Cardiometabolic multimorbidity, sleep duration and depressive symptom transitions in two cohorts
In two longitudinal cohorts, people with cardiometabolic multimorbidity had higher hazards of moving from no depressive symptoms to depressive symptoms and lower hazards of reverting to no symptoms; these associations were stronger with poor sleep duration. [1]
Automatic summary · not editorially reviewed
The key findings
Two longitudinal cohorts were analyzed: 14,468 CHARLS participants and 8,551 ELSA participants, with depressive symptoms assessed by CES-D and transitions modeled among no depressive symptoms, depressive symptoms and death. [1]
Compared with no cardiometabolic disease, one cardiometabolic disease or cardiometabolic multimorbidity was associated with higher hazards of depressive symptom onset and lower hazards of reversion to no depressive symptoms in both cohorts. [1]
Significant additive interactions between cardiometabolic multimorbidity and unhealthy sleep duration were observed, and associations were stronger among those with poor sleep duration than with good sleep duration. [1]
The source at a glance
- Study type / format
- Two longitudinal cohort studies using multi-state Markov models
- Population / context
- 14,468 CHARLS participants in China (mean age 59.3 years; 52.3% female) and 8,551 ELSA participants in the UK (mean age 66.1 years; 56.2% female).
- Summary based on
- Study abstract
- Original publication
- August 21, 2026
CHARLS and ELSA cohorts with baseline cardiometabolic disease
The abstract reports two longitudinal cohort studies: 14,468 participants from the China Health and Retirement Longitudinal Study (CHARLS) and 8,551 from the English Longitudinal Study of Ageing (ELSA). Chinese participants were on average 59.3 years old and 52.3% female; UK participants were on average 66.1 years old and 56.2% female. Depressive symptoms were assessed with the CES-D scale, and reversion meant a transition from depressive symptoms to no depressive symptoms based on CES-D thresholds. Multi-state Markov models estimated transitions among no depressive symptoms, depressive symptoms and death according to cardiometabolic multimorbidity and sleep duration at baseline.
Supporting source [1]
Higher onset and lower reversion hazards with multimorbidity
Compared with participants without cardiometabolic diseases, those with one cardiometabolic disease or cardiometabolic multimorbidity had 13% and 29% higher hazards of transitioning from no depressive symptoms to depressive symptoms in CHARLS (HR 1.13 [1.05–1.22]; HR 1.29 [1.09–1.54]) and 10% and 21% higher hazards in ELSA (HR 1.10 [1.02–1.20]; HR 1.21 [1.04–1.41]). Hazards of transitioning from depressive symptoms to no depressive symptoms were 10% and 21% lower in CHARLS (HR 0.90 [0.84–0.97]; HR 0.79 [0.67–0.94]) and 17% and 26% lower in ELSA (HR 0.83 [0.76–0.91]; HR 0.74 [0.63–0.87]). The abstract reports significant additive interactions between cardiometabolic multimorbidity and unhealthy sleep duration, with stronger associations among those with poor sleep duration than with good sleep duration.
Supporting source [1]
Abstract-only scope and association, not causation
The conclusion states that cardiometabolic multimorbidity is associated with higher hazards of depressive symptom onset and lower hazards of transitioning from depressive symptoms to no depressive symptoms, and that these associations were stronger among people with poor sleep duration. These are associations from observational cohort analyses, not evidence that multimorbidity or sleep duration causes depressive symptoms. The abstract does not report the full definition of poor sleep duration, the length of follow-up, or adjustment details; the full text was not reviewed.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. The abstract does not report the full definition of poor sleep duration, follow-up length or adjustment details. The findings are observational associations, not causal effects.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Zhang R, Sun X, Caotian G, Jiang C, Teng W. · europepmc.org · August 21, 2026