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Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Coronary Heart Disease | Research article

Sarcopenia and coronary heart disease synergistically increase the risk of new onset depressive symptoms in older adults

Authors: Xiaoyu Chen, Peipei Han, Xing Yu, Yuanyuan Zhang, Peiyu Song, Yuewen Liu, Jinghuan Liu, Jiawei Tang, Yisong Zhang, Yong Zhao, Jiejiao Zheng, Lixi Chu, Hong Bing Wang, Qi Guo

Published in: BMC Geriatrics | Issue 1/2021

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Abstract

Background

Coronary heart disease (CHD), sarcopenia and depression are common disorders that markedly impair quality of life and impose a huge financial burden on society. They are also frequently comorbid, exacerbating condition and worsening prognosis. This study aimed to investigate the additive effects of CHD and sarcopenia on the risk of new onset depressive symptoms in older adults.

Methods

The prospective cohort study comprised 897 Chinese community-dwelling participants who were aged 60 years and older (386 men; mean age 66.9 ± 5.9 years) without depressive symptoms at baseline, recruited from Chadian of Tianjin, China. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. CHD was identified via medical records or new diagnosed by at least two physicians. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS) ≥11. Longitudinal data on new onset depressive symptoms were collected up to 12 months after baseline.

Results

We found that 103 (11.5%) of the 897 participants without depressive symptoms at baseline had developed depressive symptoms. Participants were classified into mutually exclusive groups based on sarcopenia status and CHD: normal, CHD alone, sarcopenia alone, and co-occurring groups. A logistic regression showed that the CHD alone [odd ratios (OR) = 1.78, 95% confidence interval (CI) = 1.05–3.02], sarcopenia alone (OR = 2.79, 95% CI = 1.26–6.22), and co-occurring (OR = 7.19, 95% CI = 2.75–18.81) had higher risk of depressive symptoms than the normal group after adjusting for the covariates.

