The mediating role of cardiovascular risk factors in the relationship between symptoms of apathy and incident cardiovascular disease in community-dwelling older individuals
The mediating role of cardiovascular risk factors in the relationship between symptoms of apathy and incident cardiovascular disease in community-dwelling older individuals
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DOI：
10.1017/s1041610215001751
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发表时间：
2016-04-01
影响因子：
7
通讯作者：
Richard, Edo
中科院分区：
文献类型：
--
作者：
Eurelings, Lisa S. M.;Jaccard, James;Richard, Edo
背景：在老年，冷漠和抑郁都与心血管疾病（CVD）风险增加有关。本研究评估了心血管危险因素在冷漠和情绪症状与事件CVD.Methods的关系中的中介作用：前瞻性队列研究的1,790名社区居住的老年人（70-78岁）没有心血管疾病或中风的历史。在基线时，冷漠和情绪症状用15项老年抑郁量表（GDS-15）评估，其中3项代表冷漠症状。中度危险因素包括糖尿病（DM）、体重指数（BMI）、当前吸烟、缺乏体力活动、收缩压和总胆固醇。随访2年后，对CVD事件进行评估。结果：59名（3.3%）参与者发生了心血管事件。冷漠症状对心血管事件有显著的估计总效应，冷漠评分每增加一个单位，增加2.2%。在这一总效应中，22.7%是由于缺乏体力活动（13.6%）、当前吸烟（4.5%）和糖尿病（4.5%）的中介效应。其余77.3%是由于反映其他中介动态的直接影响。没有显着的（中）直接影响的情绪症状事件CVD.Conclusions：缺乏体力活动，吸烟，糖尿病占近四分之一的变化，反映冷漠症状和事件CVD之间的联系。这说明了相关的不利的健康行为和评估糖尿病的老年人与冷漠。冷漠症状对CVD事件的影响大多是由其他未知因素引起的。
Background: In old age, both apathy and depression have been associated with an increased cardiovascular disease (CVD) risk. This study evaluated the mediating role of cardiovascular risk factors in the relationship of apathy and mood symptoms with incident CVD.Methods: Prospective cohort study of 1,790 community-dwelling older individuals (70-78 years) without a history of CVD or stroke. At baseline, apathy and mood symptoms were assessed with the 15-item Geriatric Depression Scale (GDS-15), of which three items represent apathy symptoms. The mediational risk factors included were diabetes mellitus (DM), body mass index (BMI), current smoking, physical inactivity, systolic blood pressure, and total cholesterol. Incident CVD was evaluated after two years of follow-up. Data were analyzed using structural equation modeling (SEM).Results: Incident CVD occurred in 59 (3.3%) participants. Apathy symptoms had a significant estimated total effect on incident CVD, with increases of 2.2% for each unit increase in apathy score. Of this total effect, 22.7% was due to the mediational effects of physical inactivity (13.6%), current smoking (4.5%), and DM (4.5%). The remaining 77.3% was due to direct effects reflecting other mediational dynamics. No significant (in)direct effects of mood symptoms on incident CVD were found.Conclusions: Physical inactivity, smoking, and DM account for nearly one-fourth of the variation reflecting the link between apathy symptoms and incident CVD. This illustrates the relevance of unfavorable health behaviors and assessment of DM in older individuals with apathy. The majority of the effect of apathy symptoms on incident CVD is caused by other, yet unknown, factors.