Journal
EUROPEAN JOURNAL OF EPIDEMIOLOGY
Volume 28, Issue 3, Pages 249-256Publisher
SPRINGER
DOI: 10.1007/s10654-013-9765-3
Keywords
Aging; Depression; Cardiovascular disease; Epidemiology; Risk factors
Categories
Funding
- Fondation pour la Recherche Medicale
- Caisse Nationale d'Assurance Maladie des Travailleurs Salaries
- Direction Generale de la Sante
- MGEN
- Institut de la Longevite
- Regional Councils of Aquitaine and Bourgogne
- Fondation de France
- Ministry of Research-INSERM Program Cohortes et collections de donnees biologiques
- Agence Nationale de la Recherche
- Fondation Plan Alzheimer
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To investigate the association between baseline depressive symptoms and first fatal and non fatal coronary heart disease (CHD) and stroke in older adults, taking antidepressants and disability into account. In the Three City Study, a community-based prospective multicentric observational study cohort, 7,308 non-institutionalized men and women aged a parts per thousand yen65 years with no reported history of CHD, stroke or dementia, completed the 20-item Center for Epidemiologic Studies Depression Scale (CESD) questionnaire. First CHD and stroke events during follow-up were adjudicated by an independent expert committee. Hazard ratios (HRs) were estimated by Cox proportional hazard model. After a median follow-up of 5.3 years, 338 subjects had suffered a first non-fatal CHD or stroke event, and 82 had died from a CHD or stroke. After adjustment for study center, baseline socio-demographic characteristics, and conventional risk factors, depressive symptoms (CESD a parts per thousand yen 16) were associated with fatal events only: fatal CHD plus stroke (HR = 2.50; 95 % CI 1.57-3.97), fatal CHD alone (n = 57; HR = 2.21 ; 95 %CI 1.27-3.87), and fatal stroke alone (n = 25; HR = 3.27; 95 % CI 1.42-7.52). These associations were even stronger in depressed subjects receiving antidepressants (HR = 4.17; 95 % CI 1.84-9.46) and in depressed subjects with impaired Instrumental Activities of Daily Living (HR = 8.93; 95 % CI 4.60-17.34). By contrast, there was no significant association with non fatal events (HR for non-fatal CHD or stroke = 0.94; 95 % CI 0.66-1.33). In non-institutionalized elderly subjects without overt CHD, stroke or dementia, depressive symptoms were selectively and robustly associated with first fatal CHD or stroke events.
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