Abstract
Background: Comorbidity between depression and cardiometabolic diseases is an emerging health concern, with childhood maltreatment as a major risk factor. These conditions are also linked to unhealthy lifestyle behaviours such as physical inactivity, smoking, and alcohol intake. However, the precise degree to which lifestyle behaviours moderate the risk between childhood maltreatment and comorbid depression and cardiometabolic disease is entirely unknown.
Methods: We analysed clinical and self-reported data from four longitudinal studies (Npooled = 181,423; mean follow-up period of 5–18 years) to investigate the moderating effects of physical activity, smoking, and alcohol intake, on the association between retrospectively reported childhood maltreatment and i) depression, ii) cardiometabolic disease and iii) their comorbidity in older adults (mean age range of 47–66 years). Estimates of these moderation effects were derived using multinomial logistic regressions and then meta-analysed.
Results: No meaningful moderation effects were detected for any of the lifestyle behaviours on the association between childhood maltreatment and each health outcome. Physical activity was linked to lower odds of depression (OR [95% CI] = 0.94 [0.92; 0.96]), while smoking was a risk factor for all three outcomes (OR [95% CI] = 1.16 [1.04; 1.31] or larger). Alcohol intake was associated with slightly lower odds of comorbidity (OR [95% CI] = 0.69 [0.66; 0.73]), although this association was not stable across all sensitivity analyses.
Conclusions: Lifestyle behaviours did not moderate the risk association between childhood maltreatment and depression, cardiometabolic disease, and their comorbidity in older adults. However, we confirmed that childhood maltreatment was associated with these conditions. Further research should address the limitations of this study to elucidate the most optimal targets for intervention.
| Original language | English |
|---|---|
| Article number | 133 |
| Journal | BMC medicine |
| Volume | 23 |
| Issue number | 1 |
| Early online date | 5 Mar 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 5 Mar 2025 |
Bibliographical note
publishing OAAcknowledgements
We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. We also thank all the participants who took part in NESDA, as well as the data management team, interviewers, computer and laboratory technicians, volunteers, medical specialists, and other staff and stakeholders who have taken part in NESDA. The infrastructure for the NESDA study (www.nesda.nl) is funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (ZonMw, grant number 10-000-1002) and financial contributions by participating universities and mental health care organizations (VU University Medical Center, GGZ inGeest, Leiden University Medical Center, Leiden University, GGZ Rivierduinen, University Medical Center Groningen, University of Groningen, Lentis, GGZ Friesland, GGZ Drenthe, Rob Giel Onderzoekscentrum).Funding
University Research Studentship Award Horizon 2020 Framework Programme 848158, 848158, 848158, 848158, 848158, 848158, 848158, 848158 UK Research and Innovation EP/Y015037/1, EP/Y015037/1 European Research Council EP/Y015037/1, EP/Y015037/1
| Funders | Funder number |
|---|---|
| UK Research and Innovation |
Keywords
- Alcohol
- Cardiometabolic disease
- Childhood maltreatment
- Comorbidity
- Depression
- Meta-analysis
- Physical activity
- Smoking
ASJC Scopus subject areas
- General Medicine