title: Association of depressive symptoms, trait anxiety, and perceived stress with subclinical atherosclerosis: results from the Chicago Healthy Aging Study (CHAS).
abstract: OBJECTIVE
  Examine the association between multiple psychological factors (depressive symptoms, trait anxiety, perceived stress) and subclinical atherosclerosis in older age.
  
  
  METHODS
  This cross-sectional study included 1101 adults ages 65-84 from the Chicago Healthy Aging Study (CHAS - 2007-2010). Previously validated self-report instruments were used to assess psychological factors. Non-invasive methods were used to assess subclinical atherosclerosis in two regions of the body, i.e., ankle-brachial blood pressure index (ABI) and coronary artery calcification (CAC). Multivariate logistic regression was used to examine the association between each psychological measure and subclinical atherosclerosis, after the adjustment for socio-demographic factors, sleep quality, young adulthood/early middle age and late-life CVD risk status, and psychological ill-being as appropriate.
  
  
  RESULTS
  The burden of major cardiovascular disease risk factors did not significantly differ across tertiles of psychological factors. In multivariate adjusted models, trait anxiety was associated with calcification: those in the second tertile were significantly more likely to have CAC >0 compared to those in the lowest anxiety tertile [OR=1.68; 95% CI=1.09-2.58], but no significant difference was observed for Tertile III of trait anxiety [OR=1.31; 95% CI=0.75-2.27]. No association was seen between psychological measures and ABI.
  
  
  CONCLUSIONS
  Of several psychological factors, only trait anxiety was significantly associated with CAC.
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA. Electronic address: rosalba.hernandez@northwestern.edu.
authors.forename: Rosalba
authors.initials: R
authors.lastname: Hernandez
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Norrina Bai
authors.initials: NB
authors.lastname: Allen
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Stamler
authors.affiliation: Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Kathryn Jean
authors.initials: KJ
authors.lastname: Reid
authors.affiliation: Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL, USA.
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Zee
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Donghong
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Kang
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Garside
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D055109:Ankle Brachial Index; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D050197:Atherosclerosis / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002641:Chicago / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D057566:Self Report; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Ankle brachial index; Cardiovascular risk; Coronary artery calcification; Older adults; Population study; Psychological factors; Subclinical atherosclerosis