Depressive symptoms prior to and after incident cardiovascular disease and long-term survival. A population-based study of older persons
Depressive symptoms prior to and after incident cardiovascular disease and long-term survival. A population-based study of older persons
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DOI：
10.1002/da.22689
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发表时间：
2018-01-01
影响因子：
7.4
通讯作者：
Tiemeier, Henning
中科院分区：
文献类型：
--
作者：
Freak-Poli, Rosanne;Ikram, M. Arfan;Tiemeier, Henning
背景：心血管疾病事件后抑郁与死亡率增加相关。然而，鲜为人知的是如何预先存在的抑郁症影响生存后，CVD incidence.Aim：要评估是否抑郁症状前第一次发生CVD（前CVD）影响survival.Methods：从鹿特丹研究，6,932人年龄55岁以上，无痴呆症和CVD完成了中心流行病学研究抑郁症（CES-D）规模从1993年起，每4至5年。CES-D子领域包括积极情感、消极情感、躯体症状和人际情感。人的死亡率和CVD.Results：在15年的随访，22%的参与者遭受他们的第一次事件心血管疾病。在调整吸烟状况和身体功能后，CVD前抑郁症状与死亡率无关（HR/10分：1.05，95%CI：0.99-1.10）。在第一次发生CVD后，抑郁症状增加。较高的CVD后抑郁症状与死亡率增加相关（HR：1.13，95% CI：1.06，1.22）。CVD后抑郁症状与死亡率之间的关系在校正CVD前抑郁症状后不再具有统计学意义。前CVD和后CVD措施的躯体症状和积极的影响与mortality.Conclusions：在15年的随访中，在社区居住的老年人，较高的抑郁症状之间的关系测量前首次发生CVD和死亡率是不独立的健康状况。然而，CVD后测得的抑郁症状与死亡率增加相关，并不独立于CVD前的抑郁症状。考虑到积极情绪与死亡率之间的关系，积极情绪可能是我们观察到抑郁症状与死亡率之间存在关系的原因。
Background: Depression after a cardiovascular disease event (post-CVD) is associated with increased mortality. However, little is known about how pre-existing depression affects survival after CVD incidence.Aim: To evaluate whether depressive symptoms preceding first incident CVD (pre-CVD) affects survival.Methods: Fromthe Rotterdam Study, 6,932 persons aged 55+ and free of dementia and CVD completed the Center for Epidemiological Studies Depression (CES-D) scale every 4 to 5 years from 1993. CES-D subdomains were positive affect, negative affect, somatic symptoms, and interpersonal affect. Persons were followed for mortality and CVD.Results: During 15-year follow-up, 22% of participants suffered their first incident CVD. Pre-CVD depressive symptoms was not associated with mortality after adjustment for smoking status and physical function (HR per 10-point score: 1.05, 95% CI: 0.99-1.10). After first incident CVD, depressive symptoms increased. Higher post-CVD depressive symptoms was associated with increased mortality (HR: 1.13, 95% CI: 1.06, 1.22). The relation between post-CVD depressive symptoms and mortality was no longer statistically significant after adjustment for pre-CVD depressive symptoms. Pre-CVD and post-CVD measures of somatic symptoms and positive affect were associated withmortality.Conclusions: During 15 years follow-up in community-dwelling older adults, the relation between higher depressive symptoms measured before first incident CVD and mortality was not independent of health status. Whereas, higher depressive symptoms measured after CVD was associated with increased mortality, was not independent of pre-CVD depressive symptoms. Given the associations observed between positive affect and mortality, positive affect may be the reason we observed a relation between depressive symptoms and mortality.