Conclusions

CHD and sarcopenia synergistically increase the risk of new onset depressive symptoms in older adults. Thus, older adults may require early detection, and appropriate interventions should be implemented.
Literature
1.
go back to reference Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003;58(3):249–65.CrossRef Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003;58(3):249–65.CrossRef
2.
go back to reference Alexopoulos GS. Depression in the elderly. Lancet. 2005;365(9475):1961–70.CrossRef Alexopoulos GS. Depression in the elderly. Lancet. 2005;365(9475):1961–70.CrossRef
3.
go back to reference Eurelings LS, Van Dalen JW, Ter Riet G, Moll van Charante EP, Richard E, van Gool WA, et al. Apathy and depressive symptoms in older people and incident myocardial infarction, stroke, and mortality: a systematic review and meta-analysis of individual participant data. Clin Epidemiol. 2018;10:363–79.CrossRef Eurelings LS, Van Dalen JW, Ter Riet G, Moll van Charante EP, Richard E, van Gool WA, et al. Apathy and depressive symptoms in older people and incident myocardial infarction, stroke, and mortality: a systematic review and meta-analysis of individual participant data. Clin Epidemiol. 2018;10:363–79.CrossRef
4.
go back to reference Piwonski J, Piwonska A, Jedrusik P, Stokwiszewski J, Rutkowski M, Bandosz P, et al. Depressive symptoms and cardiovascular diseases in the adult polish population. Results of the NATPOL2011 study. Kardiol Pol. 2019;77(1):18–23.CrossRef Piwonski J, Piwonska A, Jedrusik P, Stokwiszewski J, Rutkowski M, Bandosz P, et al. Depressive symptoms and cardiovascular diseases in the adult polish population. Results of the NATPOL2011 study. Kardiol Pol. 2019;77(1):18–23.CrossRef
5.
go back to reference Heo JE, Shim JS, Song BM, Bae HY, Lee HJ, Lee E, et al. Association between appendicular skeletal muscle mass and depressive symptoms: review of the cardiovascular and metabolic diseases etiology research center cohort. J Affect Disord. 2018;238:8–15.CrossRef Heo JE, Shim JS, Song BM, Bae HY, Lee HJ, Lee E, et al. Association between appendicular skeletal muscle mass and depressive symptoms: review of the cardiovascular and metabolic diseases etiology research center cohort. J Affect Disord. 2018;238:8–15.CrossRef
6.
go back to reference Zhu KF, Wang YM, Zhu JZ, Zhou QY, Wang NF. National prevalence of coronary heart disease and its relationship with human development index: a systematic review. Eur J Prev Cardiol. 2016;23(5):530–43.CrossRef Zhu KF, Wang YM, Zhu JZ, Zhou QY, Wang NF. National prevalence of coronary heart disease and its relationship with human development index: a systematic review. Eur J Prev Cardiol. 2016;23(5):530–43.CrossRef
7.
go back to reference Dickens C. Depression in people with coronary heart disease: prognostic significance and mechanisms. Curr Cardiol Rep. 2015;17(10):83.CrossRef Dickens C. Depression in people with coronary heart disease: prognostic significance and mechanisms. Curr Cardiol Rep. 2015;17(10):83.CrossRef
8.
go back to reference Carney RM, Freedland KE. Depression and coronary heart disease. Nat Rev Cardiol. 2017;14(3):145–55.CrossRef Carney RM, Freedland KE. Depression and coronary heart disease. Nat Rev Cardiol. 2017;14(3):145–55.CrossRef
9.
go back to reference Han P, Kang L, Guo Q, Wang J, Zhang W, Shen S, et al. Prevalence and factors associated with sarcopenia in suburb-dwelling older Chinese using the Asian working Group for Sarcopenia Definition. J Gerontol A Biol Sci Med Sci. 2016;71(4):529–35.CrossRef Han P, Kang L, Guo Q, Wang J, Zhang W, Shen S, et al. Prevalence and factors associated with sarcopenia in suburb-dwelling older Chinese using the Asian working Group for Sarcopenia Definition. J Gerontol A Biol Sci Med Sci. 2016;71(4):529–35.CrossRef
10.
go back to reference Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15(2):95–101.CrossRef Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15(2):95–101.CrossRef
11.
go back to reference Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyere O. Health outcomes of sarcopenia: a systematic review and Meta-analysis. PLoS One. 2017;12(1):e0169548.CrossRef Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyere O. Health outcomes of sarcopenia: a systematic review and Meta-analysis. PLoS One. 2017;12(1):e0169548.CrossRef
12.
go back to reference Chen X, Guo J, Han P, Fu L, Jia L, Yu H, et al. Twelve-month incidence of depressive symptoms in suburb-dwelling Chinese older adults: role of sarcopenia. J Am Med Dir Assoc. 2019;20(1):64–9.CrossRef Chen X, Guo J, Han P, Fu L, Jia L, Yu H, et al. Twelve-month incidence of depressive symptoms in suburb-dwelling Chinese older adults: role of sarcopenia. J Am Med Dir Assoc. 2019;20(1):64–9.CrossRef
13.
go back to reference Campos AM, Moura FA, Santos SN, Freitas WM, Sposito AC. Brasilia Study on Healthy A, Brasilia Heart S. Sarcopenia, but not excess weight or increased caloric intake, is associated with coronary subclinical atherosclerosis in the very elderly. Atherosclerosis. 2017;258:138–44.CrossRef Campos AM, Moura FA, Santos SN, Freitas WM, Sposito AC. Brasilia Study on Healthy A, Brasilia Heart S. Sarcopenia, but not excess weight or increased caloric intake, is associated with coronary subclinical atherosclerosis in the very elderly. Atherosclerosis. 2017;258:138–44.CrossRef
14.
go back to reference Nichols S, O'Doherty AF, Taylor C, Clark AL, Carroll S, Ingle L. Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - a CARE CR study. Clin Physiol Funct Imaging. 2019;39(1):93–102.CrossRef Nichols S, O'Doherty AF, Taylor C, Clark AL, Carroll S, Ingle L. Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - a CARE CR study. Clin Physiol Funct Imaging. 2019;39(1):93–102.CrossRef
15.
go back to reference Xu L, Hao YT. Effect of handgrip on coronary artery disease and myocardial infarction: a Mendelian randomization study. Sci Rep. 2017;7(1):954.CrossRef Xu L, Hao YT. Effect of handgrip on coronary artery disease and myocardial infarction: a Mendelian randomization study. Sci Rep. 2017;7(1):954.CrossRef
16.
go back to reference Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the Management of Patients with Unstable Angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. Circulation. 2011;123(18):e426–579.CrossRef Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the Management of Patients with Unstable Angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. Circulation. 2011;123(18):e426–579.CrossRef
17.
go back to reference Mui AC. Geriatric depression scale as a community screening instrument for elderly Chinese immigrants. Int Psychogeriatr. 1996;8(3):445–58.CrossRef Mui AC. Geriatric depression scale as a community screening instrument for elderly Chinese immigrants. Int Psychogeriatr. 1996;8(3):445–58.CrossRef
18.
go back to reference Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37–49.CrossRef Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37–49.CrossRef
19.
go back to reference Bassett DR Jr. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1396.CrossRef Bassett DR Jr. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1396.CrossRef
20.
go back to reference Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Validation of the Mini nutritional assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13(9):782–8.CrossRef Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Validation of the Mini nutritional assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13(9):782–8.CrossRef
21.
go back to reference Liguori I, Curcio F, Russo G, Cellurale M, Aran L, Bulli G, et al. Risk of malnutrition evaluated by Mini nutritional assessment and sarcopenia in noninstitutionalized elderly people. Nutr Clin Pract. 2018;33(6):879–86.CrossRef Liguori I, Curcio F, Russo G, Cellurale M, Aran L, Bulli G, et al. Risk of malnutrition evaluated by Mini nutritional assessment and sarcopenia in noninstitutionalized elderly people. Nutr Clin Pract. 2018;33(6):879–86.CrossRef
22.
go back to reference Liu H, Song B, Jin J, Liu Y, Wen X, Cheng S, et al. Length of stay, hospital costs and mortality associated with comorbidity according to the Charlson comorbidity index in immobile patients after ischemic stroke in China: a National Study. Int J Health Policy Manag. 2021. Liu H, Song B, Jin J, Liu Y, Wen X, Cheng S, et al. Length of stay, hospital costs and mortality associated with comorbidity according to the Charlson comorbidity index in immobile patients after ischemic stroke in China: a National Study. Int J Health Policy Manag. 2021.
23.
go back to reference Zhang W, Shen S, Wang W, Zhou C, Xu L, Qiu J, et al. Poor lower extremity function was associated with pre-diabetes and diabetes in older chinese people. PLoS One. 2014;9(12):e115883.CrossRef Zhang W, Shen S, Wang W, Zhou C, Xu L, Qiu J, et al. Poor lower extremity function was associated with pre-diabetes and diabetes in older chinese people. PLoS One. 2014;9(12):e115883.CrossRef
24.
go back to reference Kim TN, Choi KM. The implications of sarcopenia and sarcopenic obesity on cardiometabolic disease. J Cell Biochem. 2015;116(7):1171–8.CrossRef Kim TN, Choi KM. The implications of sarcopenia and sarcopenic obesity on cardiometabolic disease. J Cell Biochem. 2015;116(7):1171–8.CrossRef
25.
go back to reference Pedersen BK, Febbraio MA. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012;8(8):457–65.CrossRef Pedersen BK, Febbraio MA. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012;8(8):457–65.CrossRef
26.
go back to reference Stapelberg NJ, Neumann DL, Shum DH, McConnell H, Hamilton-Craig I. A topographical map of the causal network of mechanisms underlying the relationship between major depressive disorder and coronary heart disease. Aust N Z J Psychiatry. 2011;45(5):351–69.CrossRef Stapelberg NJ, Neumann DL, Shum DH, McConnell H, Hamilton-Craig I. A topographical map of the causal network of mechanisms underlying the relationship between major depressive disorder and coronary heart disease. Aust N Z J Psychiatry. 2011;45(5):351–69.CrossRef
27.
go back to reference Sanada K, Miyachi M, Tanimoto M, Yamamoto K, Murakami H, Okumura S, et al. A cross-sectional study of sarcopenia in Japanese men and women: reference values and association with cardiovascular risk factors. Eur J Appl Physiol. 2010;110(1):57–65.CrossRef Sanada K, Miyachi M, Tanimoto M, Yamamoto K, Murakami H, Okumura S, et al. A cross-sectional study of sarcopenia in Japanese men and women: reference values and association with cardiovascular risk factors. Eur J Appl Physiol. 2010;110(1):57–65.CrossRef
28.
go back to reference Oerkild B, Frederiksen M, Hansen JF, Simonsen L, Skovgaard LT, Prescott E. Home-based cardiac rehabilitation is as effective as Centre-based cardiac rehabilitation among elderly with coronary heart disease: results from a randomised clinical trial. Age Ageing. 2011;40(1):78–85.CrossRef Oerkild B, Frederiksen M, Hansen JF, Simonsen L, Skovgaard LT, Prescott E. Home-based cardiac rehabilitation is as effective as Centre-based cardiac rehabilitation among elderly with coronary heart disease: results from a randomised clinical trial. Age Ageing. 2011;40(1):78–85.CrossRef
29.
go back to reference Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure-Smith N, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014;129(12):1350–69.CrossRef Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure-Smith N, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014;129(12):1350–69.CrossRef
30.
go back to reference Cacciatore F, Amarelli C, Maiello C, Pratillo M, Tosini P, Mattucci I, et al. Effect of Sacubitril-valsartan in reducing depression in patients with advanced heart failure. J Affect Disord. 2020;272:132–7.CrossRef Cacciatore F, Amarelli C, Maiello C, Pratillo M, Tosini P, Mattucci I, et al. Effect of Sacubitril-valsartan in reducing depression in patients with advanced heart failure. J Affect Disord. 2020;272:132–7.CrossRef
31.
go back to reference Atkins JL, Wannamathee SG. Sarcopenic obesity in ageing: cardiovascular outcomes and mortality. Br J Nutr. 2020;124(10):1102–13.CrossRef Atkins JL, Wannamathee SG. Sarcopenic obesity in ageing: cardiovascular outcomes and mortality. Br J Nutr. 2020;124(10):1102–13.CrossRef
Metadata
Title
Sarcopenia and coronary heart disease synergistically increase the risk of new onset depressive symptoms in older adults
Authors
Xiaoyu Chen
Peipei Han
Xing Yu
Yuanyuan Zhang
Peiyu Song
Yuewen Liu
Jinghuan Liu
Jiawei Tang
Yisong Zhang
Yong Zhao
Jiejiao Zheng
Lixi Chu
Hong Bing Wang
Qi Guo
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02710-z

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