Association of cardiovascular risk factors and disease with depression in later life.

Abstract

OBJECTIVE:

The objective of this study is to determine the association between established cardiovascular risk factors and depression among older men.

METHODS:

The authors conducted a cross-sectional study of a community-representative sample of 5,439 men aged 71-89 years. Cardiovascular disease and risk factors assessed included history of diabetes, hypertension, angina, myocardial infarction, and stroke; current smoking; total cholesterol and fractions; triglycerides; total plasma homocysteine; and MTHFR677 genotype. Depression was defined by a Geriatric Depression Scale 15 items score of 7 or greater.

RESULTS:

A complete data set was available for 4,204 men, of whom 212 were depressed (5%). Men who were depressed reported higher frequency of diabetes (23.1% versus 13.2%), angina (30.2% versus 20.4%), myocardial infarction (26.2% versus 16.0%), and stroke (23.6% versus 9.1%) than nondepressed men. Participants with depression were also more likely to have plasma homocysteine above 15 mumol/L (39.1% versus 25.5%) and high triglycerides (32.1% versus 20.9%) than nondepressed subjects. Depressed older men were also more likely to be active smokers (9.9% versus 4.8%). The other factors measured in the study were not significantly associated with depression. Estimation of the population-attributable fraction (PAF) after logistic regression showed that high plasma homocysteine had the highest PAF for depression (PAF:15%, 95% confidence interval [95% CI]: 5%-23%) followed by high triglycerides (PAF: 11%, 95% CI: 2%-18%), angina (PAF: 9%, 95% CI: 2%-15%), stroke (PAF: 8%, 95% CI: 3%-13%), diabetes (PAF: 7%, 95% CI: 1%-13%), myocardial infarction (PAF: 5%, 95% CI: 0%-11%), and smoking (PAF: 5%, 95% CI: 1%-9%).

CONCLUSIONS:

High plasma homocysteine and triglycerides appear to account for a considerable proportion of cases of depression in older men. The successful management of these risk factors may contribute to decrease the prevalence of depression in later life.

• Authors: Osvaldo P Almeida, Leon Flicker, Paul Norman, Graeme J Hankey, Samuel Vasikaran, Frank M van Bockxmeer, Konrad Jamrozik
• Journal: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry (Am J Geriatr Psychiatry) Vol. 15 Issue 6 Pg. 506-13 (Jun 2007) ISSN: 1064-7481 [Print] England
• PMID: 17158633 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Triglycerides
• Homocysteine

Topics

• Age of Onset
• Aged
• Aged, 80 and over
• Angina Pectoris (blood, epidemiology)
• Cardiovascular Diseases (epidemiology)
• Cross-Sectional Studies
• Depressive Disorder, Major (blood, diagnosis, epidemiology)
• Diabetes Mellitus, Type 2 (epidemiology)
• Homocysteine (blood)
• Humans
• Male
• Myocardial Infarction (blood, epidemiology)
• Risk Factors
• Stroke (blood, epidemiology)
• Surveys and Questionnaires
• Triglycerides (blood)