TitleCoronary heart disease and risk factors as predictors of trajectories of psychological distress from midlife to old age.
Publication TypeJournal Article
Year of Publication2017
AuthorsVirtanen, M, Elovainio, M, Josefsson, K, Batty, GD, Singh-Manoux, A, Kivimäki, M
Date Published05/2017
KeywordsAdult, Age Factors, Aging, Comorbidity, Coronary Disease, Female, Humans, Life Style, London, Longitudinal Studies, Male, Middle Aged, Multivariate Analysis, Nonlinear Dynamics, Obesity, Odds Ratio, Prevalence, Prospective Studies, Risk Assessment, Risk Factors, Smoking, Stress, Psychological, Surveys and Questionnaires, Time Factors

OBJECTIVE: To examine coronary heart disease (CHD) and its risk factors as predictors of long-term trajectories of psychological distress from midlife to old age.

METHODS: In the Whitehall II cohort study, 6890 participants (4814 men, 2076 women; mean age 49.5 years) had up to seven repeat assessments of psychological distress over 21 years (mean follow-up 19 years). CHD and its risk factors (lifestyle-related risk factors, diabetes, hypertension and cholesterol) were assessed at baseline. Group-based trajectory modelling was used to identify clusters of individuals with a similar pattern of psychological distress over time.

RESULTS: We identified four trajectories of psychological distress over the follow-up: 'persistently low' (69% of the participants), 'persistently intermediate' (13%), 'intermediate to low' (12%) and 'persistently high' (7%). The corresponding proportions were 60%, 16%, 13% and 11% among participants with CHD; 63%, 15%, 12% and 10% among smokers and 63%, 16%, 12% and 10% among obese participants. In multivariable adjusted multinomial regression analyses comparing other trajectories to persistently low trajectory, prevalent CHD was associated with intermediate to low (OR 1.70, 95% CI 1.08 to 2.68) and persistently high (OR 1.92, 95% CI 1.16 to 3.19) trajectories. Smoking (OR 1.33, 95% CI 1.07 to 1.64; OR 1.55, 95% CI 1.19 to 2.04) and obesity (OR 1.33, 95% CI 1.04 to 1.70; OR 1.47, 95% CI 1.07 to 2.01) were associated with persistently intermediate and persistently high trajectories, respectively.

CONCLUSION: CHD, smoking and obesity may have a role in the development of long-lasting psychological distress from midlife to old age.

Alternate JournalHeart
PubMed ID27864318
PubMed Central IDPMC5529979
Grant ListRG/13/2/30098 / / British Heart Foundation / United Kingdom
R01 HL036310 / HL / NHLBI NIH HHS / United States
R01 AG034454 / AG / NIA NIH HHS / United States
MR/K013351/1 / / Medical Research Council / United Kingdom
R01 AG013196 / AG / NIA NIH HHS / United States