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High Level of Depressive Symptoms at Repeated Study Visits and Risk of Coronary Heart Disease and Stroke over 10 Years in Older Adults: The Three‐City Study
Author(s) -
Péquignot Renaud,
Dufouil Carole,
Prugger Christof,
Pérès Karine,
Artero Sylvaine,
Tzourio Christophe,
Empana JeanPhilippe
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13872
Subject(s) - medicine , stroke (engine) , coronary heart disease , depressive symptoms , disease , gerontology , depression (economics) , physical therapy , cardiology , emergency medicine , psychiatry , anxiety , mechanical engineering , engineering , economics , macroeconomics
Backround Baseline depressive symptoms have been consistently associated with the onset of cardiovascular disease ( CVD ). Objectives Since depressive symptoms vary over time in elderly persons, and to help clarify whether or not depression is an etiological factor for CVD , we quantified the association between the course of depressive symptoms and occurrence of first coronary heart disease ( CHD ) and stroke events in older adults. Design A population‐based prospective observational study. Setting Participants were randomly selected from the electoral rolls of three large French cities. Participants A total of 9,294 participants were examined at baseline between 1999 and 2001, and thereafter at repeated study visits over 10 years. Measurements High levels of depressive symptoms ( HLDS ) were defined as a score ≥16 on the 20‐item Center for Epidemiologic Studies Depression Scale. The number of study visits with HLDS was used as a time dependent variable in Cox proportional hazard models. Results There were 7,313 participants (36.6% males) aged 73.8 ± 5.4 years with no history of CHD , stroke or dementia at baseline. After a median follow‐up of 8.4 years ( SD 2.3 years), 629 first CHD or stroke events occurred. After adjustment for sociodemographic characteristics and vascular risk factors, the risk of CHD and stroke combined increased 1.15‐fold (95% CI : 1.06 to 1.25) per each additional study visit with HLDS . The results remained unchanged when accounting for the presence of disability and antidepressant intake at baseline and during follow‐up. Conclusion Elderly persons exposed to HLDS at several occasions over 10 years showed substantial increased risk of coronary heart disease and stroke events.