Depression increases risk of early death in older adults
February 6, 2019
Science Daily/American Geriatrics Society
A research team designed a study to investigate the role depression symptoms play in an increased risk of death over time. The team also examined the role heart disease and stroke play in the link between depression symptoms and increased risk of death.
As we age, we become more likely to experience symptoms of depression. Research shows that depression's symptoms can be linked to a higher risk for death. Yet often, older adults' symptoms of depression may be missed by healthcare professionals.
What's more, symptoms of depression have been linked to heart disease and stroke in middle-aged and older adults. Researchers suggest that the depression-heart disease link could play a role in the increased risk of death among older adults who have symptoms of depression. There's also a known link between depression and deaths from cancer and falls in older adults. These connections might contribute to an increased risk of death for older adults, researchers suggest.
Since depression symptoms change over time, it's possible that studying those symptoms during an older adult's doctor visits could provide more information. To learn more, a research team designed a study to investigate the role depression symptoms play in an increased risk of death over time. The team also examined the role heart disease and stroke play in the link between depression symptoms and increased risk of death. Their study was published in the Journal of the American Geriatrics Society.
The researchers used information from the Three-City Study, a French study that investigated dementia, heart disease, and stroke in people aged 65 and older during five healthcare visits the participants made over 10 years.
At the start of the study, 16 percent of 9,294 participants had a history of heart disease. Most participants were around 73 years old; 37 percent were men.
About 23 percent of participants had symptoms of depression when the study began (28 percent of women and 13 percent of men). Almost 7 percent were taking medication for their depression. At three follow-up visits, the participants were tested again for symptoms of depression.
When the participants were monitored for depression symptoms at several visits over time, symptoms of depression were linked to an increased risk for death, including death from heart disease and stroke. However, those diseases explained only a small percentage of the deaths associated with depression symptoms over time.
The researchers said their study suggested that, for older adults living with depression, preventing heart disease may not be the only factor that will help prevent or delay death. Interestingly, antidepressants were not associated with an increased risk of death in this study.
https://www.sciencedaily.com/releases/2019/02/190206091423.htm
Death rate for depressed heart patients double than for non-depressed heart patients
July 28, 2017
Science Daily/Intermountain Medical Center
People who are diagnosed with coronary artery disease and then develop depression face a risk of death that's twice as high as heart patients without depression, according to a major new study.
The increased risk of death from any cause holds true whether the depression immediately follows the heart disease diagnosis or occurs even years later, according to Heidi May, PhD, a cardiovascular epidemiologist at Intermountain Medical Center Heart Institute and the study's lead author.
She said the findings point out the importance of screening for and treating depression even years after someone is diagnosed with heart disease.
The research, one of a number of studies to explore the connection between heart disease and development of depression by researchers at Intermountain Medical Center Heart Institute, will be published on July 28 in the European Heart Journal -- Quality of Care & Clinical Outcomes.
Researchers found that post-coronary artery disease depression was the single biggest predictor of death, and remained so even after researchers controlled for the other factors.
"No matter how long or how short it was, patients were found to have twice the risk of dying compared to those who didn't have a follow-up diagnosis of depression," Dr. May said. "Depression was the strongest risk factor for dying, compared to any other risk factors we evaluated. That included age, heart failure, diabetes, high blood pressure, kidney failure, or having a heart attack or stroke."
That association didn't change for patients who were previously diagnosed with depression before their heart disease diagnosis or for patients whose angiograms were performed for various reasons, which included stable angina, unstable angina, or heart attack.
Dr. May and the Intermountain Medical Center Heart Institute research team studied 24,138 patients who underwent angiographies, which determined they had coronary artery disease. To detect subsequent depression, the researchers looked at standardized diagnostic codes called International Classification of Diseases codes, or ICD codes.
Patients with depression were also placed into subcategories based on how long after their heart disease diagnosis the depression was identified.
Dr. May said most studies have looked at depression at a single point in time, such as within 30 days of a heart event or at the time of heart disease diagnosis. Just a handful of studies have looked over the course of a year, let alone years, such as this study, which followed patients for an average of 10 years after their coronary artery disease diagnosis to see if they were ever diagnosed with depression.
In all, 15 percent, or 2,646 patients, were diagnosed with depression at some point during follow-up. Of those, 27 percent were diagnosed within a year of their heart event, 24 percent between one and three years after, nearly 15 percent between three and five years after, and nearly 37 percent at least five years after a baseline heart disease event.
This study reinforces previous research investigating the link between depression, heart disease, and increased risks of death. It's already been shown that people with coronary artery disease don't live as long as their peers who don't have heart disease. And while life expectancy has increased with better therapies, surgeries, and more aggressive treatment of identified risk factors, depression has come under increasing scrutiny as a risk factor that could make a difference, if properly treated.
"We've completed several depression-related studies and been looking at this connection for many years," said Dr. May. "The data just keeps building on itself, showing that if you have heart disease and depression and it's not appropriately treated in a timely fashion, it's not a good thing for your long-term well-being."
Research has shown that the relationship is bi-directional: Depression may result in worse outcomes for people with heart disease, while the presence of heart disease may increase the likelihood that someone will develop depression.
Those with depression were significantly younger and more often female, diabetic, previously diagnosed with depression, and less likely to have presented with a heart attack compared to those who didn't have depression.
The study didn't explain the reason for the elevated risk of death, although Dr. May said one possibility is that depression impacts how closely patients follow their treatment plans.
"We know people with depression tend to be less compliant with medication on average and probably in general aren't following healthier diets or exercise regimens," she said. "They tend to do a poorer job of doing things that are prescribed than people without depression. That certainly doesn't mean you're depressed so you're going to be less compliant, but in general, they tend to follow those behaviors."
She also noted that physiological changes occur within the body when patients are diagnosed with depression, which might help explain the link.
The researchers emphasize the importance of continual screening of depression for all heart disease patients. "Patients who have depression need to be treated for it to improve not only their long-term risks but their quality of life," Dr. May said.
"I hope the takeaway is this: it doesn't matter how long it's been since the patient was diagnosed with coronary artery disease. Continued screening for depression needs to occur, said Dr. May. "After one year, it doesn't mean they're out of the woods. It should be ongoing, just like we keep measuring things like LDL cholesterol."
https://www.sciencedaily.com/releases/2017/07/170728092552.htm
Childhood depression may increase risk of heart disease by teen years
January 30, 2014
Science Daily/University of South Florida (USF Health)
Children with depression are more likely to be obese, smoke and be inactive, and can show the effects of heart disease as early as their teen years, according to a newly published.
The research, by Rottenberg and his colleagues at Washington University and the University of Pittsburgh, suggests that depression may increase the risk of heart problems later in life. The researchers also observed higher rates of heart disease in the parents of adolescents that had been depressed as children. The research is published online in Psychosomatic Medicineand will be included in the medical journal's February 2014 issue.
"Given that the parents in this sample were relatively young, we were quite surprised to find that the parents of the affected adolescents were reporting a history of heart attacks and other serious events," Rottenberg explained.
Cardiologists and mental health professionals have long known a link exists between depression and heart disease. Depressed adults are more likely to suffer a heart attack, and if they do have a heart attack, it's more likely to be fatal.
However it was unclear when the association between clinical depression and cardiac risk develops, or how early in life the association can be detected. These findings suggest improved prevention and treatment of childhood depression could reduce adult cardiovascular disease.
Heart disease is the leading cause of death for men and women- accounting for one in every four deaths in the United States every year, according to the Centers for Disease Control and Prevention.
During the study, Rottenberg and his colleagues followed up on Hungarian children who had participated in a 2004 study of the genetics of depression. The researchers compared heart disease risk factors -- such as smoking, obesity, physical activity level, and parental history -- across three categories of adolescents.
The investigators surveyed more than 200 children with a history of clinical depression, as well as about 200 of their siblings who have never suffered from depression. They also gathered information from more than 150 unrelated children of the same age and gender with no history of depression.
Rottenberg plans to conduct additional research in order to understand why depression early in life may put people at increased risk for cardiovascular disease. Further studies planned with the Hungarian group will also examine whether any early warning signs of heart disease are present as these adolescents move into young adulthood.
http://www.sciencedaily.com/releases/2014/01/140130164454.htm