title: Inflammation and coagulation factors in persons > 65 years of age with symptoms of depression but without evidence of myocardial ischemia.
abstract: Depression is associated with increased cardiovascular disease, but the underlying mechanisms are not well understood. This study examines associations of depressive symptoms with inflammation and coagulation factors in persons aged > 65 years. Blood samples were obtained from 4,268 subjects free of cardiovascular disease (age 72.4 +/- 5.5 years, 2,623 women). Inflammation markers were C-reactive protein (CRP), white blood cell (WBC) count, total platelet count, and albumin; coagulation factors included factors VIIc and VIIIc and fibrinogen. Depression was assessed with the Center for Epidemiologic Studies Depression scale, and states of energy depletion with a validated exhaustion index. Statistical adjustments were made for risk factors (age, sex, race, systolic blood pressure, smoking status, diabetes mellitus) and physical measures of frailty (isometric handgrip, timed 15-feet walk test, activity level). Depression was associated with elevated CRP (3.31 +/- 0.10 vs 3.51 +/- 0.21 mg/L), WBC (6.14 +/- 0.03 vs 6.43 +/- 0.11 10(6)/L), fibrinogen (319 +/- 1 vs 326 +/- 3 mg/dl), and factor VIIc (124.6 +/- 0.6% vs 127.2 +/- 1.3%; all p <0.05). Exhaustion also was related to elevated inflammation and coagulation markers (p < 0.05). Exhausted men had markedly elevated CRP levels (6.82 +/- 2.10 mg/L) versus nonexhausted men (3.05 +/- 0.16: p = 0.007). After adjustment for control variables, exhaustion remained associated with albumin (p = 0.033), fibrinogen (p = 0.017), CRP (p = 0.066), and WBC (p = 0.060), whereas associations of depressive symptoms with biochemistry measures lost statistical significance. Thus, depression and exhaustion are associated with low-grade inflammation and elevated coagulation factors in persons aged > 65 years.
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA. wjkop@mxb.usuhs.mil
authors.forename: Willem J
authors.initials: WJ
authors.lastname: Kop
authors.forename: John S
authors.initials: JS
authors.lastname: Gottdiener
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Tangen
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: McBurnie
authors.forename: Jeremy
authors.initials: J
authors.lastname: Walston
authors.forename: Anne
authors.initials: A
authors.lastname: Newman
authors.forename: Calvin
authors.initials: C
authors.lastname: Hirsch
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
mesh_terms: D000368:Aged; D001774:Blood Chemical Analysis; D001779:Blood Coagulation Factors / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D003863:Depression / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D008297:Male; D012307:Risk Factors
chemical_list: D001779:Blood Coagulation Factors