Middle-aged and older adults with a history of depression have more long-term physical health conditions at baseline and accumulate additional physical health conditions at a faster rate than those without a history of depression. These findings highlight the importance of integrated approaches to managing mental and physical health outcomes.
Depression is the most common mental disorder, affecting more than 300 million people worldwide, equivalent to about 1 in 23 people. It is more common in women than men and primarily affects adults aged 55 to 74.
Regardless of severity, depression is linked to an increased risk of mortality, primarily due to impacts on physical health, such as an increased risk of developing type 2 diabetes and cardiovascular disease.
Depression not only affects mood and emotional well-being, but can also have a significant impact on physical health. A recent study examined how depression is related to the development of physical health conditions over time in middle-aged and older adults.
The aim was to understand whether those with a history of depression accumulate more physical health problems than those who have never had the condition.
To do this, researchers from the University of Edinburgh, UK, followed 172,556 participants from the UK Biobank (UKB) cohort study, aged 40–71 at baseline (2006–2010), who had linked primary care data available.
Using self-report, primary care, hospital admission, cancer registry and death records, they assessed 69 long-term physical health conditions at baseline in the UKB and over a median follow-up of 6.9 years.
At the start of the study, about 18% of the participants had been diagnosed with depression at some point in their lives.
The scientists analyzed their medical records, including GP visits, hospital admissions and cancer records, to check for 69 different long-term physical health conditions.
The results showed that people who had previously had depression accumulated physical illnesses more quickly than those without a history of the condition. At the start of the study, those who had never had depression had an average of two chronic illnesses, while those with depression had an average of three.
Average cumulative number of long-term physical health conditions at baseline and during follow-up, stratified by history of depression at baseline, age at baseline, and sex.
Over the years, participants with depression developed new health problems at a rate 30% higher than those who had never had the condition.
This means that depression may be a risk factor for developing other diseases later in life, such as diabetes, arthritis, and cardiovascular problems.
The study reinforces the need for a broader view of the health of people with depression, going beyond treating emotional symptoms and also considering the impacts on the body.
Currently, health systems often treat each disease separately, without considering that many patients have both mental and physical health problems at the same time.
This study shows that it is essential to adopt an integrated approach that considers the patient as a whole. Improving the way we treat depression can not only alleviate mental suffering, but also help prevent and manage physical diseases later in life.
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Depression and physical multimorbidity: A cohort study of physical health condition accrual in UK Biobank
Kelly J. Fleetwood, Bruce Guthrie, Caroline A. Jackson, Paul A. T. Kelly, Stewart W. Mercer, Daniel R. Morales, John D. Norrie, Daniel J. Smith, Cathie Sudlow and Regina Prigge
PLOS Medicine. 13 February 2025,
DOI: 10.1371/journal.pmed.1004532
Abstract:
Depression is associated with a range of adverse physical health outcomes. We aimed to quantify the association between depression and the subsequent rate of accrual of long-term physical health conditions in middle and older age. We included 172,556 participants from the UK Biobank (UKB) cohort study, aged 40–71 years old at baseline assessment (2006–2010), who had linked primary care data available. Using self-report, primary care, hospital admission, cancer registry, and death records, we ascertained 69 long-term physical health conditions at both UKB baseline assessment and during a mean follow-up of 6.9 years. We used quasi-Poisson models to estimate associations between history of depression at baseline and subsequent rate of physical condition accrual. Within our cohort, 30,770 (17.8%) had a history of depression. Compared to those without depression, participants with depression had more physical conditions at baseline (mean 2.9 [SD 2.3] versus 2.1 [SD 1.9]) and accrued additional physical conditions at a faster rate (mean 0.20 versus 0.16 additional conditions/year during follow-up). After adjustment for age and sex, participants with depression accrued physical morbidities at a faster rate than those without depression (RR 1.32, 95% confidence interval [CI] [1.31, 1.34]). After adjustment for all sociodemographic characteristics, the rate of condition accrual remained higher in those with versus without depression (RR 1.30, 95% CI [1.28, 1.32]). This association attenuated but remained statistically significant after additional adjustment for baseline condition count and social/lifestyle factors (RR 1.10, 95% CI [1.09, 1.12]). The main limitation of this study is healthy volunteer selection bias, which may limit generalisability of findings to the wider population. Middle-aged and older adults with a history of depression have more long-term physical health conditions at baseline and accrue additional physical conditions at a faster rate than those without a history of depression. Our findings highlight the importance of integrated approaches to managing both mental and physical health outcomes.
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