Related Experiment Videos
Coronary heart disease and depression in the elderly--a population-based study
M Ahto1, R Isoaho, H Puolijoki
1Unit of General Practice, Oulu University Hospital, Finland.
Insights
Depression is common in elderly patients with coronary heart disease (CHD). While not an independent cause, CHD is linked to depression in men, potentially due to psychic stress from the illness.
Area of Science:
- Gerontology
- Cardiology
- Psychiatry
Background:
- Quality of life for elderly individuals with chronic diseases is a growing concern.
- Coronary heart disease (CHD) is prevalent in the elderly and can negatively impact emotional well-being.
Purpose of the Study:
- To determine the prevalence of depression and depressive symptoms in elderly CHD patients.
- To examine the relationship between depression and CHD severity.
- To investigate potential associations between CHD and depression.
Main Methods:
- Study conducted in Lieto, Finland, involving 488 men and 708 women over 64.
- Selected CHD patients (angina pectoris or myocardial infarction) and age/sex-matched controls.
- Used Zung Self-rating Depression Scale; analyzed associations with various factors via logistic regression.
Main Results:
- Depression prevalence: 29% in male CHD patients, 20% in female CHD patients.
- Depression more common in male CHD patients than male controls (P=0.011); no association found in women.
- In men, depression linked to severe dyspnea; in women, linked to prior depression, disability, and ACE inhibitor use.
Conclusions:
- Depression is frequent in elderly CHD patients.
- CHD is not an independent cause of depression in the elderly.
- The link between CHD and depression in men may stem from psychic stress related to the disease.
Background:
Growing interest is nowadays focused on the quality of life of elderly people who survive with chronic diseases. Coronary heart disease (CHD) is one of the most common diseases among the elderly and may have an unfavourable impact on the patient's emotional well-being.
Objectives:
We aimed to describe the prevalence of depression and the occurrence of depressive symptoms among elderly CHD patients, with a special emphasis on the relations between depression and the severity of CHD, and to find out the possible association between CHD and depression.
Methods:
The study was carried out at the health centre of the municipality of Lieto, in south-west Finland. The study population consisted of 488 community-dwelling men and 708 women, over 64 years old, from among whom the participants with CHD (89 men and 73 women) were selected, and for whom 178 male and 146 female sex- and age-matched controls (free of CHD) were drawn from the population. CHD patients were selected on the basis of the presence of angina pectoris or a past myocardial infarction. Depressive symptoms were measured with the Zung Self-rating Depression Scale. Depression was described in relation to the severity of dyspnoea and chest pain among patients. The associations between depression and age, health, health behaviour, drugs, functional ability and social, psychosocial and environmental factors were analysed by logistic regression analyses.
Results:
The prevalence of depression was 29% among male patients and 20% among female patients. Depression was significantly more common among male CHD patients than among male controls (P = 0.011). Among women, depression was not associated with CHD. Earlier, depression had gone undiagnosed among many CHD patients and controls, especially male patients. Among male CHD patients, depression was associated with more severe dyspnoea, but no similar association was found among female CHD patients. Among men the occurrence of CHD, physical disability, widowhood or divorce, and among women previous clinical depression, physical disability and the use of angiotensin-converting enzyme (ACE) inhibitors, were associated with depression.
Conclusion:
Depression is common among patients with CHD. It seems that CHD is not an independent factor in the aetiology of depression among the elderly. The association of CHD with depression among men is explained by the acute or chronic psychic stress caused by CHD. It may be that the more complicated the patient's CHD, the more probable is the presence of depression.