@article {1270, title = {Depressive symptoms, physical inactivity and risk of cardiovascular mortality in older adults: the Cardiovascular Health Study.}, journal = {Heart}, volume = {97}, year = {2011}, month = {2011 Mar}, pages = {500-5}, abstract = {

BACKGROUND: Depressed older individuals have a higher mortality than older persons without depression. Depression is associated with physical inactivity, and low levels of physical activity have been shown in some cohorts to be a partial mediator of the relationship between depression and cardiovascular events and mortality.

METHODS: A cohort of 5888 individuals (mean 72.8 {\textpm} 5.6 years, 58\% female, 16\% African-American) from four US communities was followed for an average of 10.3 years. Self-reported depressive symptoms (10-item Center for Epidemiological Studies Depression Scale) were assessed annually and self-reported physical activity was assessed at baseline and at 3 and 7 years. To estimate how much of the increased risk of cardiovascular mortality associated with depressive symptoms was due to physical inactivity, Cox regression with time-varying covariates was used to determine the percentage change in the log HR of depressive symptoms for cardiovascular mortality after adding physical activity variables.

RESULTS: At baseline, 20\% of participants scored above the cut-off for depressive symptoms. There were 2915 deaths (49.8\%), of which 1176 (20.1\%) were from cardiovascular causes. Depressive symptoms and physical inactivity each independently increased the risk of cardiovascular mortality and were strongly associated with each other (all p < 0.001). Individuals with both depressive symptoms and physical inactivity had greater cardiovascular mortality than those with either individually (p < 0.001, log rank test). Physical inactivity reduced the log HR of depressive symptoms for cardiovascular mortality by 26\% after adjustment. This was similar for persons with (25\%) and without (23\%) established coronary heart disease.

CONCLUSIONS: Physical inactivity accounted for a significant proportion of the risk of cardiovascular mortality due to depressive symptoms in older adults, regardless of coronary heart disease status.

}, keywords = {Aged, Aged, 80 and over, Cardiovascular Diseases, Depression, Epidemiologic Methods, Female, Humans, Male, Motor Activity, Psychiatric Status Rating Scales, United States}, issn = {1468-201X}, doi = {10.1136/hrt.2010.209767}, author = {Win, Sithu and Parakh, Kapil and Eze-Nliam, Chete M and Gottdiener, John S and Kop, Willem J and Ziegelstein, Roy C} }