Depressive symptoms prior to and after incident cardiovascular disease and long-term survival. A population-based study of older persons

Freak‐Poli, Rosanne; Ikram, M. Arfan; Franco, Oscar H.; Hofman, Albert; Tiemeier, Henning

doi:10.1002/da.22689

Cited by 12 publications

(10 citation statements)

References 47 publications

(69 reference statements)

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“…To our knowledge, only few studies investigated the predictive value of depressive symptoms more than 15 years after stroke [20,21]. In the present study, we found that more severe strokes are associated with higher Beck scores at 4 years after stroke.…”

Section: Discussionsupporting

confidence: 60%

“…The pathogenesis of PSD remains controversy whether PSD is a direct result of neuroanatomical impairment or indirectly due to the patient's abnormal reaction to a serious cerebrovascular incident [19]. However, long term data (15 years or more) on the relationship between depressive symptoms at the acute phase of stroke and the outcome of patients, measured by mortality, are scarce [20,21].…”

Section: Introductionmentioning

confidence: 99%

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Does the severity of depressive symptoms after stroke affect long-term survival? An 18-year follow-up

2018

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ObjectiveWe tested whether the severity of depressive symptoms in acute stroke and 4 years later are predictors of long-time survival.MethodWe evaluated the severity of stroke in 82 patients with acute stroke by the Barthel index, the Scandinavian Stroke Scale and the Orgogozo scale, and we also quantified the severity of depressive symptoms by the Beck and the Hamilton scales in the first week of stroke, in 1995. We re-evaluated the scales 4 years after stroke in 41 out of 48 survivors. We checked the survival status of the initial cohort 18 years after stroke. In the assessment Kaplan-Meier graphs were constructed and the outcomes between groups were compared with log-rank tests.ResultsClinically important depressive symptoms (≥10 on the Beck scale) was present in 16 patients (19,5%) with acute stroke one week after admission. Case fatality was 41% at 4 years and 84% at 18 years after stroke. Those patients who survived at 4 years were significantly younger (p<0,05). Depressive symptoms in acute stage were not independent predictor of the length of survival. More severe strokes were associated with more severe depressive symptoms 4 years after stroke. In the survival subgroup of patients, those who had more severe depression (≥10 on the Beck scale) at 4 years, had shorter post-stroke survival than those with milder or no depression (Mann-Whitney test, p = 0.022; log-rank-test, p = 0.047). In multivariate analyses, adjusted for age, sex, stroke severity and the severity of depressive symptoms, age, sex and stroke severity remained the significant predictors of the length of survival.ConclusionsThe severity of depressive symptoms either in the acute phase or 4 years after stroke is not an independent predictor of the length of survival in an 18-year follow-up.

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Does the severity of depressive symptoms after stroke affect long-term survival? An 18-year follow-up

2018

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“…Although more objective measures exist for some conditions examined (e.g., blood pressure or use of antihypertensive medications), objective measures were not available for all health conditions, and reliance on them could also result in missed cases. As several of the conditions we assessed are often undiagnosedsuch as sleep apnea (Finkel et al, 2009) the true prevalence of these conditions in our sample may well be underestimated. This may mean that the estimates presented in these analyses are conservative: if the true prevalence of these conditions is higher, then the strength or magnitude of their associations with a history of depressive symptoms may be masked or biased toward the null.…”

Section: Discussionmentioning

confidence: 99%

“…Depression-related changes in appetite, weight, and/ or sleep may either lead to or indicate physiological changes that impact cardiometabolic health over time. A large-scale study of dimensions of depression symptoms found that somatic symptoms, measured both before and after cardiovascular disease onset, are associated with mortality (Freak-Poli et al, 2018). Future research could investigate whether particular symptom clusters, or even Psychological Medicine Polygenic risk scores (PRSs) for health conditions: atrial fibrillation, diabetes, erectile dysfunction, coronary artery disease (for myocardial infarction), cholesterol, systolic blood pressure (for hypertension), sleep apnea, and stroke.…”

Section: Discussionmentioning

confidence: 99%

“…However, both somatic and cognitive dimensions of depression symptoms were independently associated with risk for new cardiac events in a recent study of heart disease patients (Norton et al, 2020). Somatic depression symptoms, both before and after the incidence of cardiovascular disease, have been associated with increased mortality (Freak-Poli, Ikram, Franco, Hofman, & Tiemeier, 2018). Somatic and nonsomatic depression symptoms may therefore play differential roles in relation to cardiometabolic health.…”

Section: Introductionmentioning

confidence: 99%

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Associations between depression and cardiometabolic health: A 27-year longitudinal study

et al. 2021

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Background Clarifying the relationship between depression symptoms and cardiometabolic and related health could clarify risk factors and treatment targets. The objective of this study was to assess whether depression symptoms in midlife are associated with the subsequent onset of cardiometabolic health problems. Methods The study sample comprised 787 male twin veterans with polygenic risk score data who participated in the Harvard Twin Study of Substance Abuse (‘baseline’) and the longitudinal Vietnam Era Twin Study of Aging (‘follow-up’). Depression symptoms were assessed at baseline [mean age 41.42 years (s.d. = 2.34)] using the Diagnostic Interview Schedule, Version III, Revised. The onset of eight cardiometabolic conditions (atrial fibrillation, diabetes, erectile dysfunction, hypercholesterolemia, hypertension, myocardial infarction, sleep apnea, and stroke) was assessed via self-reported doctor diagnosis at follow-up [mean age 67.59 years (s.d. = 2.41)]. Results Total depression symptoms were longitudinally associated with incident diabetes (OR 1.29, 95% CI 1.07–1.57), erectile dysfunction (OR 1.32, 95% CI 1.10–1.59), hypercholesterolemia (OR 1.26, 95% CI 1.04–1.53), and sleep apnea (OR 1.40, 95% CI 1.13–1.74) over 27 years after controlling for age, alcohol consumption, smoking, body mass index, C-reactive protein, and polygenic risk for specific health conditions. In sensitivity analyses that excluded somatic depression symptoms, only the association with sleep apnea remained significant (OR 1.32, 95% CI 1.09–1.60). Conclusions A history of depression symptoms by early midlife is associated with an elevated risk for subsequent development of several self-reported health conditions. When isolated, non-somatic depression symptoms are associated with incident self-reported sleep apnea. Depression symptom history may be a predictor or marker of cardiometabolic risk over decades.

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Examination of individual and multiple comorbid conditions and health-related quality of life in older cancer survivors

Siembida

Smith

Potosky³

et al. 2021

Qual Life Res

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Purpose Older cancer survivors (≥ 65 years at diagnosis) are at high-risk for multimorbidity (2 + comorbid conditions). However, few studies have utilized a generalizable sample of older cancer survivors to understand how individual comorbid conditions, as opposed to total comorbidity burden, are associated with health-related quality of life (HRQOL). We examined associations between HRQOL outcomes (pain, fatigue, physical function), individual comorbidities (cardiovascular disease [CVD], lung disease, diabetes, arthritis) and total comorbidity (cancer-only, cancer + 1 condition, cancer + 2 or more conditions). Methods Utilizing a population-based sample of 2019 older cancer survivors, we tested associations between comorbid conditions and the HRQOL outcomes using generalized linear models. HRQOL domains were assessed using Patient-Reported Outcome Measurement Information System ® (PROMIS ® ) measures. Comorbidity was assessed via self-report. Results Cancer survivors with lung disease reported significantly worse physical functioning (β = − 4.96, p < 0.001), survivors with arthritis reported significantly higher pain (β = 4.37, p < 0.001), and survivors with CVD reported significantly higher fatigue (β = 3.45, p < 0.001) compared to survivors without each condition. Having cancer + 1 condition was not as strongly associated with all outcomes as when individual conditions were tested (e.g. pain: β = 3.09, p < 0.001). Having 2+ comorbidities had a stronger association with all outcomes (e.g. physical function: β = − 7.51, p < 0.001) than examining conditions individually. Conclusions Knowing the specific comorbid condition profile of an older cancer survivor provides insight into specific HRQOL outcomes that may be impaired in cancer survivorship, but understanding total comorbidity burden, regardless of the specific conditions, sheds light on survivors at-risk for multiple impairments in HRQOL. This information, taken together, can inform risk-stratified survivorship care.

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Depressive symptoms prior to and after incident cardiovascular disease and long-term survival. A population-based study of older persons

Cited by 12 publications

References 47 publications

Does the severity of depressive symptoms after stroke affect long-term survival? An 18-year follow-up

Does the severity of depressive symptoms after stroke affect long-term survival? An 18-year follow-up

Associations between depression and cardiometabolic health: A 27-year longitudinal study

Examination of individual and multiple comorbid conditions and health-related quality of life in older cancer survivors

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