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Associations of concomitant retinopathy and depression with mortality in a nationally representative population

危险系数 医学 萧条(经济学) 视网膜病变 比例危险模型 内科学 人口 糖尿病性视网膜病变 绝对风险降低 糖尿病 置信区间 相对风险 人口学 内分泌学 环境卫生 宏观经济学 社会学 经济
作者
Zheng Lyu,Yilin Chen,Zhuoting Zhu,Xiaoyang Luo,Ying Cui,Jie Xie,Zhifan Chen,Junbin Liu,Xi‐Yu Wu,Gabrella Bulloch,Qianli Meng
出处
期刊:Journal of Affective Disorders [Elsevier]
卷期号:336: 15-24 被引量:2
标识
DOI:10.1016/j.jad.2023.05.040
摘要

To evaluate the interaction effects between retinopathy and depression on mortality risks in genral population and subpopulation with diabetes. Prospective analyses were conducted on data from the National Health and Nutrition Examination Surveys study. Associations of retinopathy, depression and their interaction with all-cause, cardiovascular disease (CVD)-specific, cancer-specific and other-specific mortality risk were estimated using Kaplan-Meier curves and multivariate Cox proportional hazards models. Among 5367 participants, the weighted prevalence of retinopathy and depression was 9.6 % and 7.1 %, respectively. After a follow-up period of 12.1 years, 1295 deaths (17.3 %) occurred. Retinopathy was associated with an increased risk of all-cause (hazard ratio [HR]; 95 % confidence interval [CI]) (1.47; 1.27–1.71), CVD-specific (1.87; 1.45–2.41), and other-specific (1.43; 1.14–1.79) mortality. Similar relationship was observed between depression and all-cause mortality (1.24; 1.02–1.52). Retinopathy and depression had a positive multiplicative and additive interaction effect on all-cause (Pinteraction = 0.015; relative excess risk of interaction [RERI] 1.30; 95 % CI 0.15–2.45) and CVD-specific mortality (Pinteraction = 0.042; RERI 2.65; 95 % CI −0.12–5.42). Concomitant retinopathy and depression was more markedly associated with all-cause (2.86; 1.91–4.28), CVD-specific (4.70; 2.57–8.62), and other-specific mortality risks (2.18; 1.14–4.15) compared to those without retinopathy and depression. These associations were more pronounced in the diabetic participants. The co-occurrence of retinopathy and depression increases the risk of all-cause and CVD-specific mortality among middle-aged and older adults in the United States, especially in population with diabetes. Focus on diabetic patients and active evaluation and intervention of retinopathy with depression may improve their quality of life and mortality outcomes.
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