Persistent Depressive Symptoms and Functional Decline Among Patients With Peripheral Arterial Disease

Ruo, Bernice; Liu, Kiang; Tian, Lü; Tan, Jerry; Ferrucci, Luigi; Guralnik, Jack M.; McDermott, Mary McGrae

doi:10.1097/psy.0b013e318063ef5c

Cited by 44 publications

(47 citation statements)

References 44 publications

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“…In addition to increasing the risk of PAD, depression also appears to impact the functional status and symptoms of patients with PAD, leading to more dramatic annual declines in functional performance 13 , reduced walking distance 14 , and reduced quality of life benefit following revascularization 15 . The findings from this study add to a growing body of literature on behavioral and psychosocial risk factors in the development of cardiovascular disorders.…”

Section: Discussionmentioning

confidence: 99%

“…12 Others have shown that among patients with PAD, those with depression have worse functional outcomes, greater need for revascularization, poorer quality of life outcomes following revascularization, and higher risk for adverse events after revascularization. 13-16 Prior research has also indicated that women with PAD below the age of 65 years are particularly vulnerable to experiencing depressive symptoms and that these symptoms seem to be accompanied with high rates of smoking. 17 …”

Section: Introductionmentioning

confidence: 99%

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Peripheral arterial disease, gender, and depression in the Heart and Soul Study

Grenon

Cohen

Smolderen

et al. 2014

Journal of Vascular Surgery

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Background Despite the high prevalence of peripheral artery disease (PAD) in women, risk factors for PAD in women are not well understood. Methods Gender-specific risk factors for PAD were examined in a prospective cohort study of 1024 patients (184 women and 840 men) with stable coronary artery disease who were recruited between 2000 to 2002. Logistic regression models were used to evaluate associations between traditional and non-traditional risk factors and PAD in both men and women. Results 11% of women and 13% of men were found to have PAD. Women with PAD had a similar prevalence of traditional risk factors (hypertension, hyperlipidemia, and smoking) compared to women without PAD. Women with PAD were significantly more likely to suffer from depression than women without PAD. Men with PAD were more likely to have hypertension, diabetes mellitus, a history of smoking, a worse lipid profile and higher levels of inflammatory biomarkers compared to men without PAD. In a multivariate model, depression was the only significant factor associated with PAD in women while smoking and elevated fibrinogen were independently associated with PAD in men. Conclusions The current findings suggest gender differences in risk factors for the development of PAD. Further research is needed to understand the role of depression in PAD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Peripheral arterial disease, gender, and depression in the Heart and Soul Study

Grenon

Cohen

Smolderen

et al. 2014

Journal of Vascular Surgery

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“…A recent study suggests that body mass index (BMI) influences functional performance in older adults such that obese older adults perform worse on the Short Performance Physical Battery (SPPB) as compared to their non-obese counterparts (7). Individuals with depressive symptoms show greater decline in 6-minute walk distance, fast walking velocity and the SPPB summary score in comparison to those with no depressive symptoms (8). Nonagenarians perform poorly on the Reduced Continuous Scale-Physical Function Performance Test compared to more active older adults between the ages of 60–74 years, an effect that is correlated with lower levels of PA (9).…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Physical Functioning and Physical Activity in the Lifestyle Interventions and Independence for Elders Pilot

Chalé-Rush

Guralnik

Walkup

et al. 2010

J American Geriatrics Society

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OBJECTIVES-To determine if participation in usual moderate-intensity or more vigorous physical activity (MVPA) is associated with physical function performance and to identify sociodemographic, psychosocial and disease-related covariates that may also compromise physical function performance. DESIGN-Cross-sectional analysis of baseline variables of randomized controlled intervention trial. ACR -analysis and interpretation of data, and preparation of manuscript. JMG -concept and design, acquisition of subjects and/or data, analysis and interpretation of data, and review and editing of manuscript. MPW, MEM -concept and design, analysis and interpretation of data, and review and editing of manuscript. WJR -acquisition of subjects and/or data, analysis and interpretation of data, and review and editing of manuscript. JAK -acquisition of subjects and/or data, analysis and interpretation of data, and review and editing of manuscript. ACK -concept and design, acquisition of subjects and/or data, analysis and interpretation of data, and review and editing of manuscript. NWG -acquisition of subjects and/or data, analysis and interpretation of data, and review and editing of manuscript. SNB -concept and design, acquisition of subjects and/or data, analysis and interpretation of data, and review and editing of manuscript. RAF -concept and design, analysis and interpretation of data, and review and editing of manuscript. RESULTS-The SPPB summary score was associated with minutes of MVPA (ρ = 0.16, P = 0.001). In multiple regression analyses, age, minutes of MVPA, number of medications and depressive symptoms were associated with performance on the composite SPPB (P < 0.05). There was an association between 400 m walk time and minutes of MVPA (ρ = −0.18; P = 0.0002). In multiple regression analyses, age, gender, minutes of MVPA, BMI and number of medications were associated with performance on the 400 m walk test (P < 0.05). SETTING-Four NIH Public AccessCONCLUSION-Minutes of MVPA, gender, BMI, depressive symptoms, age, and number of medications are associated with physical function performance and all should be taken into consideration in the prevention of mobility-disability.

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“…Depression has been reported to occur in approximately one out of five patients with PAD, while the average prevalence of depression in later life has been estimated to be 13% in community-dwelling people. [2][3][4][5] PAD patients with depression have been described to have greater impairment of lower extremity functioning, 4 more functional decline, 6 and to be at greater risk for poor long-term outcomes. 7 Interventions in PAD are primarily aimed at relieving symptoms and disease burden.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous transluminal angioplasty: Association between depressive symptoms and diminished health status benefits

et al. 2011

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Depressive symptoms are known to compromise health status in cardiac disease, but this relationship has not been described in peripheral artery disease (PAD). Depressive symptoms (PHQ-9) and disease-specific health status (Peripheral Artery Questionnaire, PAQ) were assessed in 242 PAD patients undergoing percutaneous transluminal angioplasty (PTA) at baseline and 1 year. Patients were classified by baseline and follow-up depression status (moderate-severe depressive symptoms = PHQ ≥ 10). Changes were categorized as no depression/improvement of depression versus persistent/worsened depression. At baseline, 20% of patients were depressed; at 1 year, 17% of patients experienced persistent/worsened depression. Although this group improved on most PAQ subscales, they improved to a significantly lesser degree than those without depressive symptoms or those who improved by 1 year (p-values < 0.05). Baseline depressive symptoms (B per 5-point increment = -11.9, 95% CI -15.3, -8.5, p < 0.0001) and changes in depression were independently associated with a decrease in 1-year health status (B per 5-point increment = -11.7, 95% CI -14.3, -9.2, p < 0.0001).In conclusion, depressive symptoms are associated with less improvement in health status 1 year after undergoing a peripheral endovascular revascularization (PER) as compared with those having no depression or whose depressive symptoms improve. Efforts to improve depression detection and treatment among patients with PAD may improve the health status outcomes of these patients.

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Persistent Depressive Symptoms and Functional Decline Among Patients With Peripheral Arterial Disease

Cited by 44 publications

References 44 publications

Peripheral arterial disease, gender, and depression in the Heart and Soul Study

Peripheral arterial disease, gender, and depression in the Heart and Soul Study

Relationship Between Physical Functioning and Physical Activity in the Lifestyle Interventions and Independence for Elders Pilot

Percutaneous transluminal angioplasty: Association between depressive symptoms and diminished health status benefits

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