The association between depression during perimenopause and progression of chronic conditions and multimorbidity: results from a Chinese prospective cohort.

Publisher: Springer Country of Publication: Austria NLM ID: 9815663 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1435-1102 (Electronic) Linking ISSN: 14341816 NLM ISO Abbreviation: Arch Womens Ment Health Subsets: MEDLINE

Original Publication: Wien ; New York : Springer, c1998-

Depression*/epidemiology ; Perimenopause*; Female ; Humans ; Chronic Disease ; East Asian People ; Multimorbidity

Purpose: The association between perimenopausal depression and many chronic conditions among women has been well-established. However, the role of depression during perimenopause in the progression of multiple chronic conditions (multimorbidity) remains poorly understood.
Material and Methods: A total of 1,216 community-dwelling women in their perimenopause period between 2010 and 2016 were enrolled in our analysis, and followed up for the progression of multimorbidity. Depression, as well as its severity, was evaluated by the Center for Epidemiologic Studies Depression 10-item scale (CES-D-10). Progression of multimorbidity was defined as the first report of two or more chronic conditions for participants without multimorbidity or the new report of one or more conditions for those with multimorbidity. Univariable and multivariable Cox proportional hazards model and the restricted cubic spline regression model were performed to assess the prospective association between perimenopausal depression and the progression of multimorbidity.
Results: A total of 480 (39.5%) women reported depression during perimenopause, and 529 (43.5%) women progressed to multimorbidity. After adjusting for socio-demographic and lifestyle factors, perimenopausal depression was independently associated with the progression of multimorbidity (hazard ratio [HR]: 1.34; 95% confidence interval [CI]: 1.13 to 1.60). Moreover, the severity of depression was positively and linearly associated with the progression of multimorbidity (P < 0.05).
Conclusions: Our finding reveals a prospective association between perimenopausal depression and the progression of multimorbidity, indicating interventions targeting perimenopausal depression may reduce the burden of chronic diseases and multimorbidity in women's post-menopausal life.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Auro K et al (2014) A metabolic view on menopause and ageing. Nat Commun 5:4708. https://doi.org/10.1038/ncomms5708. (PMID: 10.1038/ncomms570825144627)
Auteri M, Zizzo MG, Serio R (2015) GABA and GABA receptors in the gastrointestinal tract: from motility to inflammation. Pharmacol Res 93:11–21. https://doi.org/10.1016/j.phrs.2014.12.001. (PMID: 10.1016/j.phrs.2014.12.00125526825)
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B (2012) Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet 380:37–43. https://doi.org/10.1016/S0140-6736(12)60240-2. (PMID: 10.1016/S0140-6736(12)60240-2)
Beaumont J-F, Charest A-S (2012) Bootstrap variance estimation with survey data when estimating model parameters. Comput Stat Data Anal 56:4450–4461. https://doi.org/10.1016/j.csda.2012.03.011. (PMID: 10.1016/j.csda.2012.03.011)
Boey KW (1999) Cross-validation of a short form of the CES-D in Chinese elderly. Int J Geriatr Psychiatry 14:608–617. https://doi.org/10.1002/(SICI)1099-1166(199908)14:8%3c608::AID-GPS991%3e3.0.CO;2-Z. (PMID: 10.1002/(SICI)1099-1166(199908)14:8<608::AID-GPS991>3.0.CO;2-Z10489651)
Calderón-Larrañaga A et al (2018) Rapidly developing multimorbidity and disability in older adults: does social background matter? J Intern Med 283:489–499. https://doi.org/10.1111/joim.12739. (PMID: 10.1111/joim.1273929415323)
Cheng HG, Chen S, McBride O, Phillips MR (2016) Prospective relationship of depressive symptoms, drinking, and tobacco smoking among middle-aged and elderly community-dwelling adults: Results from the China Health and Retirement Longitudinal Study (CHARLS). J Affect Disord 195:136–143. https://doi.org/10.1016/j.jad.2016.02.023. (PMID: 10.1016/j.jad.2016.02.02326895091)
Cheng ST, Chan AC (2005) The Center for Epidemiologic Studies Depression Scale in older Chinese: thresholds for long and short forms. Int J Geriatr Psychiatry 20:465–470. https://doi.org/10.1002/gps.1314. (PMID: 10.1002/gps.131415852439)
Davern PJ, Chowdhury S, Jackson KL, Nguyen-Huu TP, Head GA (2014) GABAA receptor dysfunction contributes to high blood pressure and exaggerated response to stress in Schlager genetically hypertensive mice. J Hypertens 32:352–362. https://doi.org/10.1097/hjh.0000000000000015. (PMID: 10.1097/hjh.000000000000001524270178)
de Kruif M, Spijker AT, Molendijk ML (2016) Depression during the perimenopause: A meta-analysis. J Affect Disord 206:174–180. https://doi.org/10.1016/j.jad.2016.07.040. (PMID: 10.1016/j.jad.2016.07.04027475888)
De Leo V, Morgante G, Musacchio MC, Faldini E, Delia A, Petraglia F (2006) The safety of veralipride. Expert Opin Drug Saf 5:695–701. https://doi.org/10.1517/14740338.5.5.695. (PMID: 10.1517/14740338.5.5.69516907659)
Ditmars HL, et al. (2021). Associations between depression and cardiometabolic health: A 27-year longitudinal study. Psychol Med, 1–11. https://doi.org/10.1017/s003329172000505x.
Efron B, Tibshirani RJ (1993) An introduction to the Bootstrap. Chapman and Hall/CRC, vol 23. https://doi.org/10.1201/9780429246593.
Eskola PJ et al (2015) Depression and Insulin Resistance: Additional Support for the Novel Heuristic Model in Perimenopausal Depression. Am J Psychiatry 172:796–797. https://doi.org/10.1176/appi.ajp.2015.15030377. (PMID: 10.1176/appi.ajp.2015.1503037726234605)
Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H (2012) A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med 10:142–151. https://doi.org/10.1370/afm.1337. (PMID: 10.1370/afm.1337224120063315131)
García-Montero, C et al (2022). The Problem of Malnutrition Associated with Major Depressive Disorder from a Sex-Gender Perspective. Nutrients, 14. https://doi.org/10.3390/nu14051107.
Georgakis MK et al (2016) Association of Age at Menopause and Duration of Reproductive Period With Depression After Menopause: A Systematic Review and Meta-analysis. JAMA Psychiat 73:139–149. https://doi.org/10.1001/jamapsychiatry.2015.2653. (PMID: 10.1001/jamapsychiatry.2015.2653)
Hughes MJ, McGettrick HM, Sapey E (2020). Shared mechanisms of multimorbidity in COPD, atherosclerosis and type-2 diabetes: the neutrophil as a potential inflammatory target. Eur Respir Rev, 29. https://doi.org/10.1183/16000617.0102-2019 .
Jagtap BL, Prasad BS, Chaudhury S (2016) Psychiatric morbidity in perimenopausal women. Ind Psychiatry J 25:86–92. https://doi.org/10.4103/0972-6748.196056. (PMID: 10.4103/0972-6748.196056281634135248425)
Jiang CH, Zhu F, Qin TT (2020) Relationships between Chronic Diseases and Depression among Middle-aged and Elderly People in China: A Prospective Study from CHARLS. Curr Med Sci 40:858–870. https://doi.org/10.1007/s11596-020-2270-5. (PMID: 10.1007/s11596-020-2270-533123901)
Kochar B et al (2018) Depression Is Associated With More Aggressive Inflammatory Bowel Disease. Am J Gastroenterol 113:80–85. https://doi.org/10.1038/ajg.2017.423. (PMID: 10.1038/ajg.2017.42329134965)
Lee SP, Sung I-K, Kim JH, Lee S-Y, Park HS, Shim CS (2015) The effect of emotional stress and depression on the prevalence of digestive diseases. Journal of Neurogastroenterology and Motility 21:273–282. https://doi.org/10.5056/jnm14116. (PMID: 10.5056/jnm14116257796924398234)
Li H et al (2019) Association of Depressive Symptoms With Incident Cardiovascular Diseases in Middle-Aged and Older Chinese Adults. JAMA Netw Open 2:e1916591. https://doi.org/10.1001/jamanetworkopen.2019.16591. (PMID: 10.1001/jamanetworkopen.2019.16591318000666902756)
Liu Y et al (2020) Gut Microbiome Fermentation Determines the Efficacy of Exercise for Diabetes Prevention. Cell Metab 31:77-91.e75. https://doi.org/10.1016/j.cmet.2019.11.001. (PMID: 10.1016/j.cmet.2019.11.00131786155)
Lu MC, Guo HR, Lin MC, Livneh H, Lai NS, Tsai TY (2016) Bidirectional associations between rheumatoid arthritis and depression: a nationwide longitudinal study. Sci Rep 6:20647. https://doi.org/10.1038/srep20647. (PMID: 10.1038/srep20647268570284746638)
Lui Filho JF, Baccaro LF, Fernandes T, Conde DM, Costa-Paiva L, Pinto Neto AM (2015) Factors associated with menopausal symptoms in women from a metropolitan region in Southeastern Brazil: a population-based household survey. Rev Bras Ginecol Obstet 37:152–158. https://doi.org/10.1590/so100-720320150005282. (PMID: 10.1590/so100-72032015000528225992497)
Luo H et al (2018) Obesity and the onset of depressive symptoms among middle-aged and older adults in China: evidence from the CHARLS. BMC Public Health 18:909–909. https://doi.org/10.1186/s12889-018-5834-6. (PMID: 10.1186/s12889-018-5834-6300416326057008)
Muka T, Oliver-Williams C, Colpani V, Kunutsor S, Chowdhury S, Chowdhury R, Kavousi M, Franco OH (2016) Association of Vasomotor and other menopausal symptoms with risk of cardiovascular disease: a systematic review and meta-analysis. PLoS One 11(6):e0157417. https://doi.org/10.1371/journal.pone.0157417.
Ouyang P, Sun W (2019) Depression and sleep duration: findings from middle-aged and elderly people in China. Public Health 166:148–154. https://doi.org/10.1016/j.puhe.2018.10.007. (PMID: 10.1016/j.puhe.2018.10.00730503968)
Parry BL (2010) Optimal management of perimenopausal depression. Int J Womens Health 2:143–151. https://doi.org/10.2147/ijwh.s7155. (PMID: 10.2147/ijwh.s7155210723072971729)
Reiche EMV, Nunes SOV, Morimoto HK (2004) Stress, depression, the immune system, and cancer. Lancet Oncol 5:617–625. (PMID: 10.1016/S1470-2045(04)01597-915465465)
Rocca WA et al (2016) Accelerated Accumulation of Multimorbidity After Bilateral Oophorectomy: A Population-Based Cohort Study. Mayo Clin Proc 91:1577–1589. https://doi.org/10.1016/j.mayocp.2016.08.002. (PMID: 10.1016/j.mayocp.2016.08.00227693001)
Rocca WA et al (2018) Loss of Ovarian Hormones and Accelerated Somatic and Mental Aging. Physiology (bethesda) 33:374–383. https://doi.org/10.1152/physiol.00024.2018. (PMID: 10.1152/physiol.00024.201830303778)
Rubinow DR, Girdler SS (2011) Hormones, heart disease, and health: individualized medicine versus throwing the baby out with the bathwater. Depress Anxiety 28:E1-e15. https://doi.org/10.1002/da.20833. (PMID: 10.1002/da.2083321648024)
Rudzinskas S, Hoffman JF, Martinez P, Rubinow DR, Schmidt PJ, Goldman D (2021) In vitro model of perimenopausal depression implicates steroid metabolic and proinflammatory genes. Mol Psychiatry 26:3266–3276. https://doi.org/10.1038/s41380-020-00860-x. (PMID: 10.1038/s41380-020-00860-x32788687)
Rymer J, Morris EP (2000) "Extracts from “Clinical evidence”: Menopausal symptoms. BMJ 321:1516–1519. https://doi.org/10.1136/bmj.321.7275.1516. (PMID: 10.1136/bmj.321.7275.1516111181821119220)
Santoro N (2016) Perimenopause: From Research to Practice. J Womens Health (larchmt) 25:332–339. https://doi.org/10.1089/jwh.2015.5556. (PMID: 10.1089/jwh.2015.555626653408)
