title: Association of depression with subsequent mortality, cardiovascular morbidity and incident dementia in people aged 80 and over and suffering from hypertension. Data from the Hypertension in the Very Elderly Trial (HYVET).
abstract: BACKGROUND
  depression is common in elderly people and may be associated with increased cardiovascular risk and incident dementia.
  
  
  METHODS
  participants in the Hypertension in the Very Elderly Trial (HYVET) completed a depression screening instrument, the Geriatric Depression Score (GDS), at baseline and annually. We examined the association of GDS score with incident stroke, mortality and dementia using Cox proportional hazards models (hazard ratios, HR and 95% confidence intervals, CI) adjusted for treatment group and other potential confounders.
  
  
  RESULTS
  2,656 HYVET participants completed the GDS. The mean follow-up was 2.1 years. A GDS score > or =6 was associated with increased risks of all-cause (HR 1.8, 95% CI 1.4-2.3) and cardiovascular mortality (HR 2.10, 95% CI 1.5-3.0), all stroke (HR 1.8, 95% CI 1.2-2.8) and all cardiovascular events (HR 1.6, 95% CI 1.2-2.1). Risk of incident dementia also tended to be increased (HR 1.28, 95% CI 0.95-1.73). Each additional GDS point at baseline also gave rise to a significantly increased risk of fatal and non-fatal cardiovascular events, all-cause mortality and dementia.
  
  
  CONCLUSIONS
  there was a strong association between baseline depression scores and later fatal and non-fatal cardiovascular endpoints over a mean follow-up of 2 years in a hypertensive very elderly group. The mechanism of this association warrants further study.
authors.affiliation: Imperial College London, UK. r.peters@imperial.ac.uk
authors.forename: Ruth
authors.initials: R
authors.lastname: Peters
authors.forename: Elisabete
authors.initials: E
authors.lastname: Pinto
authors.forename: Nigel
authors.initials: N
authors.lastname: Beckett
authors.forename: Cameron
authors.initials: C
authors.lastname: Swift
authors.forename: John
authors.initials: J
authors.lastname: Potter
authors.forename: Terry
authors.initials: T
authors.lastname: McCormack
authors.forename: Maria
authors.initials: M
authors.lastname: Nunes
authors.forename: John
authors.initials: J
authors.lastname: Grimley-Evans
authors.forename: Astrid
authors.initials: A
authors.lastname: Fletcher
authors.forename: Christopher
authors.initials: C
authors.lastname: Bulpitt
mesh_terms: D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007190:Indapamide / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D020913:Perindopril / Q000627:therapeutic use; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy / Q000401:mortality
chemical_list: D000959:Antihypertensive Agents; D007190:Indapamide; D020913:Perindopril