Associations of multiple chronic disease and depressive symptoms with incident stroke among Chinese middle-aged and elderly adults: a nationwide population-based cohort study

Table 3 The independent associations of multiple chronic disease status and depressive symptoms as well as their combination with incident stroke

	Incident stroke (case, No.)	Incidence rate, per 1000 person-years	Model 1		Model 2		Model 3
	Incident stroke (case, No.)	Incidence rate, per 1000 person-years	HR (95% CI)	P-value	HR (95% CI)	P-value	HR (95% CI)	P-value
MCD ^a
0	90	4.00	1.00 (reference)		1.00 (reference)		1.00 (reference)
1	150	7.71	1.922 (1.480–2.497)	< 0.001	1.607 (1.213–2.130)	0.001	1.562 (1.124–2.170)	0.008
≥ 2	168	13.47	3.336 (2.582–4.309)	< 0.001	2.578 (1.946–3.415)	< 0.001	2.436 (1.702–3.487)	< 0.001
Depressive symptoms
No	294	6.97	1.00 (reference)		NA		NA
Yes	115	9.16	1.313 (1.058 ~ 1.629)	0.013	NA		NA
Combined effects
MCD(0)-not having depressive symptoms	67	3.75	1.00 (reference)		1.00 (reference)		1.00 (reference)
MCD(0)-having depressive symptoms	23	4.97	1.326 (0.825–2.129)	0.243	1.469 (0.897–2.406)	0.127	1.662 (0.953–2.897)	0.073
MCD(1)-not having depressive symptoms	113	7.52	2.002 (1.480–2.708)	< 0.001	1.756 (1.268–2.432)	0.001	1.738 (1.182–2.555)	0.005
MCD(1)-having depressive symptoms	37	8.35	2.219 (1.485–3.315)	< 0.001	1.795 (1.143–2.817)	0.011	1.943 (1.166–3.238)	0.011
MCD(≥ 2)-not having depressive symptoms	113	12.45	3.290 (2.432–4.451)	< 0.001	2.730 (1.963–3.796)	< 0.001	2.793 (1.842–4.234)	< 0.001
MCD(≥ 2)-having depressive symptoms	55	16.23	4.276 (2.993–6.109)	< 0.001	3.262 (2.183–4.876)	< 0.001	3.000 (1.846–4.877)	< 0.001
Multiplicative interaction
Multiple chronic disease × Depressive symptoms	NA	NA	NA	0.941	NA	0.640	NA	0.258

Abbreviation: MCD Multiple chronic diseases, No. Number, HR Hazard ratio, CI Confidence interval, NA Not applicable
Model 1: Unadjusted model
Model 2: Adjusting for gender, age, marital status, education level, ever smoking, last year drinking, residence, and body mass index at baseline
Model 3: Adjusting for the variables in Model 2 plus clinical variables, including fasting blood glucose, triglycerides, creatine, total Cholesterol, HDL cholesterol, LDL cholesterol, High sensitivity C-reactive protein, hemoglobin, uric acid, and Cystatin C

ISSN: 1471-2318