title: Association of cardiovascular risk factors and disease with depression in later life.
abstract: OBJECTIVE
  The objective of this study is to determine the association between established cardiovascular risk factors and depression among older men.
  
  
  METHODS
  The authors conducted a cross-sectional study of a community-representative sample of 5,439 men aged 71-89 years. Cardiovascular disease and risk factors assessed included history of diabetes, hypertension, angina, myocardial infarction, and stroke; current smoking; total cholesterol and fractions; triglycerides; total plasma homocysteine; and MTHFR677 genotype. Depression was defined by a Geriatric Depression Scale 15 items score of 7 or greater.
  
  
  RESULTS
  A complete data set was available for 4,204 men, of whom 212 were depressed (5%). Men who were depressed reported higher frequency of diabetes (23.1% versus 13.2%), angina (30.2% versus 20.4%), myocardial infarction (26.2% versus 16.0%), and stroke (23.6% versus 9.1%) than nondepressed men. Participants with depression were also more likely to have plasma homocysteine above 15 mumol/L (39.1% versus 25.5%) and high triglycerides (32.1% versus 20.9%) than nondepressed subjects. Depressed older men were also more likely to be active smokers (9.9% versus 4.8%). The other factors measured in the study were not significantly associated with depression. Estimation of the population-attributable fraction (PAF) after logistic regression showed that high plasma homocysteine had the highest PAF for depression (PAF:15%, 95% confidence interval [95% CI]: 5%-23%) followed by high triglycerides (PAF: 11%, 95% CI: 2%-18%), angina (PAF: 9%, 95% CI: 2%-15%), stroke (PAF: 8%, 95% CI: 3%-13%), diabetes (PAF: 7%, 95% CI: 1%-13%), myocardial infarction (PAF: 5%, 95% CI: 0%-11%), and smoking (PAF: 5%, 95% CI: 1%-9%).
  
  
  CONCLUSIONS
  High plasma homocysteine and triglycerides appear to account for a considerable proportion of cases of depression in older men. The successful management of these risk factors may contribute to decrease the prevalence of depression in later life.
authors.affiliation: Unit of Geriatric Psychiatry, University of Western Australia and Royal Perth Hospital, Perth, WA, Australia. osvaldo.almeida@uwa.edu.au
authors.forename: Osvaldo P
authors.initials: OP
authors.lastname: Almeida
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.forename: Paul
authors.initials: P
authors.lastname: Norman
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.forename: Samuel
authors.initials: S
authors.lastname: Vasikaran
authors.forename: Frank M
authors.initials: FM
authors.lastname: van Bockxmeer
authors.forename: Konrad
authors.initials: K
authors.lastname: Jamrozik
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000097:blood / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D006710:Homocysteine