OBJECTIVES: To determine whether depression status is associated with an increased risk of coronary heart disease (CHD) events, defined as CHD death or nonfatal acute myocardial infarction (MI). DESIGN: Prospective cohort study. SETTING: An urban primary care practice. PARTICIPANTS: Two thousand seven hundred twenty-eight adults (71.4% women, 65.5% black), age 60 years and older, who were screened for depression between 1991 and 1993. MEASUREMENTS: Depressive symptom severity at baseline was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Data regarding baseline demographic and clinical variables, as well as laboratory evidence of acute MI, were obtained from an electronic medical record system. All-cause mortality and CHD death were determined from the National Death Index through 2006. RESULTS: A total of 423 (15.5%) participants reported elevated symptoms of depression (CES-D score ≥16). During the 13 to 16 years of follow-up, 1,646 (60.3%) individuals died from any cause, and 727 (26.6%) died from CHD or suffered an acute MI. Cox proportional hazards models revealed that individuals with elevated depressive symptoms were more likely to experience a CHD event, even after adjustment for demographics and comorbid health conditions (relative risk = 1.46, 95% confidence interval: 1.20-1.77). Depression status was also a significant predictor of all-cause mortality in adjusted models. CONCLUSIONS: We report the longest prospective study to date to examine depression status as an independent risk factor for CHD among a cohort of older adults including large numbers of women and underrepresented minorities. The present findings underscore the need to consider depression as a common and modifiable risk factor for CHD events among older adults.
OBJECTIVES: To determine whether depression status is associated with an increased risk of coronary heart disease (CHD) events, defined as CHD death or nonfatal acute myocardial infarction (MI). DESIGN: Prospective cohort study. SETTING: An urban primary care practice. PARTICIPANTS: Two thousand seven hundred twenty-eight adults (71.4% women, 65.5% black), age 60 years and older, who were screened for depression between 1991 and 1993. MEASUREMENTS: Depressive symptom severity at baseline was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Data regarding baseline demographic and clinical variables, as well as laboratory evidence of acute MI, were obtained from an electronic medical record system. All-cause mortality and CHD death were determined from the National Death Index through 2006. RESULTS: A total of 423 (15.5%) participants reported elevated symptoms of depression (CES-D score ≥16). During the 13 to 16 years of follow-up, 1,646 (60.3%) individuals died from any cause, and 727 (26.6%) died from CHD or suffered an acute MI. Cox proportional hazards models revealed that individuals with elevated depressive symptoms were more likely to experience a CHD event, even after adjustment for demographics and comorbid health conditions (relative risk = 1.46, 95% confidence interval: 1.20-1.77). Depression status was also a significant predictor of all-cause mortality in adjusted models. CONCLUSIONS: We report the longest prospective study to date to examine depression status as an independent risk factor for CHD among a cohort of older adults including large numbers of women and underrepresented minorities. The present findings underscore the need to consider depression as a common and modifiable risk factor for CHD events among older adults.
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Authors: Daniëlle A I Groffen; Annemarie Koster; Hans Bosma; Marjan van den Akker; Gertrudis I J M Kempen; Jacques Th M van Eijk; Coen H van Gool; Brenda W J H Penninx; Tamara B Harris; Susan M Rubin; Marco Pahor; Richard Schulz; Eleanor M Simonsick; Sara E Perry; Hilsa N Ayonayon; Stephen B Kritchevsky Journal: Am J Geriatr Psychiatry Date: 2013-02-06 Impact factor: 4.105
Authors: Shannon L Gillespie; Cindy M Anderson; Songzhu Zhao; Yubo Tan; David Kline; Guy Brock; James Odei; Emily O'Brien; Mario Sims; Sophie A Lazarus; Darryl B Hood; Karen Patricia Williams; Joshua J Joseph Journal: Psychoneuroendocrinology Date: 2019-07-04 Impact factor: 4.905