Depressive symptoms predict mortality in elderly subjects with chronic heart failure

Background Chronic heart failure ( CHF) is characterized by a high mortality in the elderly. Moreover, depression status is also related to poor prognosis in advancing age. Thus, we sought to determine whether depressive status predicts long- term mortality in subject with or without CHF. Methods and results Long- term mortality after 12- year follow- up in 125 elderly subjects with CHF and 1143 elderly subjects without CHF was studied. Depression was evaluated using the Geriatric Depression Scale ( GDS), and all subjects were stratified in tertiles according to GDS score ( 0- 10, 11- 20 and 21- 30). With increasing GDS score, long- term mortality at the end of follow- up increased from 43 4% to 72 0% in subjects without ( P < 0 001) and from 52 6% to 83 9% in subjects with ( P < 0 007) CHF. In multivariate analysis, GDS appeared to be predictive of long- term mortality in the absence ( Hazard ratio = 1 01; confidence interval 95% 1 00- 1 05; P = 0 04) and, even more, in the presence of CHF ( Hazard ratio = 1 08; confidence interval 95% 1 01- 1 15; P < 0 01). Conclusions Depression symptoms predict long- term mortality in elderly subjects without and, even more, with CHF. Thus, depression can be considered a strong predictor of death in CHF elderly subjects.