Which chronic diseases are linked to depression and anxiety?

New research reveals that long-term cancer and cardiovascular disease are hard on mental health, but it’s osteoarthritis that could pose the greatest risk for depression and anxiety.

Living with chronic disease comes with a considerable mental burden, and now a new observational study based on data from the Sax Institute’s 45 and Up Study is revealing just how great the impact is – linking cancer, cardiovascular disease and osteoarthritis to higher rates of depression and anxiety.

Researchers tracked 115,000 healthy Australians between the ages of 45 and 64, with an eight-year follow up, and found that 12.5% of healthy participants had depression. However, those who developed chronic diseases fared worse for depression: 15.1% for cancer or CVD sufferers; 16.7% for those with diabetes; and 25.4% for individuals with osteoarthritis.

The study also observed that women were considerably more likely to have depression and anxiety than men, both in the healthy population (14.8% in women and 9.8% in men) and after developing cancer, CVD, diabetes or osteoarthritis.

Osteoarthritis in particular scored highly for depression and anxiety in both women (28.4%) and men (20.1%). Why was this case? Study co-author, Professor Cassandra Szoeke, Neurologist and Director of the Women’s Healthy Ageing Project (WHAP) says that osteoarthritis is a “difficult disease.”

“I think the degenerative progression, cause of pain and limitation on daily living activities without a way to reverse the disease all cause the impact we observe on worsening mental health,” says Professor Szoeke.

Osteoarthritis is the degeneration of joint cartilage and underlying bone, especially in the hip, knee, and thumb joints. The government estimates that one in 11 Australians (9.3%) have osteoarthritis, and three in five sufferers are female. Given the high rate of osteoarthritis in women, the study suggests this could partly explain the gender gap in depression and anxiety when it comes to chronic disease.

By shedding light on mental health, Professor Szoeke says we can further support patients. “People tell us that the impact of living with chronic disease is not at all well considered.  Furthermore, patients report a focus on disease metrics over their quality of life outcomes, which often means the most to them. It’s really important that we link mental and physical health.”

This study joins a growing body of Australian research that is using data from the Sax Institute’s 45 and Up Study to understand mental health patterns and decode the secrets of healthy living in Australia.


Find out more about 45 and Up and how it’s powering mental health research.


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