Cardiovascular risk profile and subsequent disability and mental well-being: the Zutphen Elderly Study.
OBJECTIVE
It is insufficiently known whether "classic" cardiovascular risk factors are associated with subsequent functional disability and mental well-being in elderly men.


METHODS
A population-based cohort study with 15 years of follow-up from 1985 onward.


METHODS
The Zutphen Study started as the Dutch contribution to the Seven Countries Study.


METHODS
Five hundred forty-five (59.2%) of 887 men (aged 64-84 years) who were free of preexisting cardiovascular disease and cancer.


METHODS
High cardiovascular risk was defined as having >/=2 "classic" risk factors: body mass index >/=30.0 kg/m(2), presently smoking, hypertension (systolic blood pressure >/=160 mm Hg, diastolic blood pressure >/=95 mm Hg, or antihypertensive medication), serum cholesterol >/=6.5 mmol/L, and diabetes mellitus. Self-rated health and dispositional optimism were assessed in 1985, 1990, 1995, and 2000. Disability and depressive symptoms (by the Zung self-rating depression scale) were assessed from 1990 onward.


RESULTS
The high-risk (N = 230) versus low-risk group (N = 315) had higher multivariate adjusted risks of all-cause and cardiovascular mortality (hazard ratios: 1.43; confidence interval[CI]: 1.15, 1.76; and 1.61; CI: 1.20, 2.18, respectively). High-risk status was also associated with more functional disability at 5, 10, and 15 years (odds ratios of 2.00, 95% CI: 1.25-3.20; 2.51, 95% CI: 1.36-4.65; and 2.45, 95% CI: 0.91-6.61, respectively), adjusted for baseline age, self-rated health, and dispositional optimism. Risk status was not associated with self-rated health, dispositional optimism, or depressive symptoms at follow-up.


CONCLUSIONS
Combined "classic" cardiovascular risk factors are not associated with impaired self-rated health or mental well-being in elderly men, but are predictive of functional disability.
Giltay
Erik J
EJ
Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. giltay@dds.nl
Zitman
Frans G
FG
Kromhout
Daan
D
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000523:psychology*; D015331:Cohort Studies; D016001:Confidence Intervals; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D024821:Metabolic Syndrome / Q000401:mortality; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires