Depression is common and precludes accurate assessment of functional status in elderly patients with congestive heart failure

Krichten, Catherine M.; Zietowski, Gretchen; Alves, Lynette; Freudenberger, Ronald S; Robinson, Shawn; Fisher, Michael L.; Gottlieb, Stephen S.

doi:10.1054/jcaf.2000.19222

Cited by 135 publications

(116 citation statements)

References 23 publications

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“…The authors concluded that the rating by experienced clinicians was able to distinguish disability contributing to depression from disability resulting from medical illness and/or cognitive impairment (28) . Another study reported that depressed elderly out-patients with chronic heart failure showed a tendency to underestimate their physical ability, whereas they had similar energy expenditure and walking ability as their non-depressive counterparts (27) . As expected, the SF-36 components 'role emotional', 'vitality' and 'mental health' were reduced in depressed residents and, as has been reported in other studies, quality of life was reduced in individuals with impaired nutritional status (5) .…”

Section: Discussionmentioning

confidence: 99%

Malnutrition and depression in the institutionalised elderly

et al. 2009

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Malnutrition and depression are highly prevalent in the institutionalised elderly and can lead to unfavourable outcomes. The aim of the present study was to assess associations between nutritional status and depressive symptoms and to explore their impact on self-caring capacity and quality of life (QoL) in elderly nursing-home residents (NHR). We conducted a cross-sectional study with 114 NHR (eighty-six female) with a mean age of 84·6 (SD 9·1) years. Nutritional status was assessed with the Mini Nutritional Assessment (MNA). Depressive symptoms were rated with the Geriatric Depression Scale (GDS). Self-caring capacity was measured with the Barthel index (BI) and QoL was assessed with the short-form thirtysix-item (SF-36) questionnaire. Of the NHR, twenty-six (22·8 %) were malnourished according to the MNA and sixty-six (57·9 %) were at nutritional risk. Of the residents, seventy-five could be assessed with the GDS, whereof sixteen (21·3 %) had major and twenty-six (34·7 %) had minor depressive symptoms. GDS scores tended to be higher in patients with impaired nutritional status (5·4 (SD 3·6) in well-nourished subjects and 6·9 (SD 3·2) in residents with malnutrition or at risk of malnutrition). The MNA correlated significantly with the GDS (r 20·313; P¼ 0·006) and the GDS emerged as the only independent risk factor for malnutrition in a multiple regression analysis, whereas age, sex, care level, number of prescriptions and self-caring capacity had no influence. The BI was not reduced in patients with a high GDS. QoL was affected in malnourished residents as well as in study participants with depressive symptoms. The results of the present study point towards an association between malnutrition and depressive symptoms. However, the relationship is complex and it remains unclear whether depression in NHR is the cause or consequence of impaired nutritional status. Further studies are needed to identify the direction of this relationship and to assess the effect of depression treatment on nutritional and functional status as well as on QoL.Nursing-home residents: Malnutrition: Depression: Quality of life Malnutrition is a frequent problem in aged individuals. Whereas the prevalence in free-living elderly ranges between 5 and 10 % (1) , it can reach up to 60 % in institutionalised individuals (2,3) . The aetiology of malnutrition is multifactorial and the consequences are severe: a decrease in functional status (4) and consequently high dependency, an impaired quality of life (5) as well as higher morbidity and mortality (6,7) .Depression is a further common health problem in late life with prevalence rates of up to 45 % in the institutionalised elderly (8 -10) . The consequences of untreated depression are manifold and cause an increased use of health care and medical services (9,11) , affect quality of life and well-being negatively (11) and can cause increased mortality (12) . Despite growing evidence that depression is a problem especially in the institutionalised elderly, only little attention is paid to this ...

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Section: Discussionmentioning

confidence: 99%

Malnutrition and depression in the institutionalised elderly

et al. 2009

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“…It is a self-administrated, 21-item questionnaire that has been established for the screening of depressive symptoms in various populations. The severity of depression was categorized as absent (0-13), mild (14)(15)(16)(17)(18)(19), moderate (20)(21)(22)(23)(24)(25)(26)(27)(28) or severe (≥29). These cutoff values have been verified for the likelihood for detecting depressive symptoms of Japanese subjects.…”

Section: Depression and Anxietymentioning

confidence: 99%

“…[13][14][15]26 The prevalence of depression in HF patients is affected by the method of assessment, the definition and classification of depression, and the severity of HF in the study patients. 27 In addition, HF-specific symptoms, such as fatigue, insomnia, and loss of appetite, may overlap with the symptoms of depression.…”

Section: Depression Anxiety and Social Support In Hf Patientsmentioning

confidence: 99%

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Anxiety and Poor Social Support are Independently Associated With Adverse Outcomes in Patients With Mild Heart Failure

Tsuchihashi-Makaya

Kato

Chishaki

et al. 2009

Circ J

102

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Background The impact of psychosocial states, such as depression or anxiety, and social support on the outcomes of stable outpatients with mild heart failure (HF) has not been evaluated in the "real world" clinical practice. Methods and ResultsIn the present study, 139 patients with a prior history of admission for HF provided the baseline demographic, clinical, socio-environmental, and psychosocial information. Cardiac death or re-admission because of worsening of HF was monitored during the follow-up period of 1 year. The prevalence of depression and anxiety were 37% and 37%, respectively, in HF patients. Depression was independently associated with male (sβ=-0.36, P=0.01), social ties (sβ=0.22, P=0.04) and low social support (sβ=-0.39, P<0.01). Anxiety was associated with alcohol drinking (sβ=0.22, P=0.04), brain natriuretic peptide ≥200 pg/dl (sβ=0.35, P<0.01), and low social support (sβ=-0.28, P=0.01). Kaplan-Meier analysis demonstrated that patients with anxiety (log-lank test; P<0.01) and lower scores of social support (P<0.01) had a higher rate of HF-related re-admission. Conclusions Anxiety and low social support were independently associated with HF-related re-admission, which indicates the need for their inclusion in the assessment and management of HF. (Circ J 2009; 73: 280 -287)

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“…Among hospitalized patients with HF, depression rates ranged from 13.9% 22 to 77.5%. 12 Among outpatients with HF, depression rates ranged from 13% 23 to 48%. 24 Given that patients with HF frequently cycle between periods of stabilization and periods of hospitalization, depressive symptoms may also change in the short term, depending on the patient's health and functional status during hospitalization and 4 to 6 weeks post discharge.…”

Section: Depression and Heart Failurementioning

confidence: 99%

Depression, Anxiety and Heart Failure: A Review

Jong¹,

Konstam²,

Moser³

2005

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, Emphasis in the literature is on physical symptom recognition and management, in contrast to the patient's perspective of the effects of heart failure on his/her daily life.Methods: This review summarizes and integrates research findings on anxiety and depression and translates these findings to clinical practice.Results: Depression and anxiety are prevalent among patients with heart failure, and require assessment and intervention. Short-term nonpharmacologic approaches, in conjunction with drug therapy, hold promise in for successful management of patients who are depressed and or anxious. Conclusions:Carefully designed clinical trials that are tailored to individual needs, yet are embedded within a systemic framework, are needed to inform clinicians regarding optimal practices for the treatment of patients with heart failure who suffer from depression and/or anxiety.Key words: heart failure, depression, anxiety, cognitive behavioral therapy 4 Although HF has been described as "a new epidemic" with more than five million Americans identified and 500,000 newly diagnosed with HF annually, it has also been identified as a "last frontier" of behavioral cardiology.Psychosocial issues, particularly depression and anxiety, in patients with HF have been

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Depression is common and precludes accurate assessment of functional status in elderly patients with congestive heart failure

Cited by 135 publications

References 23 publications

Malnutrition and depression in the institutionalised elderly

Malnutrition and depression in the institutionalised elderly

Anxiety and Poor Social Support are Independently Associated With Adverse Outcomes in Patients With Mild Heart Failure

Depression, Anxiety and Heart Failure: A Review

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