Table 3.
Association of elevated time-varying depressive symptoms with mortality, stratified by race and income, for REGARDS participants
| Overall (n = 29,477) | Black (n = 12,124) | White (n = 17,353) | Income <$35,000 (n = 12,466) | Income ≥$35,000 (n = 17,011) | |
|---|---|---|---|---|---|
| HR (95%CI) for categorical CES-D (score ≥4 vs. <4) | |||||
| All-cause mortality | |||||
| Events, n | 3660 | 2008 | 1652 | 2147 | 1513 |
| Crude | 1.66 (1.53–1.80) | 1.56 (1.39–1.74) | 1.71 (1.53–1.91) | 1.39 (1.26–1.53) | 1.65 (1.43–1.90) |
| Fully adjusted* | 1.25 (l.15–1.37) | 1.26 (1.11–1.42) | 1.24 (1.10–1.41) | 1.28 (1.16–1.43) | 1.19 (1.02–1.38) |
| Interaction term P-value† (depression × race) | – | 0.68 | – | ||
| Interaction term P-value† (depression × income) | – | – | 0.76 | ||
| CVD death | |||||
| Events, n | 1628 | 801 | 827 | 972 | 656 |
| Crude | 1.61 (1.40–1.84) | 1.57 (1.31–1.89) | 1.53 (1.25–1.88) | 1.36 (1.15–1.60) | 1.49 (1.16–1.93) |
| Fully adjusted* | 1.14 (0.98–1.33) | 1.17 (0.95–1.43) | 1.07 (0.86–1.35) | 1.18 (0.99–1.42) | 1.05 (0.79–1.38) |
| Interaction term P-value† (depression × race) | – | 0.54 | – | ||
| Interaction term P-value† (depression × income) | – | – | 0.77 | ||
| NonCVD death | |||||
| Events, n | 3137 | 1823 | 1314 | 1859 | 1278 |
| Crude | 1.69 (1.53–1.86) | 1.55 (1.35–1.78) | 1.79 (1.57–2.05) | 1.41 (1.25, 1.59) | 1.72 (1.46, 2.04) |
| Fully adjusted* | 1.31 (1.18–1.46) | 1.31 (1.13–1.53) | 1.33 (1.15–1.53) | 1.35 (1.18, 1.54) | 1.25 (1.05, 1.50) |
| Interaction term P-value† (depression × race) | – | 0.37 | – | ||
| Interaction term P-value† (depression × income) | – | – | 0.63 | ||
| Cancer death | |||||
| Events, n | 1461 | 846 | 615 | 753 | 708 |
| Crude | 1.25 (1.07–1.47) | 1.18 (0.94–1.49) | 1.30 (1.05–1.62) | 1.18 (0.98–1.43) | 1.05 (0.78–1.39) |
| Fully adjusted* | 1.12 (0.94–1.32) | 1.13 (0.89–1.45) | 1.12 (0.89–1.42) | 1.24 (1.01–1.53) | 0.89 (0.66–1.22) |
| Interaction term P-value† (depression × race) | – | 0.65 | – | ||
| Interaction term P-value† (depression × income) | – | – | 0.19 | ||
Each participant contributes to up to 3 time-varying CES-D measures. End of follow-up, December 31, 2012.
All results presented are from multiply imputed models.
SF-12 = Short-Form Health Survey.
Fully adjusted model includes sociodemographics (age, gender, region, income, health insurance, education, race, or income depending on the model of interest), medical conditions, physiological factors, and medication use (systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, use of aspirin, statins, antihypertensives, antidepressants, body mass index, logarithmically transformed albumin to creatinine ratio; diabetes, cardiovascular disease, medication use as a proxy for chronic obstructive pulmonary disease, and cognitive impairment), behavioral risk factors (pack-years of cigarette smoking, self-reported alcohol use, physical inactivity, medication nonadherence), and other factors (physical health component score of SF-12, log-transformed high-sensitivity C-reactive protein, and perceived stress).
Interaction term P-value is from the fully adjusted model and consists of depression and race or depression and income depending on the model of interest.