Epidemiology and Health

Original Article

Association between cardiovascular health measured by Life’s Essential 8 and depressive symptoms: Jeong Hyun Ahn, Hyejin Kim, Hyeon Chang Kim, Hokyou Lee, Younga Heather Lee, Donald M. Lloyd-Jones, Sun Jae Jung; Epidemiol Health. 2026;48:e2026013. Published online February 27, 2026; DOI: https://doi.org/10.4178/epih.e2026013

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Poor cardiovascular health (CVH) and the high prevalence of depressive symptoms represent significant public health concerns, underscoring the importance of examining their association. This study aimed to investigate the association between CVH, as defined by the American Heart Association’s 2022 Life’s Essential 8 (LE8) framework, and depressive symptoms.
METHODS
This study used data from the 2014, 2016, 2018, and 2020 Korea National Health and Nutrition Examination Survey. Overall CVH, measured using LE8, was categorized into 3 groups: low score (0–<50), moderate score (50–<80), and high score (80–100). LE8 comprises 2 subdomains: health behaviors and health factors. Depressive symptoms were defined as a total score ≥10 on the Patient Health Questionnaire-9. Multiple logistic regression analyses were performed, adjusting for sex, age, socioeconomic status, and current drinking status.
RESULTS
Among 17,294 adults, 257 male and 681 female reported significant depressive symptoms. Compared with individuals in the low LE8 category (reference), the odds ratio (OR) for depressive symptoms was 0.29 (95% confidence interval [CI], 0.21 to 0.40) for those in the high LE8 category. The OR for depressive symptoms was 0.39 (95% CI, 0.29 to 0.53) for individuals with a high health behavior score compared with those with a low health behavior score. In contrast, the health factor score was not significantly associated with depressive symptoms.
CONCLUSIONS
These findings suggest that overall CVH, particularly the health behavior subdomain, was associated with lower odds of depressive symptoms. Prospective longitudinal studies are warranted to validate these findings and clarify the directionality of the observed associations.; Summary

Korean summary
본 연구는 국민건강영양조사 데이터를 활용하여 한국 성인을 대상으로 Life’s Essential 8로 측정한 심혈관 건강과 우울 증상 간의 연관성을 분석하였다. 심혈관 건강점수가 높을수록 이상적인 심혈관 건강 상태를 의미하였다. 심혈관 건강 점수가 낮은 대상자와 비교하였을 때, 중간 또는 높은 심혈관 건강 점수에 해당하는 대상자의 우울증상에 대한 오즈비는 각각 0.57 (95% CI=0.46-0.69), 0.29 (95% CI=0.21-0.40)로 나타났다. 이러한 결과는 향후 종단 연구를 통해 추가적인 검증이 필요함을 시사한다.

Key Message
This study used nationally representative data to examine the association between cardiovascular health (CVH), measured by Life’s Essential 8, and depressive symptoms among Korean adults. Individuals with higher CVH scores indicated more ideal cardiovascular health. Participants with moderate or high CVH were associated with lower odds of depressive symptoms compared with low CVH. Moreover, similar associations were observed for individual CVH components, including ideal diet, non-smoking status, ideal sleep health, and ideal blood glucose. These findings warrant further investigation using longitudinal study designs.

COVID-19: Cohort Profile

Cohort profile: Cardiovascular Metabolic Etiological Research Center COVID-19 Mental Health Survey (CC-MHS): Sun Jae Jung, Dongkyu Lee, Ji Su Yang, Sunghyuk Kang, Hyejin Kim, Jeong Hyun Ahn, Yunseong Heo, Jieun Noh, Changhyun Kim, Hyeon Chang Kim; Epidemiol Health. 2025;47:e2025033. Published online June 30, 2025; DOI: https://doi.org/10.4178/epih.e2025033

