Dyadic Associations of Depressive Symptoms and Cardiovascular Health Trajectories in Middle-Aged and Older Couples

BACKGROUND:Depressive symptoms can contribute to poor cardiovascular health (CVH) but prior research largely focused on individual-based studies. Yet, health behaviours and outcomes are interlinked within social relationships, particularly in spouses. This study examined how depressive symptoms in opposite-sex spouses may jointly and uniquely impact CVH over time. METHODS:We analysed 4360 opposite-sex spousal dyads in the Health and Retirement Study-a prospective cohort of middle-aged and older adults (2004-2016). Depressive symptoms were measured at baseline (2004/2006) using the 8-item Center for Epidemiologic Studies-Depression scale. CVH scores (range: 0-100; higher scores=better CVH), based on body mass index, blood pressure, fasting glucose, total cholesterol and smoking were assessed across three follow-up waves (2006/2008-2014/2016; 8-year follow-up period). We used the Actor-Partner Interdependence Model and latent growth curve modelling to examine how both spouses' depressive symptoms were associated with subsequent CVH, adjusting for sociodemographics and prior cardiovascular disease. RESULTS:In wives, a one-unit increment in depressive symptoms at baseline was associated with lower CVH scores (β=-1.25; 95% CI -1.60 to -0.91) at Wave 2. Similar associations were observed in husbands (β=-1.19; 95% CI -1.58 to -0.81). Wives' depressive symptoms were also associated with lower husbands' CVH scores (β=-0.39; 95% CI -0.70 to -0.07), while husbands' depressive symptoms were associated with faster CVH decline in wives over time (β=-0.08; 95% CI -0.14 to -0.03). No other significant spousal effects were found. CONCLUSION:Depressive symptoms in both spouses may contribute to one's own and one's partner's CVH, with distinct gender-specific patterns. These results may inform targeted dyadic interventions to optimise CVH in middle-aged and older opposite-sex couples.