{"doi":"10.1016/j.eclinm.2025.103182","title":"Contribution of depression and cardiometabolic diseases and the role of depression treatment in survival and functioning in older adults","abstract":"Background: Achieving survival free from physical disability or neurocognitive impairment, known as disability-free survival (DFS), is a key public health goal. This study aimed to (1) determine the long-term interactive effects of depression and cardiometabolic diseases (CMDs) on DFS, and (2) explore any associated antidepressant treatment effect on improvements in DFS among older adults. Methods: We used data from the ASPREE trial and its observational follow-ups (2010-2019), involving community-dwelling adults aged ≥ 70 years (≥65 for U.S. minorities). Time-updated Cox models were used to estimate the combined effect of depression and CMDs (type 2 diabetes, dyslipidemia, hypertension, chronic kidney disease, metabolic-associated steatotic liver disease, and major adverse cardiovascular events) as well as cardiometabolic multimorbidity (≥2 CMDs) on DFS. To evaluate the improvement in DFS associated with antidepressant treatment in individuals with depression, we estimated the number needed to treat (NNT) to achieve a one-year increase in DFS through antidepressant therapy. Findings: 18,739 participants (mean [SD] age, 75.1 [4.6] years; 56.0% female) were included, with a median follow-up of seven years; individuals with both depression and CMDs demonstrated a significantly lower DFS compared to those without either condition. In individuals with depressive symptoms, antidepressant use was associated with a median increase in DFS of 2.95 years (95% CI, 2.12-3.04), with an estimated NNT of 8.05 (95% CI, 5.63-14.86) associated with a one-year increase in DFS. Interpretation: Integrating depression treatment into chronic disease management, when appropriate, is associated with an improvement in DFS among older adults. Funding: Deakin University Postgraduate Research Scholarship.","journal":"EClinicalMedicine","year":2025,"id":519314,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9654,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":453418,"name":"Malcolm Forbes","orcid":"0000-0002-8339-6471","position":1,"is_corresponding":false},{"id":56340,"name":"Michael Berk","orcid":"0000-0002-5554-6946","position":2,"is_corresponding":false},{"id":1032173,"name":"Daniel Clayton‐Chubb","orcid":"0000-0001-7479-9669","position":3,"is_corresponding":false},{"id":258474,"name":"Rachel Huxley","orcid":"0000-0002-2705-6616","position":4,"is_corresponding":false},{"id":258453,"name":"Crystal Lee","orcid":"0000-0001-6613-5491","position":5,"is_corresponding":false},{"id":284809,"name":"Mojtaba Lotfaliany","orcid":"0000-0001-6594-9004","position":6,"is_corresponding":false},{"id":264297,"name":"John J. McNeil","orcid":"0000-0002-1049-5129","position":7,"is_corresponding":false},{"id":6025,"name":"Julie A. Pasco","orcid":"0000-0002-8968-4714","position":8,"is_corresponding":false},{"id":48623,"name":"Kevan R. Polkinghorne","orcid":"0000-0002-9851-002X","position":9,"is_corresponding":false},{"id":916814,"name":"Greg Roebuck","orcid":null,"position":10,"is_corresponding":false},{"id":332013,"name":"Joanne Ryan","orcid":"0000-0002-7039-6325","position":11,"is_corresponding":false},{"id":284811,"name":"Andrew Tonkin","orcid":"0000-0001-5291-0610","position":12,"is_corresponding":false},{"id":264292,"name":"Robyn L. Woods","orcid":"0000-0003-1249-6149","position":13,"is_corresponding":false},{"id":284812,"name":"Mohammadreza Mohebbi","orcid":"0000-0001-9713-7211","position":14,"is_corresponding":false},{"id":1387667,"name":"Najmeh Davoodian","orcid":"0000-0001-6410-6400","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T02:49:18.751199Z","pmid":"40235951","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}