TY - JOUR
T1 - Depressive tendency and the risk of death from pneumonia
T2 - The jacc study
AU - Tanabe, Naohito
AU - Seki, Nao
AU - Horikawa, Chika
AU - Yatsuya, Hiroshi
AU - Yamagishi, Kazumasa
AU - Iso, Hiroyasu
AU - Ukawa, Shigekazu
AU - Tamakoshi, Akiko
N1 - Funding Information:
This work was supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT) (MonbuKagaku-sho); Grants-in-Aid for Scientific Research on Priority Areas of Cancer; and Grants-in-Aid for Scientific Research on Priority Areas of Cancer Epidemiology from MEXT ( MonbuKagaku-sho ) ( Nos. 61010076, 62010074, 63010074, 1010068, 2151065, 3151064, 4151063, 5151069, 6279102, 11181101, 17015022, 18014011, 20014026, 20390156, and 26293138), by Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number JP 16H 06277, and by Grant-in-Aid from the Ministry of Health, Labour and Welfare, Health and Labour Sciences research grants, Japan (Research on Health Services: H17-Kenkou-007; Comprehensive Research on Cardiovascular Disease and Life-Related Disease: H 18-Junkankitou [Seishuu]-Ippan-012; Comprehensive Research on Cardiovascular Disease and Life-Related Disease: H19-Junkankitou [Seishuu]-Ippan-012; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H20-Junkankitou [Seishuu]-Ippan-013; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H23-Junkankitou [Seishuu]-Ippan-005); an Intramural Research Fund (22-4-5) for Cardiovascular Diseases of National Cerebral and Cardiovascular Center; Comprehensive Research on Cardiovascular and Life-Style Related Diseases (H26-Junkankitou [Seisaku]-Ippan-001) and H29-Junkankitou [Seishuu]-Ippan-003).
Publisher Copyright:
© 2020 The Japanese Society of Internal Medicine.
PY - 2020/12/15
Y1 - 2020/12/15
N2 - Objective The burden of death from pneumonia is expected to increase with the aging of the population, as has been observed in Japan. Depressive tendency, a common psychosocial sign, may be a risk factor for pneumonia due to its possible association with some immune dysfunction. This study aimed to clarify the association between depressive tendency and the risk of death from pneumonia. Methods A population-based cohort that consisted of 75,174 Japanese men and women was followed for a median of 19.1 years. Four psychological and behavioral symptoms (depressive symptoms) were used to evaluate depressive tendency. Results A total of 1,329 deaths from pneumonia were observed. Depressive symptoms were positively and dose-dependently associated with the risk of death from pneumonia (p<0.001 for trend), and subjects with ≥2 depressive symptoms showed a significantly elevated risk compared to those without any symptoms [multivariable hazard ratio (HR), 1.66; 95% confidence interval (CI), 1.39-1.99]. This association was not significantly affected by sex or age at baseline. The elevated risk was still significant even when subjects were limited to those without any medical histories. The excess risk was observed not only for death occurring within the first 10 years of follow-up (multivariable HR, 2.05; 95% CI, 1.51-2.78) but also for that occurring in the longer follow-up period (multivariable HR, 1.48; 95% CI, 1.18-1.85). Conclusion Depressive tendency may be a risk factor for death from pneumonia. Further studies using a more reliable tool for the evaluation of depressive state are necessary to confirm this relationship.
AB - Objective The burden of death from pneumonia is expected to increase with the aging of the population, as has been observed in Japan. Depressive tendency, a common psychosocial sign, may be a risk factor for pneumonia due to its possible association with some immune dysfunction. This study aimed to clarify the association between depressive tendency and the risk of death from pneumonia. Methods A population-based cohort that consisted of 75,174 Japanese men and women was followed for a median of 19.1 years. Four psychological and behavioral symptoms (depressive symptoms) were used to evaluate depressive tendency. Results A total of 1,329 deaths from pneumonia were observed. Depressive symptoms were positively and dose-dependently associated with the risk of death from pneumonia (p<0.001 for trend), and subjects with ≥2 depressive symptoms showed a significantly elevated risk compared to those without any symptoms [multivariable hazard ratio (HR), 1.66; 95% confidence interval (CI), 1.39-1.99]. This association was not significantly affected by sex or age at baseline. The elevated risk was still significant even when subjects were limited to those without any medical histories. The excess risk was observed not only for death occurring within the first 10 years of follow-up (multivariable HR, 2.05; 95% CI, 1.51-2.78) but also for that occurring in the longer follow-up period (multivariable HR, 1.48; 95% CI, 1.18-1.85). Conclusion Depressive tendency may be a risk factor for death from pneumonia. Further studies using a more reliable tool for the evaluation of depressive state are necessary to confirm this relationship.
UR - http://www.scopus.com/inward/record.url?scp=85097974538&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85097974538&partnerID=8YFLogxK
U2 - 10.2169/internalmedicine.5052-20
DO - 10.2169/internalmedicine.5052-20
M3 - Article
C2 - 32788541
AN - SCOPUS:85097974538
VL - 59
SP - 3123
EP - 3130
JO - Internal Medicine
JF - Internal Medicine
SN - 0918-2918
IS - 24
ER -