Category Archive for: ‘Depression / optimism’
Depressive symptoms related to CVD mortality
Elderly men from the FINE study cohorts of Finland, the Netherlands and Italy who manifested a number of depressive symptoms had a 2-fold greater 10-year CVD mortality. The relative risk did not change after excluding cases that died from CVD in the first 5 years of follow-up. The strongest associations were observed with the mortality from stroke and heart failure and the relation with CHD mortality was of borderline statistical significance. Depressive symptoms were not related to risk of other degenerative heart diseases and no differences in risk from depression were observed between northern and southern Europe.
The results of this study provide strong support for the hypothesis that depressive symptoms are a real and causal risk factor for CVD. Its prospective design, established that the depressive symptoms preceded the fatal CVD event. Furthermore, the large sample size and the long follow-up made it possible to exclude subjects who died from CVD in the first five years after baseline, making reversed causality unlikely, that is, that the event caused the depressive symptoms. Adjustment for many confounding variables made it likely that the depressive symptoms had an independent effect.
Disability and depressive symptoms related to all-cause mortality
Self-rated health, disability and depressive symptoms were independent from each other, and were associated with all-cause mortality in elderly men from Finland, The Netherlands and Italy (the FINE study). After adjustment for the prevalence of chronic diseases severity of disability and depressive symptoms remained related to all-cause mortality.
Combinations of measures also associated with all-cause mortality
For the combination of disability and self-rated health a 3-fold greater mortality risk was observed for men who had severe disability and a poor self-rated health compared to the reference group. Men with severe disability in the two highest categories of depressive symptoms had also a 3-fold higher mortality risk.
These results suggest that for adequate prognosis of mortality and for developing intervention strategies information is needed on other and different health outcomes.
Depression and physical inactivity, two sides of the same coin?
The relationship between depressive symptoms and CVD risk may be the consequence of a more sedentary lifestyle of depressed persons. Thus, physical inactivity may be the intermediate factor in the relation between depressive symptoms and CVD. The independent and combined effects of depressive symptoms and physical activity on CVD mortality were investigated prospectively in elderly men from the FINE study cohorts of Finland, the Netherlands and Italy.
Physical inactivity and depression both related to cardiovascular risk.
A 30 min/d lower level of physical activity at entry was associated with a 9% excess CVD mortality after 10 years. A one-standard deviation greater score for depressive symptoms was related to a 37% higher CVD mortality, after adjustment for physical activity. The excess risk of CVD mortality attributable to the combined effect of depressive symptoms with inactivity was 47%. The greater risk of CVD due to depressive symptoms cannot be explained by physical inactivity. However, depressive symptoms and physical inactivity may interact to increase CVD risk.
Poor lung function associated with depression
Data from the Finnish and Italian cohorts showed that poor lung function in men aged 50-69 was associated with subsequent depressive symptoms 15-30 years later. This association was stronger in men with chronic diseases than in those without.
Decline in serum cholesterol predictor of depression
Among elderly men from Finland, The Netherlands and Italy, a 5-year decline in total serum cholesterol level was a predictor of depressive symptoms 5 years later. Men with two or more cardiovascular risk factors at entry (obesity, smoking, hypertension, hypercholesterolaemia, or diabetes) had no higher future risk of depression in the Zutphen Elderly Study.
- Giltay et al Am J Geriatr Psychiatry 2008;16:874-82
- Bots et al. Int J Geriatr Psychiatry 2008;23:478-84
- Giltay et al. Psychosomatic Med 2010;72:53-60