That one begged for further investigation.
The Deadly Effects of Depression
“All-cause mortality” is a way of saying “death.” Not just death directly caused or attributed to multiple sclerosis in this case, but total deaths from any cause. In the case of this study, investigators looked at all-cause mortality (over a 10-year period) in two groups: One group had MS (a combination of relapsing and progressive forms of the disease), and 21 percent of that group also had depression; the control group did not have MS, and 9 percent of that group had depression. While depression is not considered a symptom of multiple sclerosis, it is regarded as one of the most common comorbidities of MS. The study, published in September 2021 in Neurology, concluded that people with both MS and depression died at a rate more than five times that of people who have neither MS nor depression. RELATED: Depression, Anxiety, and MS: What’s the Connection?
Would Treatment for Depression Lower Death Rate?
Raffaele Palladino, MD, PhD, a research associate at Imperial College London, reported that he and his colleagues observed that while both MS and depression on their own had impacts on life expectancy, the joint effect of MS plus depression equaled more than the effect of each factor alone. Further studies have been called for to confirm both the results (including that 14 percent of the effect was attributable to the interaction between MS and depression) and whether treatment for depression in people with MS might reduce the observed increase in mortality rates.
High Incidence of Vascular Disease Among Those With MS
One factor that surprised me to read at first — but then made more sense when I considered that many people with MS have reduced mobility — was the greater prevalence of vascular disease (heart and blood vessel disease) in people with MS, regardless of a diagnosis of depression. People with MS had increased risk of vascular disease whether they had comorbid depression or not, compared with controls who had neither condition. This risk was, however, highest in people with both depression and MS. The researchers noted that the increased risk of vascular disease among people with MS was not fully accounted for by traditional risk factors such as diabetes, high blood pressure, and smoking. The retrospective study in question involved 12,251 MS patients and 72,572 matched controls from the Clinical Research Datalink database in England from 1987 to 2018. The study built on data reported in a Canadian study published in 2018, which found that the effects of depression on mortality risk in MS (and in rheumatoid arthritis) are greater than associations of these immune-mediated inflammatory diseases and depression alone. RELATED: MS, Depression, and Fatigue: Expert Examines How to Break the Vicious Cycle
What Can We Do Now to Protect Our Health?
More research into the relationship between MS, depression, and vascular disease is indeed called for. While those studies are being designed, however, it is important for those of us living with MS to consider our cardiovascular health and how multiple sclerosis (and possible MS-related depression) may be playing with our heart health. Perhaps it’s time to schedule a visit with the cardiologist to get a baseline assessment, while keeping an eye on our mental health at the same time. We may not move around like we use to, we may have slipped into unhealthy eating habits (particularly if depressed), and those two factors could compound into something bigger than we might have thought. Until more research is available, I think I’m going to err on the side of caution. Wishing you and your family the best of health. Cheers, Trevis
