective was to investigate the associations of body mass index (BMI; weight (kg)/height (m)(2)) and blood pressure with the risk of developing depression in a large sample of elderly French participants (aged ≥65 years) followed for 10 years (Dijon portion of the Three-City Study, 1999-2010). Depression was defined as either having major depressive symptoms according to the Mini-International Neuropsychiatric Interview or taking antidepressant medication. The authors fitted marginal structural models to examine the relations of BMI and blood pressure with depression. Among subjects who were depression-free at baseline (n = 3,090), 478 developed incident depression over 10 years of follow-up. The analyses showed that after baseline values and time-dependent confounders were controlled, subjects with high BMI at follow-up had an increased adjusted risk of developing depression compared with subjects with normal BMI (risk ratio = 1.60, 95% confidence interval: 1.03, 2.51). Compared with subjects with normal blood pressure, those with high blood pressure were not at increased risk of incident depression, whereas those with low blood pressure had a higher risk of developing depression. These findings provide some epidemiologic support for implication of lifestyle risk factors in the development of depression in the elderly. Future studies should focus on evaluating lifestyle and obesity interventions among the elderly.

Hypertension and risk of depression in the elderly: a meta-analysis of prospective cohort studies

“…The inconsistent results can be explained by the different study designs, the different follow-up years and samples, the different questions/hypotheses being investigated and the inherent challenges of obtaining epidemiologic measurements of intricate and time-varying constructs such as depression and cardiovascular status. 7 Blood pressure measurements may vary according to the psychological, physiologic or environmental factors, especially in the elderly. 29 Besides, there are recent population studies in elderly persons that have found higher levels of depressive symptoms in subjects with low blood pressure.…”

“…5,6 There is mounting interest in searching for risk factors that affect depression in the elderly, and the relationship between hypertension and depression has been highlighted. 7,8 Considering the fact that hypertension and depression are the major constituents of health-related burden worldwide, 9 the identification of any association between these two highly common diseases would be beneficial in both public health and clinical contexts. 10 The relationship between hypertension and depression has been discussed for a long time, but the results are controversial.…”

Application of fatty acid and lipid measurements in neuropsychiatry

“…Second, people with affective disorders on average have a higher body mass index (BMI) than the general population [63]. Nearly one in five patients with bipolar disorder have metabolic syndrome and from 16% up to 36% have components of it [65]. Lipid dysregulation can be associated with genetics, comorbidity, psychiatric psychopathology, lifestyle, diet, physical activity, alcohol abuse, smoking and pharmacotherapy [64,[66][67][68][69][70][71].…”

Depressive Symptoms in Postmenopausal Women: Results from the MEDIS Study

“…However, most studies have been focused on the perimenopausal period, while studies focused on depressive symptoms during the postmenopausal period and their determinants are still limited (Clayton & Ninan, 2010;Cohen et al, 2006;Lee, 2003;Schmidt, Haq, & Rubinow, 2004;Timur & Sahin, 2010). Determinants such as socioeconomic factors, educational level, smoking, living alone, body mass index (BMI), and diabetes have been mentioned to be associated with depressive symptoms; however, their role in depressive symptoms during the postmenopausal period needs further study (Godin, Elbejjani & Kaufman, 2012;Lorant et al, 2003;Miech & Shanahan, 2000;Nouwen et al, 2010;Potts, 1997;Wilhelm et al, 2003;Woo et al, 1994).…”