The Relationship between Depression and Metabolic Syndrome in the Elderly Population: The Cohort Aging Study
Abstract
Objective: Metabolic syndrome (MetS) and depression are two important causes of disability in the elderly. The association between MetS and depressive symptoms in Iranian elderly is unclear. In this population-based study, we aimed at evaluating the relationship between MetS and its components with depression in Iranian elderly population.
Method: This cross sectional study was derived from Amirkola Health and Ageing Project (AHAP).The participants of this study included 1560 elders over the age of 60 during 2012 and 2013. MetS was diagnosed based on Adult Treatment Panel III report and depressive symptoms according to Geriatric Depression Scale. Odds ratio (OR) and 95% confidence interval (CI) based on age and gender were estimated using regression logistic model.
Results: Depressive symptoms were observed in 28.7% of men and 46.2% of women. Age- and gender-adjusted OR of depressive symptoms did not show a significant difference among the participants with or without MetS. A significant association between MetS components (including waist circumference, HDL-C, fasting blood glucose, triglyceride) and depressive symptoms was observed, but this association no longer existed after age and gender adjustment. Elevated blood pressure revealed a significant relationship with depressive symptoms in men only (OR, 0.665; 95% CI, 0.469-0.943).
Conclusion: Depressive symptoms were associated with blood pressure component but not MetS in the elderly population of Amirkola, Iran. This association highlights the relevance of norepinephrine signal and sympathetic nervous activity disturbance for the emergence of depressive symptoms in the elderly. Therefore, it is reasonable to consider depression in hypertensive patients, especially in men.
Sanderson WC, Scherbov S, Gerland P. Probabilistic population aging. PloS one. 2017; 12: e0179171.
Campbell ML, Putnam M. Reducing the Shared Burden of Chronic Conditions among Persons Aging with Disability and Older Adults in the United States through Bridging Aging and Disability. Healthcare (Basel) 2017; 5(3): 56.
Sekita A, Arima H, Ninomiya T, Ohara T, Doi Y, Hirakawa Y, et al. Elevated depressive symptoms in metabolic syndrome in a general population of Japanese men: a cross-sectional study. BMC public health 2013; 13: 862.
Samson SL, Garber AJ. Metabolic syndrome. Endocrinol Metab Clin North Am 2014; 43: 1-23.
Nolan PB, Carrick-Ranson G, Stinear JW, Reading SA, Dalleck LC. Prevalence of metabolic syndrome and metabolic syndrome components in young adults: A pooled analysis. Prev Med Rep 2017; 7: 211-215.
Dalvand S, Niksima SH, Meshkani R, Ghanei Gheshlagh R, Sadegh-Nejadi S, Kooti W, et al. Prevalence of Metabolic Syndrome among Iranian Population: A Systematic Review and Meta-analysis. Iran J Public Health 2017; 46: 456-467.
Sarrafzadegan N, Gharipour M, Sadeghi M, Khosravi AR, Tavassoli AA. Metabolic syndrome in Iranian elderly. ARYA Atheroscler 2012; 7: 157-161.
Bakhtiari A, Hajian-Tilaki K, Omidvar S, Nasiri Amiri F. Association of lipid peroxidation and antioxidant status with metabolic syndrome in Iranian healthy elderly women. Biomed Rep 2017; 7: 331-336.
Sarokhani D, Parvareh M, Hasanpour Dehkordi A, Sayehmiri K, Moghimbeigi A. Prevalence of Depression among Iranian Elderly: Systematic Review and Meta-Analysis. Iran J Psychiatry 2018; 13: 55-64.
Almeida OP. Prevention of depression in older age. Maturitas 2014; 79: 136-141.
Nishina M, Nishina K, Ohira T, Makino K, Iso H. Associations of psychological distress with metabolic syndrome among Japanese urban residents. J Atheroscler Thromb 2011; 18: 396-402.
Herva A, Rasanen P, Miettunen J, Timonen M, Laksy K, Veijola J, et al. Co-occurrence of metabolic syndrome with depression and anxiety in young adults: the Northern Finland 1966 Birth Cohort Study. Psychosom Med 2006; 68: 213-216.
Hildrum B, Mykletun A, Midthjell K, Ismail K, Dahl AA. No association of depression and anxiety with the metabolic syndrome: the Norwegian HUNT study. Acta Psychiatr Scand 2009; 120: 14-22.
Takeuchi T, Nakao M, Nomura K, Inoue M, Tsurugano S, Shinozaki Y, et al. Association of the metabolic syndrome with depression and anxiety in Japanese men: a 1-year cohort study. Diabetes Metab Res Rev 2009; 25: 762-767.
Kimura Y, Matsushita Y, Nanri A, Mizoue T. Metabolic syndrome and depressive symptoms among Japanese men and women. Environ Health Prev Med 2011; 16: 363-368.
Skilton MR, Moulin P, Terra JL, Bonnet F. Associations between anxiety, depression, and the metabolic syndrome. Biol Psychiatry 2007; 62: 1251-1257.
Kamezaki F, Sonoda S, Nakata S, Okazaki M, Tamura M, Abe H, et al. Elevated depressive symptoms are associated with hypertriglyceridemia in Japanese male workers. Intern Med 2011; 50: 2485-2490.
Hosseini SR, Cumming RG, Kheirkhah F, Nooreddini H, Baiani M, Mikaniki E, et al. Cohort profile: the Amirkola Health and Ageing Project (AHAP).Int J Epidemiol 2014; 43: 1393-1400.
Malakouti SK, Fatollahi P, Mirabzadeh A, Salavati M, Zandi T. Reliability, validity and factor structure of the GDS-15 in Iranian elderly. Int J Geriatr Psychiatry 2006; 21: 588-593.
