OBJECTIVE
To investigate the relationship between depressive symptoms and risk for COVID-19 hospitalization and death in a United States general population-based sample.
METHODS
We studied participants enrolled into observational NIH-funded cohorts from 1971-2010 with ongoing follow-up through 2023. Pre-pandemic Centers for Epidemiologic Studies Depression (CES-D) 10-item scale scores ≥10 defined elevated depressive symptoms. Questionnaires, medical records, and death certificates classified incident COVID-19 as severe (hospitalized/fatal) or non-severe from April 2020 through February 2023.
RESULTS
Of 33,565 participants, 633 (1.9%) had incident severe COVID-19 over a mean (SD) follow-up of 453 (207) days. Elevated pre-pandemic depressive symptoms were present in 4,922 (16.3%) of participants. Elevated pre-pandemic depressive symptoms increased the hazard of severe COVID-19 in fully-adjusted (aHR=1.27; 95%CI: 1.03-1.57) models. In sex-stratified models (p-interaction=0.03), elevated depressive symptoms increased the hazard in women (aHR=1.49; 95%CI: 1.17-1.90) but not in men (aHR=0.96; 95%CI: 0.67-1.39).
CONCLUSIONS
Pre-pandemic depressive symptoms were associated with increased risk of severe COVID-19 among women in a large US general population-based study of adults, and associations in men were neither confirmed nor ruled out. These results support current CDC recommendations that depression be considered an underlying medical condition associated with higher risk for severe COVID-19 and suggest that increased clinical focus on risk mitigation for COVID-19 and other acute respiratory infections among patients with depressive symptoms is warranted.
E. Oelsner, Yi-Fei Sun, P. Balte et al.· Biopsychosocial science and...· 0 citations
BACKGROUND
Daily heart rate (HR) and physical activity are biomarkers of cardiovascular disease. A smartwatch-derived metric, daily HR per step (DHRPS), has also been associated with cardiovascular disease. Integrating smartwatch data with neuropsychological assessments in older adults makes it possible to capture subclinical cardiovascular factors relevant to brain health.
METHODS
This cross-sectional study combined the electronic Framingham Heart Study smartwatch data (2021-2024) with neuropsychological assessments (2018-2023). The primary exposure was DHRPS defined as the average daily HR divided by steps per day. The dependent measure was assessed by composite neuropsychological scores including memory, executive function, language, and visuospatial cognitive domains. Linear mixed-effects models were used to examine the association between each exposure and repeated cognitive measures, adjusting for covariates.
RESULTS
A total of 248 older adults (mean age=73 years; median Mini-Mental State Examination score=29; 56% women; 14% multiethnic [including participants of Black, Hispanic, Asian, Indian, Pacific Islander, and Native American origins]) were assessed for a median of 662 smartwatch wear days, during which daily average HR (median 74 bpm [25th-75th percentiles: 69-78]) and daily steps (median 4810 [25th-75th percentiles: 3270-6831]) were recorded. Each 1-SD higher DHRPS was associated with 0.06-SD lower composite neuropsychological score (adjusted 95% CI, -0.11 to -0.01; P=0.01). Every 1000 more steps per day were associated with 0.03-SD higher composite neuropsychological score (adjusted 95% CI, 0.004-0.05; P=0.02).
CONCLUSIONS
Higher DHRPS was associated with lower cognitive function in older adults beyond HR or steps alone. Longitudinal evaluation of DHRPS exposures is needed to determine its utility for predicting cognitive decline trajectories.
Jie He, Yuankai Zhang, Xuzhi Wang et al.· Journal of the American Hear...· 0 citations
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