Dual-Disease Co-management in an Aging Society: The Social Roots and Governance Pathways of the Comorbidity of Cardiovascular Disease and Depression

Abstract

In the context of population aging, the comorbidity of cardiovascular disease and depression among older adults has emerged as a prominent public health challenge. These two conditions interact through multiple biological mechanisms, including immune-inflammatory responses, neurotransmitter imbalance, and dysregulation of the hypothalamic–pituitary–adrenal axis. Such interactions create a vicious cycle that leads to poor prognosis and increased mortality among patients. However, the traditional specialty-segmented medical system has intensified the fragmentation of healthcare services, making it difficult to effectively manage comorbid conditions. This study finds that social determinants—such as disparities in socioeconomic status, insufficient social security, weak social support, and the digital divide—constitute the fundamental drivers of the comorbidity of cardiovascular disease and depression among older adults and further exacerbate health inequalities. In response to these challenges, this paper proposes an integrated governance pathway centered on the concept of “dual-disease co-management.” Specific measures include establishing a targeted medical subsidy mechanism to reduce economic barriers, improving social pension programs to strengthen social security, implementing community-based intervention strategies to alleviate loneliness among older adults, promoting age-friendly electronic health technologies to bridge the digital divide, and integrating collaborative care models for chronic disease management within primary healthcare. From a social-ecological perspective, this framework integrates medical interventions with social governance, thereby providing a new theoretical basis and practical paradigm for addressing the complex health challenges associated with population aging.