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Abstract Summary PDF: Abstract
The Cardiovascular Metabolic Etiological Research Center COVID-19 Mental Health Survey (CC-MHS) is a comprehensive longitudinal cohort study investigating the mental health impact of the coronavirus disease 2019 pandemic by utilizing pre-existing baseline data from the Cardiovascular Metabolic Etiological Research Center cohort (2013-2018). This study assesses physical health, lifestyle changes, and mental health using validated tools, including the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and the PTSD Checklist for DSM-5, and evaluates a population of urban and suburban Korean participants across multiple dimensions. Through online surveys, the research identified gender-specific social support mechanisms, showing that men benefit from larger social networks, whereas women derive protective effects from stronger emotional connections. Key findings underscore complex interactions among demographic factors, psychological variables, and public health responses, especially in the context of vaccination attitudes and trust in pandemic management. The CC-MHS delivers critical insights into mental health trajectories during global health crises, offering valuable evidence for developing adaptive public health strategies and for understanding the intricate relationships between individual psychological resilience and broader societal health challenges.; Summary

Korean summary
본 CC-MHS 코호트는 팬데믹 이전 4,060명 대상 CMERC 기초자료 활용하였다 본 CC-MHS 코호트는 우울, 불안, PTSD 등 정신건강 평가를 7차례 추적조사하였다. 본 코호트에서는 성별 보호요인과 사회적 지지·신뢰의 중요성 규명하였다.

Key Message
In CC-MHS, we utilized pre-pandemic baseline data from 4,060 adults in the CMERC cohort. We conducted 7 waves of mental health surveys assessing depression, anxiety, PTSD, and resilience. In this cohort, we identified gender-specific protective factors and emphasized the importance of social support and trust.

Original Article

Gender differences in the association between multimorbidity and depression in older Korean adults: an analysis of data from the National Survey of Older Koreans (2011-2017): SeoYeon Hwang, Jin Young Nam, Jeong Hyun Ahn, Soojin Park; Epidemiol Health. 2022;44:e2022049. Published online May 24, 2022; DOI: https://doi.org/10.4178/epih.e2022049

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10 Web of Science
10 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Previous studies have shown that people with multimorbidity have a higher risk of depression than those without multimorbidity. However, few studies have examined the association between depression and multimorbidity in men and women separately. Since the rates of depression and multimorbidity are different in men and women, it is necessary to examine whether gender differences affect their association.

METHODS

This study included 30,138 participants (aged ≥ 65 years) from the National Survey of Older Koreans (2011-2017). Depression was defined using the Korean version of the Geriatric Depression Scale (SGDS-K). Multimorbidity was defined as people who had 2 or more chronic diseases, including arthritis, diabetes, heart disease, hypertension, pulmonary disease, cancer, stroke, or osteoporosis. Multiple logistic regression analysis was performed to determine the association between depression and multimorbidity.

RESULTS

In total, 22.2% and 30.7% of men and women, respectively, had depression. Those with multimorbidity had a higher risk of depression than those without chronic conditions; specifically, the difference in risk among men was greater than that among women. Age was considered a moderator for women. While the effects of pulmonary disease, stroke, and cancer were especially substantial in the integrated analysis, gender differences were observed related to various chronic conditions comorbid with heart disease.

CONCLUSIONS

There are gender differences in the association between multimorbidity and depression among older Korean adults. Therefore, gender-specific care should be provided to reduce depression in older adults with multimorbidity.

Summary

Korean summary
복합만성질환을 가진 남성 노인이 복합만성질환을 가진 여성 노인보다 우울증을 경험할 위험이 높았다. 특히 심장질환을 가진 남성 노인과 여성 노인은 심장질환을 포함한 만성질환의 개수에 따라 우울증 위험에 차이가 있었다. 노인들의 수명 향상을 위해 성별 차이를 고려한 치료 방안과 정책이 마련되어야 한다.

Key Message
Multimorbidity was associated with a high-risk of depression in older Korean adults and the effects of multimorbidity differed by gender.

Citations

Citations to this article as recorded by

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