Risk of coronary heart disease events over 15 years among older adults with depressive symptoms

Jessica M. Brown, Jesse C. Stewart, Timothy E. Stump, Christopher Callahan

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objectives: To determine whether depression status is associated with an increased risk of coronary heart disease (CHD) events, defined as CHD death or nonfatal acute myocardial infarction (MI). Design: Prospective cohort study. Setting: An urban primary care practice. Participants: Two thousand seven hundred twenty-eight adults (71.4% women, 65.5% black), age 60 years and older, who were screened for depression between 1991 and 1993. Measurements: Depressive symptom severity at baseline was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Data regarding baseline demographic and clinical variables, as well as laboratory evidence of acute MI, were obtained from an electronic medical record system. All-cause mortality and CHD death were determined from the National Death Index through 2006. Results: A total of 423 (15.5%) participants reported elevated symptoms of depression (CES-D score 16). During the 13 to 16 years of follow-up, 1,646 (60.3%) individuals died from any cause, and 727 (26.6%) died from CHD or suffered an acute MI. Cox proportional hazards models revealed that individuals with elevated depressive symptoms were more likely to experience a CHD event, even after adjustment for demographics and comorbid health conditions (relative risk = 1.46, 95% confidence interval: 1.20-1.77). Depression status was also a significant predictor of all-cause mortality in adjusted models. Conclusions: We report the longest prospective study to date to examine depression status as an independent risk factor for CHD among a cohort of older adults including large numbers of women and underrepresented minorities. The present findings underscore the need to consider depression as a common and modifiable risk factor for CHD events among older adults.

Original languageEnglish
Pages (from-to)721-729
Number of pages9
JournalAmerican Journal of Geriatric Psychiatry
Volume19
Issue number8
DOIs
StatePublished - Aug 2011

Fingerprint

Coronary Disease
Depression
Myocardial Infarction
Epidemiologic Studies
Demography
Prospective Studies
Mortality
Electronic Health Records
Proportional Hazards Models
Primary Health Care
Cohort Studies
Confidence Intervals
Health

Keywords

  • Cardiovascular disease
  • coronary heart disease
  • depression
  • elderly
  • myocardial infarction mortality
  • primary care
  • prospective study

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology

Cite this

Risk of coronary heart disease events over 15 years among older adults with depressive symptoms. / Brown, Jessica M.; Stewart, Jesse C.; Stump, Timothy E.; Callahan, Christopher.

In: American Journal of Geriatric Psychiatry, Vol. 19, No. 8, 08.2011, p. 721-729.

Research output: Contribution to journalArticle

@article{8425873b8688441dabe915cf49710e09,
title = "Risk of coronary heart disease events over 15 years among older adults with depressive symptoms",
abstract = "Objectives: To determine whether depression status is associated with an increased risk of coronary heart disease (CHD) events, defined as CHD death or nonfatal acute myocardial infarction (MI). Design: Prospective cohort study. Setting: An urban primary care practice. Participants: Two thousand seven hundred twenty-eight adults (71.4{\%} women, 65.5{\%} black), age 60 years and older, who were screened for depression between 1991 and 1993. Measurements: Depressive symptom severity at baseline was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Data regarding baseline demographic and clinical variables, as well as laboratory evidence of acute MI, were obtained from an electronic medical record system. All-cause mortality and CHD death were determined from the National Death Index through 2006. Results: A total of 423 (15.5{\%}) participants reported elevated symptoms of depression (CES-D score 16). During the 13 to 16 years of follow-up, 1,646 (60.3{\%}) individuals died from any cause, and 727 (26.6{\%}) died from CHD or suffered an acute MI. Cox proportional hazards models revealed that individuals with elevated depressive symptoms were more likely to experience a CHD event, even after adjustment for demographics and comorbid health conditions (relative risk = 1.46, 95{\%} confidence interval: 1.20-1.77). Depression status was also a significant predictor of all-cause mortality in adjusted models. Conclusions: We report the longest prospective study to date to examine depression status as an independent risk factor for CHD among a cohort of older adults including large numbers of women and underrepresented minorities. The present findings underscore the need to consider depression as a common and modifiable risk factor for CHD events among older adults.",
keywords = "Cardiovascular disease, coronary heart disease, depression, elderly, myocardial infarction mortality, primary care, prospective study",
author = "Brown, {Jessica M.} and Stewart, {Jesse C.} and Stump, {Timothy E.} and Christopher Callahan",
year = "2011",
month = "8",
doi = "10.1097/JGP.0b013e3181faee19",
language = "English",
volume = "19",
pages = "721--729",
journal = "American Journal of Geriatric Psychiatry",
issn = "1064-7481",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Risk of coronary heart disease events over 15 years among older adults with depressive symptoms

AU - Brown, Jessica M.

AU - Stewart, Jesse C.

AU - Stump, Timothy E.

AU - Callahan, Christopher

PY - 2011/8

Y1 - 2011/8

N2 - Objectives: To determine whether depression status is associated with an increased risk of coronary heart disease (CHD) events, defined as CHD death or nonfatal acute myocardial infarction (MI). Design: Prospective cohort study. Setting: An urban primary care practice. Participants: Two thousand seven hundred twenty-eight adults (71.4% women, 65.5% black), age 60 years and older, who were screened for depression between 1991 and 1993. Measurements: Depressive symptom severity at baseline was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Data regarding baseline demographic and clinical variables, as well as laboratory evidence of acute MI, were obtained from an electronic medical record system. All-cause mortality and CHD death were determined from the National Death Index through 2006. Results: A total of 423 (15.5%) participants reported elevated symptoms of depression (CES-D score 16). During the 13 to 16 years of follow-up, 1,646 (60.3%) individuals died from any cause, and 727 (26.6%) died from CHD or suffered an acute MI. Cox proportional hazards models revealed that individuals with elevated depressive symptoms were more likely to experience a CHD event, even after adjustment for demographics and comorbid health conditions (relative risk = 1.46, 95% confidence interval: 1.20-1.77). Depression status was also a significant predictor of all-cause mortality in adjusted models. Conclusions: We report the longest prospective study to date to examine depression status as an independent risk factor for CHD among a cohort of older adults including large numbers of women and underrepresented minorities. The present findings underscore the need to consider depression as a common and modifiable risk factor for CHD events among older adults.

AB - Objectives: To determine whether depression status is associated with an increased risk of coronary heart disease (CHD) events, defined as CHD death or nonfatal acute myocardial infarction (MI). Design: Prospective cohort study. Setting: An urban primary care practice. Participants: Two thousand seven hundred twenty-eight adults (71.4% women, 65.5% black), age 60 years and older, who were screened for depression between 1991 and 1993. Measurements: Depressive symptom severity at baseline was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Data regarding baseline demographic and clinical variables, as well as laboratory evidence of acute MI, were obtained from an electronic medical record system. All-cause mortality and CHD death were determined from the National Death Index through 2006. Results: A total of 423 (15.5%) participants reported elevated symptoms of depression (CES-D score 16). During the 13 to 16 years of follow-up, 1,646 (60.3%) individuals died from any cause, and 727 (26.6%) died from CHD or suffered an acute MI. Cox proportional hazards models revealed that individuals with elevated depressive symptoms were more likely to experience a CHD event, even after adjustment for demographics and comorbid health conditions (relative risk = 1.46, 95% confidence interval: 1.20-1.77). Depression status was also a significant predictor of all-cause mortality in adjusted models. Conclusions: We report the longest prospective study to date to examine depression status as an independent risk factor for CHD among a cohort of older adults including large numbers of women and underrepresented minorities. The present findings underscore the need to consider depression as a common and modifiable risk factor for CHD events among older adults.

KW - Cardiovascular disease

KW - coronary heart disease

KW - depression

KW - elderly

KW - myocardial infarction mortality

KW - primary care

KW - prospective study

UR - http://www.scopus.com/inward/record.url?scp=80051548821&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051548821&partnerID=8YFLogxK

U2 - 10.1097/JGP.0b013e3181faee19

DO - 10.1097/JGP.0b013e3181faee19

M3 - Article

C2 - 21788922

AN - SCOPUS:80051548821

VL - 19

SP - 721

EP - 729

JO - American Journal of Geriatric Psychiatry

JF - American Journal of Geriatric Psychiatry

SN - 1064-7481

IS - 8

ER -