title: Gender differences in the relationship between depression and cardiac autonomic function among community elderly.
abstract: OBJECTIVE
  The mechanism underlying the differential effect of depression on morbidity and mortality in men and women remains unknown. This survey was designed to examine gender effects on the relationship between depressive symptoms and cardiac autonomic function among community dwelling elderly.
  
  
  METHODS
  Six hundred and six randomly selected community-dwelling elderly men and women > or = 65 years of age were enrolled. Depressive symptoms were assessed with the Hospital Anxiety and Depression Scale. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters. Frequency-domain indices of HRV were obtained.
  
  
  RESULTS
  Among the subjects, 58.4% were male with a mean age of 77.9 years. Stratified analyses by gender revealed a dose-response association between depressive symptoms and lower cardiac vagal control among elderly males (p = 0.003). Male subjects with mild depressive symptoms (depression scores: 5-6) showed prominent cardiac sympathetic predominance compared with the reference group (depression scores: < 5) (p = 0.005). In contrast, these findings did not exist among elderly females.
  
  
  CONCLUSIONS
  The association of depressive symptoms with poor cardiac vagal control and sympathetic predominance was more robust among elderly males than females. This finding may help explain gender differences in the association of depression with morbidity and mortality.
authors.affiliation: Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hsi-Chung
authors.initials: HC
authors.lastname: Chen
authors.forename: Cheryl C H
authors.initials: CC
authors.lastname: Yang
authors.forename: Terry B J
authors.initials: TB
authors.lastname: Kuo
authors.forename: Tung-Ping
authors.initials: TP
authors.lastname: Su
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology; D003866:Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013624:Taiwan / Q000453:epidemiology