Risk and rate of accumulating chronic conditions increases with depression, anxiety

The risk and rate of accumulating chronic conditions increased with diagnoses of depression and anxiety for both men and women, according to a study published in JAMA Network Open.

“Although a direct link between depression, anxiety and accelerated aging has not been demonstrated, there is increasing evidence of shared biological mechanisms between depression and chronic conditions known to occur later in life,” William V. Bobo, MD, MPH, of the department of psychiatry and psychology at Mayo Clinic Florida, and colleagues wrote.

Bobo and colleagues sought to compare the risk and rate of chronic conditions in those diagnosed with depression, anxiety or both, with those who have neither diagnosis.

The cohort study utilized medical records from the Rochester Epidemiology Project linkage system to identify 40,360 residents (53.3% female) of Olmsted County, Minnesota, from 2005 to 2014, with a follow-up lasting through the end of 2017.

Participants were divided into three cohorts anchored at the ages of 20, 40 and 60 years, and classified at each specific age as having depression alone, anxiety alone, comorbid depression and anxiety, or a reference group who had neither, using electronically extracted diagnosis codes in the 5 years before each anchoring age.

Data were analyzed from August 2020, through November 2021. The main outcome was sex-specific risk, calculated as hazard ratios (HRs), as well as rates of accumulation, calculated as mean annual incidence rates per 100 person-years.

Researchers found when comparing those in the same age cohorts, the risk of accumulating chronic conditions was elevated in women with depression alone across all three groups — aged 20 years: HR, 1.20 (95% CI, 1.02-1.42); 40 years: HR, 1.20 (95% CI, 1.10-1.31); 60 years: HR, 1.09 (95% CI, 1.02-1.16). Likewise, this was observed in women with comorbid depression and anxiety — aged 20 years: HR, 1.60 (95% CI, 1.28-1.99); 40 years: HR, 1.41 (95% CI, 1.21-1.65); 60 years: HR, 1.29 (95% CI, 1.15-1.44).

In men with comorbid depression and anxiety, risk of accumulating chronic conditions was elevated in the aged 20 years cohort — HR, 1.77; 95% CI, 1.08-2.91.

Data additionally revealed that, compared with the reference group, rates of accumulation were significantly higher in men with comorbid depression and anxiety in the cohort aged 20 years (difference, 1.4 [95% CI, 0.1-2.6] per 100 person-years) and in men with depression in the 40 years cohort (difference, 2.0 [95% CI, 0.8-3.2] per 100 person-years).

“Identification of treatable risk factors for multimorbidity, such as depression and anxiety is vital from a public health perspective because of the high prevalence and associated costs of multimorbidity, which are expected to continue to increase,” Bobo and colleagues wrote.