title: The association of a heart attack or stroke with depressive symptoms stratified by the presence of a close social contact: findings from the National Health and Aging Trends Study Cohort.
abstract: OBJECTIVE
  The objective of the study is to examine whether the risk of having clinically significant depressive symptoms following a heart attack or stroke varies by the presence of a close social contact.
  
  
  METHODS
  The National Health and Aging Trends Study is a nationally representative longitudinal survey of US Medicare beneficiaries aged 65 and older initiated in 2011. A total of 5643 older adults had information on social contacts at baseline and depressive symptoms at the 1-year follow-up interview. The two-item Patient Health Questionnaire identified clinically significant depressive symptoms. Interview questions examined social contacts and the presence of self-reported heart attack or stroke during the year of follow-up.
  
  
  RESULTS
  A total of 297 older adults reported experiencing a heart attack and/or stroke between their baseline and follow-up interviews. In regression analyses accounting for sociodemographics, baseline depressive symptoms, medical comorbidity, and activities of daily living impairment, older adults with no close social contacts had increased odds of depressive symptoms at follow-up after experiencing a heart attack or stroke, while those with close social contacts had increased odds of depressive symptoms at follow-up after experiencing a stroke, but not a heart attack.
  
  
  CONCLUSIONS
  Older adults have increased odds of having depressive symptoms following a self-reported stroke, but only those with no close social contacts had increased odds of depressive symptoms following a heart attack. Social networks may play a role in the mechanisms underlying depression among older adults experiencing certain acute health events. Future work exploring the potential causal relationships suggested here, if confirmed, could inform interventions to alleviate or prevent depression among at risk older adults. Copyright © 2017 John Wiley & Sons, Ltd.
authors.affiliation: Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
authors.forename: Adam
authors.identifier: http://orcid.org/0000-0003-1293-3521
authors.initials: A
authors.lastname: Simning
authors.affiliation: Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.|Office for Aging Research and Health Services, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Seplaki
authors.affiliation: Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.|Office for Aging Research and Health Services, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Yeates
authors.initials: Y
authors.lastname: Conwell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009203:Myocardial Infarction / Q000523:psychology*; D012044:Regression Analysis; D012307:Risk Factors; D057566:Self Report; D012919:Social Behavior; D060756:Social Networking; D012944:Social Support; D020521:Stroke / Q000523:psychology*
keywords: epidemiology; longitudinal; medical comorbidity; social support