Shang X, Peng W, Hill E, Szoeke C, He M, Zhang L (2020) Incidence, Progression, and Patterns of Multimorbidity in Community-Dwelling Middle-Aged Men and Women. Front Public Health 8:404. https://doi.org/10.3389/fpubh.2020.00404. (PMID: 10.3389/fpubh.2020.00404330149567461897)
Shieh A et al (2022) Associations of Age at Menopause With Postmenopausal Bone Mineral Density and Fracture Risk in Women. J Clin Endocrinol Metab 107:e561–e569. https://doi.org/10.1210/clinem/dgab690. (PMID: 10.1210/clinem/dgab69034537850)
Smarr KL, Keefer AL (2011) Measures of depression and depressive symptoms: Beck Depression Inventory-II (BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), Geriatric Depression Scale (GDS), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9). Arthritis Care Res 63:S454–S466. https://doi.org/10.1002/acr.20556. (PMID: 10.1002/acr.20556)
Soares CN (2013) Depression in Peri- and Postmenopausal Women: Prevalence, Pathophysiology and Pharmacological Management. Drugs Aging 30:677–685. https://doi.org/10.1007/s40266-013-0100-1. (PMID: 10.1007/s40266-013-0100-123801148)
Stekhoven DJ, Bühlmann P (2012) MissForest–non-parametric missing value imputation for mixed-type data. Bioinformatics 28:112–118. https://doi.org/10.1093/bioinformatics/btr597. (PMID: 10.1093/bioinformatics/btr59722039212)
Tang R et al (2020) Relationships Between Vasomotor Symptoms and Mood in Midlife Urban Chinese Women: Observations in a Prospective Study. J Clin Endocrinol Metab 105. https://doi.org/10.1210/clinem/dgaa554 .
Timur S, Sahin NH (2010) The prevalence of depression symptoms and influencing factors among perimenopausal and postmenopausal women. Menopause 17:545–551. https://doi.org/10.1097/gme.0b013e3181cf8997. (PMID: 10.1097/gme.0b013e3181cf899720400922)
Vivian-Taylor J, Hickey M (2014) Menopause and depression: is there a link? Maturitas 79:142–146. https://doi.org/10.1016/j.maturitas.2014.05.014. (PMID: 10.1016/j.maturitas.2014.05.01424951102)
Wang J, Wu X, Lai W, Long E, Zhang X, Li W, Zhu Y, Chen C, Zhong X, Liu Z, Wang D, Lin H (2017) Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis. BMJ open 7(8):e017173. https://doi.org/10.1136/bmjopen-2017-017173.
Xu X, Jones M, Mishra GD (2020) Age at natural menopause and development of chronic conditions and multimorbidity: results from an Australian prospective cohort. Hum Reprod 35:203–211. https://doi.org/10.1093/humrep/dez259. (PMID: 10.1093/humrep/dez25931955198)
Xu X, Mishra GD, Jones M (2017) Evidence on multimorbidity from definition to intervention: An overview of systematic reviews. Ageing Res Rev 37:53–68. https://doi.org/10.1016/j.arr.2017.05.003. (PMID: 10.1016/j.arr.2017.05.00328511964)
Yuan X, Liu T, Wu L, Zou Z-Y, Li C (2015) Validity of self-reported diabetes among middle-aged and older Chinese adults: the China Health and Retirement Longitudinal Study. BMJ Open 5:e006633–e006633. https://doi.org/10.1136/bmjopen-2014-006633. (PMID: 10.1136/bmjopen-2014-006633258729374401856)
Zhao Y, Hu Y, Smith JP, Strauss J, Yang G (2014) Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). Int J Epidemiol 43:61–68. https://doi.org/10.1093/ije/dys203. (PMID: 10.1093/ije/dys20323243115)
Zhou L, Ma X, Wang W (2021) Relationship between Cognitive Performance and Depressive Symptoms in Chinese Older Adults: The China Health and Retirement Longitudinal Study (CHARLS). J Affect Disord 281:454–458. https://doi.org/10.1016/j.jad.2020.12.059. (PMID: 10.1016/j.jad.2020.12.05933360747)

Keywords: Depression; Elderly; Multimorbidity; Perimenopause

Date Created: 20230807 Date Completed: 20230911 Latest Revision: 20231007

20260130

10.1007/s00737-023-01354-9

37550508