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Effects of depression, metabolic syndrome, and cardiorespiratory fitness on mortality: results from the Cooper Center Longitudinal Study

Published online by Cambridge University Press:  17 April 2017

C. D. Rethorst ,
D. Leonard ,
C. E. Barlow ,
B. L. Willis ,
M. H. Trivedi  and
L. F. DeFina
C. D. Rethorst*
Affiliation:
Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
D. Leonard
Affiliation:
Cooper Institute, Dallas, TX, USA
C. E. Barlow
Affiliation:
Cooper Institute, Dallas, TX, USA
B. L. Willis
Affiliation:
Cooper Institute, Dallas, TX, USA
M. H. Trivedi
Affiliation:
Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
L. F. DeFina
Affiliation:
Cooper Institute, Dallas, TX, USA
*
*Address for correspondence: C. D. Rethorst, Ph.D., Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA. (Email: chad.rethorst@utsouthwestern.edu)
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Abstract

Background

Depression and metabolic syndrome (MetS) are frequently comorbid disorders that are independently associated with premature mortality. Conversely, cardiorespiratory fitness (CRF) is associated with reduced mortality risk. These factors may interact to impact mortality; however, their effects have not been assessed concurrently. This analysis assessed the mortality risk of comorbid depression/MetS and the effect of CRF on mortality in those with depression/MetS.

Methods

Prospective study of 47 702 adults in the Cooper Center Longitudinal Study. Mortality status was attained from the National Death Index. History of depression was determined by patient response (yes or no) to a standardized medical history questionnaire. MetS was categorized using the American Heart Association/National Heart, Lung, and Blood Institute criteria. CRF was estimated from the final speed/grade of a treadmill graded exercise test.

Results

13.9% reported a history of depression, 21.4% met criteria for MetS, and 3.0% met criteria for both MetS and history of depression. History of depression (HR = 1.24, p = 0.003) and MetS (HR = 1.28, p < 0.001) were independently associated with an increased mortality risk, with the greatest mortality risk among individuals with both a history of depression and MetS (HR = 1.59, p < 0.001). Higher CRF was associated with a significantly lower risk of mortality (p < 0.001) in all individuals, including those with MetS and/or a history of depression.

Conclusions

Those with higher levels CRF had reduced mortality risk in the context of depression/MetS. Interventions that improve CRF could have substantial impact on the health of persons with depression/MetS.

Keywords

Cardiorespiratory fitnessphysical activitydepressionmetabolic syndromemortality
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 14 , October 2017 , pp. 2414 - 2420
Copyright
Copyright © Cambridge University Press 2017 

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