title: Depressive symptoms and development of coronary heart disease events: the Italian longitudinal study on aging.
abstract: BACKGROUND
  Studies on the association between depressive symptomatology (DS) and cardiovascular events and mortality in elderly persons have yielded contradictory findings. To address this issue, the authors assessed DS and an extensive array of sociodemographic, behavioral, and biological variables in the largest population-based sample of older Italians ever studied and analyzed their association with coronary heart disease (CHD) morbidity and total number of deaths.
  
  
  METHODS
  This prospective, community-based cohort study included a sample of 5632 Italians, 65 years and older, who were recruited from the demographic registries of eight municipalities in Italy. Depressive symptomatology was assessed using the Geriatric Depression Scale, and a score > or =10 was used to indicate the presence of DS. All traditional cardiovascular disease risk factors were assessed at baseline, through questionnaires, blood tests, and physical examinations. The outcomes were CHD fatal and nonfatal events and total number of deaths. The association of the predictive variables with the outcomes was assessed using different Cox models.
  
  
  RESULTS
  Baseline DS was associated with a higher incidence of fatal and nonfatal CHD events (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.06-2.60) and with cardiovascular mortality in men (HR, 2.49; 95% CI, 1.60-3.87) and with total mortality in men (HR, 2.02; 95% CI, 1.58-2.58) and women (HR, 1.43; 95% CI, 1.04-1.95) at the 4-year follow-up assessment. This association was observed after adjusting for a vast array of potential confounding variables, including major chronic conditions.
  
  
  CONCLUSIONS
  Depressive symptomatology confers an increased risk for CHD in men and for total mortality in men and women but is not explained by health behaviors, social isolation, or biological or clinical determinants.
authors.affiliation: National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Marzari
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.forename: Carla
authors.initials: C
authors.lastname: Destro
authors.forename: Marianna
authors.initials: M
authors.lastname: Noale
authors.forename: Daniele
authors.initials: D
authors.lastname: Bianchi
authors.forename: Nadia
authors.initials: N
authors.lastname: Minicuci
authors.forename: Gino
authors.initials: G
authors.lastname: Farchi
authors.forename: Marzia
authors.initials: M
authors.lastname: Baldereschi
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Carlo
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality*; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors