title: Late-life depression and cardiovascular disease burden: examination of reciprocal relationship.
abstract: OBJECTIVE
  Empirical studies of the relationship between depression and cardiovascular disease (CVD) tend to be limited to examination of one-way relationships. This study assessed both cross-sectional association and longitudinal reciprocal relationships between late-life depressive symptoms and CVD.
  
  
  METHODS
  The National Health and Aging Trends Study waves 1 (T1) and 2 (T2, one year later) provided the data. The study sample (N = 5,414) represented Medicare beneficiaries aged 65 years or older. We fit structural equation models to examine: 1) cross-sectional association between depression and CVD at each wave; and 2) longitudinal reciprocal relationship between T1 depression and T2 CVD and between T1 CVD and T2 depression.
  
  
  RESULTS
  At T1, 28.6% reported a CVD diagnosis, and at T2, 4.9% reported having had a new diagnosis or new episode of heart attack or heart disease and 2.2% reported having had a stroke since T1. In addition to significant cross-sectional relationships between depression and CVD, T1 CVD had significant impact on T2 depressive symptoms, and T1 depressive symptoms had significant impact on T2 CVD, with a 1-point increase in depressive symptom score increasing the odds of having a new CVD diagnosis or episode by 21%.
  
  
  CONCLUSIONS
  The care of older adults with CVD and/or depression needs to include interventions focusing on lifestyle and psychological factors that can reduce risks for both CVD and depression. Depression prevention and treatment also needs to be an integral part of CVD prevention and management.
authors.affiliation: School of Social Work, University of Texas at Austin, Austin, TX. Electronic address: nchoi@austin.utexas.edu.
authors.forename: Namkee G
authors.initials: NG
authors.lastname: Choi
authors.affiliation: Department of Social Welfare, Seoul Women's University, Seoul, Korea.
authors.forename: Jinseok
authors.initials: J
authors.lastname: Kim
authors.affiliation: Division of Statistics and Scientific Computation, College of Natural Sciences, University of Texas at Austin, Austin, TX.
authors.forename: C Nathan
authors.initials: CN
authors.lastname: Marti
authors.affiliation: Division of Health Services Research, Department of Internal Medicine, the University of Kansas Medical Center, Kansas City, KS.
authors.forename: G John
authors.initials: GJ
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
keywords: CVD; Depression; older adults