Women’s Health
The association between perimenopausal depression and risk of mortality Alicia Nevriana* Alicia Nevriana Donghao Lu
Introduction
Perimenopausal depression is a common condition, affecting around 30% of women going through menopausal transitions. However, there is a lack of understanding of the potential long-term consequences following perimenopausal depression, including the risk of mortality.
Objectives
To determine the association between perimenopausal depression and mortality.
Methods
Population-based matched cohort study using linkage of Swedish healthcare registers. We included women aged 45-55 and identified the first episode of perimenopausal depression between 1 January 2003 and 31 December 2022 recorded in specialist/primary care. To ensure that it is a new episode instead of a routine follow-up, for those with history of depression, we only included depression diagnosis recorded as unplanned visit. Using incidence density sampling, we randomly matched by birth year (+/- 1 year) and county of residence to 10 unexposed women. Participants were followed from index (matched) date until death, emigration, diagnosis of perimenopausal depression (for the unexposed group), or 31 December 2022, whichever was earliest. We estimated hazard ratios (HRs) using Cox regression.
Results
We included 104,758 women with perimenopausal depression and 1,047,580 unexposed women. Women with perimenopausal depression received the diagnosis at an average age of 49.6 years. During a mean follow-up of 10 years (SD: 5.5 years), we observed 5,197 deaths among women exposed to perimenopausal depression (rate 4.7 per 1,000 person-years) and 28,033 deaths among unexposed women (rate 2.7 per 1,000 person-years). Compared to unexposed women, women with perimenopausal depression had a higher risk of mortality (HR 1.79, 95% CI 1.73-1.84).
Conclusion
Preliminary findings from this study indicated that perimenopausal depression was associated with a higher risk of early death overall. We plan to control for a range of potential confounders and stratify the risk by cause of death in the next step of the study.