Cardiovascular health based on life's essential eight and its association with depressive symptoms in older Mexican adults: A cross-sectional study

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BACKGROUND: To examine the association between the Life's Essential 8 (LE8) cardiovascular health index and depressive symptoms among older adults in Mexico. MATERIALS AND METHODS: This cross-sectional study analysed data from 700 adults aged ≥55 years (59% women) participating in the Mexican Health and Aging Study (MHAS) and the Mex-Cog ancillary study (2015-2016). LE8 comprises eight components - food insecurity, physical activity, smoking, sleep, body mass index, blood lipids, blood glucose, and blood pressure - each scored from 0 to 100 and classified as low (0-49), moderate (50-79), or high (80-100) cardiovascular health. Depressive symptoms were assessed using the 9-item Center for Epidemiologic Studies Depression Scale (CES-D), with scores ≥5 indicating probable depression. Binary and multinomial logistic regression models estimated associations, adjusting for age, sex, education, comorbidities, alcohol consumption, and socioeconomic status. RESULTS: For depressive symptom burden (CES-D score), compared with the high cardiovascular health group, individuals in the low cardiovascular health group had significantly higher odds of depressive symptoms (OR 2.84; 95% CI 1.62-4.99). Relative to the moderate cardiovascular health group, the low cardiovascular health group also showed increased odds (OR 2.47; 95% CI 1.71-3.58). For probable depression (CES-D ≥5), the low cardiovascular health group exhibited higher odds compared with both the high cardiovascular health group (OR 3.47; 95% CI 1.57-7.70) and moderate cardiovascular health groups (OR 2.74; 95% CI 1.76-4.28). CONCLUSIONS: Poor cardiovascular health, reflected by lower LE8 scores, was independently associated with greater odds of depressive symptoms in older Mexican adults. These findings support the potential utility of LE8 as a practical framework for identifying individuals with a higher burden of depressive symptoms and warrant further longitudinal investigation.

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