Bolghan-Abadi M, Segal DL, Coolidge FL, Gottschling J. Persian version of the Geriatric Anxiety Scale: translation and preliminary psychometric properties among Iranian older adults. Aging Ment Health 2013; 17: 896-900.
Sagud M, Mihaljevic-Peles A, Uzun S, Cusa BV, Kozumplik O, Kudlek-Mikulic S, et al. The lack of association between components of metabolic syndrome and treatment resistance in depression. Psychopharmacology (Berl) 2013; 230: 15-21.
Vogelzangs N, Beekman AT, Boelhouwer IG, Bandinelli S, Milaneschi Y, Ferrucci L, et al. Metabolic depression: a chronic depressive subtype? Findings from the InCHIANTI study of older persons. J Clin Psychiatry 2011; 72: 598-604.
Akbaraly TN, Ancelin ML, Jaussent I, Ritchie C, Barberger-Gateau P, Dufouil C, et al. Metabolic syndrome and onset of depressive symptoms in the elderly: findings from the three-city study. Diabetes Care 2011; 34: 904-909.
Shojaei VL, N; Ghalehnoea, M; Saleh- Abadi, S; Parizad, N; Ghanei, R. [The relationship between metabolic syndrome and depression in elderly patients with cardiovascular disease (In Persian)]. J of Center for Nursing Care Research, Iran University of Medical Sciences 2014; 27:65-72.
Hung CI, Liu CY, Hsiao MC, Yu NW, Chu CL. Metabolic syndrome among psychiatric outpatients with mood and anxiety disorders. BMC Psychiatry 2014; 14: 185.
Ohmori Y, Ito H, Morita A, Deura K, Miyachi M. Associations between depression and unhealthy behaviours related to metabolic syndrome: a cross sectional study. Asia Pac J Clin Nutr 2017; 26: 130-140.
Licht CM, Vreeburg SA, van Reedt Dortland AK, Giltay EJ, Hoogendijk WJ, DeRijk RH, et al. Increased sympathetic and decreased parasympathetic activity rather than changes in hypothalamic-pituitary-adrenal axis activity is associated with metabolic abnormalities. J Clin Endocrinol Metab. 2010; 95: 2458-2466.
Rosmond R. Role of stress in the pathogenesis of the metabolic syndrome. Psychoneuroendocrinology 2005; 30: 1-10.
Jabben N, Nolen WA, Smit JH, Vreeburg SA, Beekman AT, Penninx BW. Co-occurring manic symptomatology influences HPA axis alterations in depression. J Psychiatr Res 2011; 45: 1208-1213.
Gil K, Radzillowicz P, Zdrojewski T, Pakalska-Korcala A, Chwojnicki K, Piwonski J, et al. Relationship between the prevalence of depressive symptoms and metabolic syndrome. Results of the SOPKARD Project. Kardiol Pol 2006; 64: 464-469.
Laudisio A, Marzetti E, Pagano F, Pozzi G, Bernabei R, Zuccala G. Depressive symptoms and metabolic syndrome: selective association in older women. J Geriatr Psychiatry Neurol 2009; 22: 215-222.
Kinder LS, Carnethon MR, Palaniappan LP, King AC, Fortmann SP. Depression and the metabolic syndrome in young adults: findings from the Third National Health and Nutrition Examination Survey. Psychosom Med 2004; 66: 316-322.
Davidson K, Jonas BS, Dixon KE, Markovitz JH. Do depression symptoms predict early hypertension incidence in young adults in the CARDIA study? Coronary Artery Risk Development in Young Adults. Arch Intern Med 2000; 160: 1495-1500.
Jonas BS, Lando JF. Negative affect as a prospective risk factor for hypertension. Psychosom Med 2000; 62: 188-196.
Meng L, Chen D, Yang Y, Zheng Y, Hui R. Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies. J Hypertens 2012; 30: 842-851.
Lambert E, Dawood T, Straznicky N, Sari C, Schlaich M, Esler M, et al. Association between the sympathetic firing pattern and anxiety level in patients with the metabolic syndrome and elevated blood pressure. J Hypertens 2010; 28: 543-550.
Cheung BM, Au T, Chan S, Lam C, Lau S, Lee R, et al. The relationship between hypertension and anxiety or depression in Hong Kong Chinese. Exp Clin Cardiol 2005; 10: 21-24.
Malan L, Mashele N, Malan NT, Harvey BH, Potgieter JC, Van Rooyen JM. Depression Symptoms Facilitated Fibrinolytic Dysregulation and Future Coronary Artery Disease Risk in a Black Male Cohort: The Sympathetic Activity and Ambulatory Blood Pressure in Africans Study. J Cardiovasc Nurs 2017; 32: 401-408.
Rubio-Guerra AF, Rodriguez-Lopez L, Vargas-Ayala G, Huerta-Ramirez S, Serna DC, Lozano-Nuevo JJ. Depression increases the risk for uncontrolled hypertension. Exp Clin Cardiol 2013; 18: 10-12.
Balog P, Falger P, Szabo G, Degi, CL; Kallay E, Stauder A, Szekely A, Kopp M. Marital Distress, Treatment for hypertension and depression: Gender Differences. J Cognitive Behav Psychotherapies 2013; 13: 371-384.
Bijani A, Ghadimi R, Mikaniki E, Kheirkhah F, Mozaffarpur SA, Motallebnejad M, et al. Cohort Profile Update: The Amirkola Health and Ageing Project (AHAP).Caspian J Intern Med 2017; 8: 205–212.
Files | ||
Issue | Vol 13 No 4 (2018) | |
Section | Original Article(s) | |
Keywords | ||
Amirkola Blood Pressure Component Depression Elderly Metabolic Syndrome |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |