[Anxiety-depressive States in elderly patients with chronic heart failure]

Aim of the study was determination of factors of social desadaptation, which negatively affect psychoemotional status and quality of life of elderly patients with chronic heart failure (CHF). We included into the study 248 patients aged 60-85 years and 82 patients aged 39-59 years with NYHA class II-IV CHF. General state of patients we assessed with the help of clinical state assessment scale (CSAS), presence and severity of anxiety and depression -with hospital anxiety and depression scale, exercise tolerance - with 6 minute walk test. Patients of both groups were comparable by sex, severity of the CHF course quality of life, concomitant pathology, and treatment. Clinically manifest depression was found in 22.8% of patients aged 60 years and older and in 16% of patients younger than 60 years (p=0.460), clinically manifest anxiety was found in 22.8% and 20%, respectively (p=0.945). Risk factors of anxiety-depressive state in elderly patients were disability (relative risk [RR] 3.05, 95% confidence interval [CI] 1.04-8.97, p =0.042), insufficient education (RR 2.44, 95%CI 1.08-5.34; p=0.0320, and severe CHF according to CSAS (OR 1.22, 95%CI 1.07-1.4; p=0.003). According to data of multifactorial analysis disability (RR 1.78, 95%CI 1.01-3.13; p=0.045) and severe CHF (RR 1.17, 95%CI 1.07-1.27; p=0.001) were independently related to anxiety-depressive state in elderly patients.

[corrected] Thus social dysadaptation and medical factors turned out to be leading parameters determining worsening of quality of life and development of anxiety-depressive state in elderly patients with CHF.