P113 Rheumatoid arthritis modifies the relationship between depression and overall mortality among African Americans

• Published in: Rheumatology (Oxford, England) Vol. 63; no. Supplement_1
• Main Authors: Banerjee, Sri, Khubchandani, Jagdish, Mesidor, Maica, Lane, Pilar, Gonzales-Lagos, Rafael
• Format: Journal Article
• Language: English
• Published: 24-04-2024
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/keae163.154

Abstract
Background/Aims
Rheumatoid arthritis (RA) has been known to be connected with many comorbidities and vascular diseases. Depression is two times more common in the RA population versus the general population. In this research, we will demonstrate the effect of depression on overall mortality and how the connection is influenced by rheumatoid arthritis among African Americans.
Methods
The National Health and Nutrition Examination Survey (NHANES) is a survey completed by non-institutionalized population of the United States. All respondents from the NHANES survey, who were 20 years or older and African American between the years 2005-2010 were included in the analysis with follow-up through December 31, 2019. Healthcare diagnosed self-reported information was used for the determination of RA. We determined depression by Patient Health Questionnaire (PHQ-9) with score ≥ 10. Analysis was performed using complex samples Cox regression to determine the relationship of depression on all-cause mortality and how rheumatoid arthritis influences this.
Results
Percent mortality among African American individuals with rheumatoid arthritis was 23.34% (CI 17.18%-29.34%) among males and 20.83% (CI 15.8-25.8) among females with mean follow-up of 10.1 years. For overall mortality, the age and sex-adjusted hazard ratio (HR) for depression was 2.52 (95% confidence interval [CI], 1.34-4.74 p = 0.01). The adjusted HR was elevated, 3.82 (CI 1.07-13.58, p = 0.04), among people with depression who also had rheumatoid arthritis but close to 1.0 (1.79 CI 0.47-6.88, p = 0.37) among individuals with depression who had no rheumatoid arthritis, after adjusting for medical (tobacco use, hypertension, and obesity) and demographic risk factors (poverty-income-ratio, age, and gender).
Conclusion
Among African Americans, we found that not only does depression lead to 2.5 times higher overall mortality but also rheumatoid arthritis occurrence affects this relationship even after controlling for potential confounders. As for treatment, African Americans are treated less with Disease-Modifying Anti-Rheumatic Drugs (DMARDS) than Caucasians according to previous research. Prevention and treatment programs for rheumatoid arthritis and screening for depression are especially important to treat comorbidities and to implement social change.
Disclosure
S. Banerjee: None. J. Khubchandani: None. M. Mesidor: None. P. Lane: None. R. Gonzales-Lagos: None.