Association between anaemia and adult depression: a systematic review and meta-analysis of observational studies

Summary & key facts

This meta-analysis combined 14 observational studies and found that anaemia was associated with higher odds of adult depression (pooled estimate 1.43; 95% CI 1.23 to 1.65). The analysis included 10,764 cases of depression from studies with average ages between 38.4 and 75.0 years. The authors reported moderate differences across studies, some evidence of publication bias, and a limited number of prospective cohort studies, which reduce certainty about the result.

Key facts:

• The review searched four databases up to November 2019 and initially retrieved 9,706 papers, of which 14 studies were included in the meta-analysis.
• The 14 included studies comprised 9 case-control studies and 5 prospective cohort studies and together contained 10,764 cases of depression.
• The pooled association between anaemia (low haemoglobin) and adult depression was an odds ratio or relative risk of 1.43 with a 95% confidence interval of 1.23 to 1.65.
• Mean ages of study participants ranged from 38.4 years to 75.0 years across the included studies.
• Subgroup analyses by study design, participant age, how anaemia was defined, region, number of participants, study quality, and adjustment for factors like education, smoking, other illnesses, physical activity, alcohol, and medications sho
• The authors used a random-effects statistical model and assessed study quality with the Newcastle-Ottawa Scale.
• Key limitations noted were a moderate degree of heterogeneity (mainly because studies used different tools to identify depression), some evidence of publication bias, and a relatively small number of prospective cohort studies.

Abstract

The current study showed that anaemia was related to an increased risk of adult depression. One of the important limitations of our study was a moderate degree of heterogeneity due to the variety of assessment tools used to identify depression and the existence of publication bias. Another limitation of this meta-analysis was the lack of prospective cohort studies.

Topics

Hemoglobinopathies and Related Disorders Iron Metabolism and Disorders Pharmacological Effects and Toxicity Studies

Categories

Health Sciences Hematology Medicine

Tags

Cochrane Library Cohort study Confounding Depression (economics) Economics Epidemiology Internal medicine Law Macroeconomics Medicine MEDLINE Meta-analysis Observational study Political science Psychiatry PsycINFO Strengthening the reporting of observational studies in epidemiology Systematic review