Coronary heart disease and depression in the elderly--a population- based study |
| |
Authors: | Ahto M; Isoaho R; Puolijoki H; Laippala P; Romo M; Kivela SL |
| |
Institution: | Unit of General Practice, Oulu University Hospital, Finland. |
| |
Abstract: | 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.
|
| |
Keywords: | |
本文献已被 Oxford 等数据库收录! |
|