The effects of preexisting depression on cerebrovascular health outcomes in geriatric continuing care.
BACKGROUND
Previous studies have investigated depression as the cause and outcome of vascular deficit in elderly persons.


METHODS
The authors wanted to determine whether baseline depression is predictive of subsequent cardiovascular events in very elderly persons residing in a continuing care retirement community (n = 181).


RESULTS
Controlling for demographic factors, both depression and the number of cardiovascular risk factors (CVRFs) at baseline were strongly predictive of stroke, whereas only CVRFs strongly predicted myocardial infarctions. Depression accounted for 12% of the variance in stroke incidence, beyond the contribution of CVRFs. Path analysis indicated that depression was also a partial moderator of the effect of CVRFs.


CONCLUSIONS
In support of the vascular depression hypothesis, the study findings indicate that, for the oldest old, depression may be a strong predictor of future stroke. The presence of depression in elderly patients should alert physicians to carefully investigate other stroke risk factors and to integrate depression into an overall intervention regimen for reducing patients' risks for stroke.
Krishnan
Mohan
M
Institute of Gerontology, Wayne State University, 87 E. Ferry Street, Detroit, MI 48202, USA.
Mast
Benjamin T
BT
Ficker
Lisa J
LJ
Lawhorne
Larry
L
Lichtenberg
Peter A
PA
D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D016852:Housing for the Elderly; D006801:Humans; D015994:Incidence; D008297:Male; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*