Coronavirus disease 2019 is associated with long-term depressive symptoms in Spanish older adults with overweight/obesity and metabolic syndrome

Sangeetha Shyam; Carlos Gómez-Martínez; Indira Paz-Graniel; José J. Gaforio; Miguel Ángel Martínez-González; Dolores Corella; Montserrat Fitó; J. Alfredo Martínez; Ángel M. Alonso-Gómez; Julia Wärnberg; Jesús Vioque; Dora Romaguera; José López-Miranda; Ramon Estruch; Francisco J. Tinahones; José Manuel Santos-Lozano; J. Luís Serra-Majem; Aurora Bueno-Cavanillas; Josep A. Tur; Vicente Martín Sánchez; Xavier Pintó; María Ortiz Ramos; Josep Vidal; Maria Mar Alcarria; Lidia Daimiel; Emilio Ros; Fernando Fernandez-Aranda; Stephanie K. Nishi; Oscar García Regata; Estefania Toledo; Jose V. Sorli; Olga Castañer; Antonio Garcia-Rios; Rafael Valls-Enguix; Napoleon Perez-Farinos; M. Angeles Zulet; Elena Rayó-Gago; Rosa Casas; Mario Rivera-Izquierdo; Lucas Tojal-Sierra; Miguel Damas-Fuentes; Pilar Buil-Cosiales; Rebeca Fernández-Carrion; Albert Goday; Patricia J. Peña-Orihuela; Laura Compañ-Gabucio; Javier Diez-Espino; Susanna Tello; Ana González-Pinto; Víctor de la O; Miguel Delgado-Rodríguez; Nancy Babio; Jordi Salas-Salvadó

doi:10.1017/S0033291723002313

Coronavirus disease 2019 is associated with long-term depressive symptoms in Spanish older adults with overweight/obesity and metabolic syndrome

Published online by Cambridge University Press: 05 September 2023

Sangeetha Shyam

Carlos Gómez-Martínez ,

Indira Paz-Graniel ,

José J. Gaforio ,

Miguel Ángel Martínez-González ,

Dolores Corella ,

Montserrat Fitó ,

J. Alfredo Martínez ,

Ángel M. Alonso-Gómez and

Julia Wärnberg

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Sangeetha Shyam*: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Departament de Bioquímica i Biotecnologia, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
Carlos Gómez-Martínez: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Departament de Bioquímica i Biotecnologia, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
Indira Paz-Graniel: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Departament de Bioquímica i Biotecnologia, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
José J. Gaforio: Affiliation:
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Departamento de Ciencias de la Salud, Instituto Universitario de Investigación en Olivar y Aceites de Oliva, Universidad de Jaén, Jaén, Spain
Miguel Ángel Martínez-González: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Dolores Corella: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Preventive Medicine, University of Valencia, Valencia, Spain
Montserrat Fitó: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
J. Alfredo Martínez: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain Precision Nutrition and Cardiometabolic Health Program, IEA Food, CEI UAM + CSIC, Madrid, Spain
Ángel M. Alonso-Gómez: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
Julia Wärnberg: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain EpiPHAAN Research Group, School of Health Sciences, University of Málaga – Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain
Jesús Vioque: Affiliation:
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
Dora Romaguera: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
José López-Miranda: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
Ramon Estruch: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, Barcelona, Spain
Francisco J. Tinahones: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
José Manuel Santos-Lozano: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
J. Luís Serra-Majem: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain
Aurora Bueno-Cavanillas: Affiliation:
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
Josep A. Tur: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
Vicente Martín Sánchez: Affiliation:
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Precision Nutrition and Cardiometabolic Health Program, IEA Food, CEI UAM + CSIC, Madrid, Spain Institute of Biomedicine (IBIOMED), University of León, León, Spain
Xavier Pintó: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat – Barcelona, Barcelona, Spain
María Ortiz Ramos: Affiliation:
Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Josep Vidal: Affiliation:
CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Department of Endocrinology, Institut d`Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
Maria Mar Alcarria: Affiliation:
Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autonoma, Madrid, Spain
Lidia Daimiel: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain Departamento de Ciencias Farmacéuticas y de la Salud, Faculty de Farmacia, Universidad San Pablo-CEU, CEU Universities, Boadilla del Monte, Spain
Emilio Ros: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
Fernando Fernandez-Aranda: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Psychoneurobiology of Eating and Addictive Behaviors Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain Department of Psychiatry, University Hospital of Bellvitge and University of Barcelona, Barcelona, Spain
Stephanie K. Nishi: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Departament de Bioquímica i Biotecnologia, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada
Oscar García Regata: Affiliation:
Department of Internal Medicine, OSI ARABA, University Hospital Araba, Vitoria-Gasteiz, Spain
Estefania Toledo: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain
Jose V. Sorli: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Preventive Medicine, University of Valencia, Valencia, Spain
Olga Castañer: Affiliation:
Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
Antonio Garcia-Rios: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
Rafael Valls-Enguix: Affiliation:
Health Care Centre Raval-Elche, Elche, Spain
Napoleon Perez-Farinos: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain EpiPHAAN Research Group, School of Health Sciences, University of Málaga – Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain
M. Angeles Zulet: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
Elena Rayó-Gago: Affiliation:
Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
Rosa Casas: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, Barcelona, Spain
Mario Rivera-Izquierdo: Affiliation:
Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
Lucas Tojal-Sierra: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
Miguel Damas-Fuentes: Affiliation:
Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
Pilar Buil-Cosiales: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain Atención Primaria, Servicio Navarro de Salud, Pamplona, Spain
Rebeca Fernández-Carrion: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Preventive Medicine, University of Valencia, Valencia, Spain
Albert Goday: Affiliation:
Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
Patricia J. Peña-Orihuela: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
Laura Compañ-Gabucio: Affiliation:
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
Javier Diez-Espino: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain Atención Primaria, Servicio Navarro de Salud, Pamplona, Spain
Susanna Tello: Affiliation:
Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
Ana González-Pinto: Affiliation:
Department of Psychiatry, Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, CIBERSAM, Vitoria-Gasteiz, Spain
Víctor de la O: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain
Miguel Delgado-Rodríguez: Affiliation:
Precision Nutrition and Cardiometabolic Health Program, IEA Food, CEI UAM + CSIC, Madrid, Spain Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
Nancy Babio*: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Departament de Bioquímica i Biotecnologia, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
Jordi Salas-Salvadó: Affiliation:
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain Departament de Bioquímica i Biotecnologia, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
*: Corresponding author: Sangeetha Shyam; Email: Sangeetha.shyam@urv.cat; Nancy Babio; Email: nancy.babio@urv.cat
Corresponding author: Sangeetha Shyam; Email: Sangeetha.shyam@urv.cat; Nancy Babio; Email: nancy.babio@urv.cat

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Abstract

Background

The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.

Methods

Participants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.

Results

COVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).

Conclusions

COVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.

Keywords

COVID-19 depression older adults PREDIMED-Plus SARS-CoV-2

Type: Original Article
Information: Psychological Medicine , Volume 54 , Issue 3 , February 2024 , pp. 620 - 630

DOI: https://doi.org/10.1017/S0033291723002313 [Opens in a new window]
Copyright: Copyright © The Author(s), 2023. Published by Cambridge University Press

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