LAUSR

Abstract Background Cardiometabolic diseases are prevalent in the older population worldwide and might have important roles in developing depression. However, few studies have investigated the associations between cardiometabolic multimorbidity and depression in older Chinese people. We aimed to examine the associations between cardiometabolic multimorbidity and depression in middle-aged and older Chinese people. Methods We included 15 162 participants aged 45 years or above from the China Health and Retirement Longitudinal Study (known as CHARLS). For this study, cardiometabolic multimorbidity included hypertension, heart problems, dyslipidaemia, and diabetes. We used the Center for Epidemiological Studies Depression Scale-10 to assess depression. We used generalised estimating equations to estimate the associations between cardiometabolic multimorbidity and depression. Findings After adjusting for covariates, compared with no cardiometabolic multimorbidity, one (odds ratio 1·10; 95% CI 1·03–1·17), two (1·37; 1·25–1·50), three (1·55; 1·32–1·81), and four cardiometabolic multimorbidities (1·73; 1·33–2·25) were associated with depression. Compared with people with no cardiometabolic multimorbidity, those with hypertension only were not associated with depression (1·02; 0·94–1·10), whereas hypertension with one (1·34; 1·21–1·48), two (1·55; 1·31–1·82), and three cardiometabolic multimorbidities (1·73; 1·33–2·25) were associated with an increased risk of depression. For those with hypertension, compared with hypertension only, hypertension with heart problems only (1·50; 1·28–1·74), dyslipidaemia only (1·17; 1·01–1·37), diabetes only (1·32; 1·07–1·62), heart problems and dyslipidaemia (1·67; 1·38–2·01), heart problems and diabetes (2·14; 1·48–3·10), and all cardiometabolic multimorbidities (1·77; 1·35–2·31) were associated with depression. Interpretation In middle-aged and older Chinese people, hypertension with no cardiometabolic multimorbidity is not associated with depression, whereas hypertension with cardiometabolic multimorbidity is associated with an increased risk of depression. A better understanding of the role of cardiometabolic multimorbidity on depression development might be helpful in improving the health-care plan for patients with cardiometabolic multimorbidity with a high risk of depression. Funding The National Natural Science Foundation of China (81703304).