Objectives Conflicting results have been reported when the associations between metabolic health, obesity and depression were examined previously. The primary aim of this study was to determine whether metabolic health or obesity are independently associated with depressive symptoms, among a representative sample of older people living in England. Independent associations between covariates and depression were also examined.
Design Prospective study with a 2-year follow-up.
Setting The English Longitudinal Study of Ageing Wave 6 (2012–2013) and Wave 7 (2014–2015).
Participants 6804 participants aged older than 50 years.
Data Analysis Multivariate models were used to determine whether metabolic health or obesity are independently associated with depressive symptoms at 2-year follow-up. Unadjusted and adjusted ORs with corresponding 95% CI were calculated; the adjusted ORs took account of baseline depression, gender, age, wealth, obesity and poor metabolic health.
Results Before adjusting for covariates, poor metabolic health was associated with depressive symptoms at 2-year follow-up (OR 1.24; 95% CI, 1.07 to 1.44, p<0.01). After adjusting for covariates, the association was no longer statistically significant (OR 1.17; 95% CI, 0.99 to 1.38, p=0.07). Similarly, obesity was associated with depressive symptoms at 2-year follow-up before adjusting for covariates (OR 1.54; 95% CI, 1.33 to 1.79, p<0.01). However, after adjusting for covariates the association between obesity and depressive symptoms at 2-year follow-up became statistically insignificant (OR 1.19; 95% CI, 1.00 to 1.41, p=0.06). The strongest predictors for future depression were baseline depression (OR 10.59; 95% CI, 8.90 to 12.53, p<0.01) and lower wealth (OR 3.23; 95% CI, 2.44 to 4.35, p<0.01).
Conclusion Neither poor metabolic health nor obesity were associated with a risk of depressive symptoms at 2-year follow-up, after adjusting for covariates. As wealth inequalities continue to rise across England, the risk of depressive symptoms at 2-year follow-up is likely to be elevated in individuals living in the lower wealth quintiles.
- metabolic health
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Patient consent for publication Not required.
Contributors MF, CR, SW and RHV contributed to the study idea. MF led the study. Data analysis was conducted by MF, CR and NS. All authors had full access to ELSA Wave 6 and Wave 7 data, supplied by the UK Data Service and they take full responsibility for the integrity and accurate analysis of data. All authors contributed to data interpretation. NS drafted the manuscript with contributions from MF, CR, SW and RHV. MF and NS are the guarantors for this study.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Ethics approval All ELSA waves have been ethically approved by the National Research and Ethics Committee under the National Research and Ethics Service.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available for this study; however, all ELSA data are anonymised and publicly available from https://discover.ukdataservice.ac.uk/.
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