03004nas a2200337 4500008004100000022001400041245013200055210006900187260001300256300001000269490000700279520201500286653000902301653002202310653002802332653001502360653002602375653001102401653001102412653000902423653001902432653003702451653001802488100001502506700001802521700002402539700002402563700001902587700002402606856003602630 2011 eng d a1468-201X00aDepressive symptoms, physical inactivity and risk of cardiovascular mortality in older adults: the Cardiovascular Health Study.0 aDepressive symptoms physical inactivity and risk of cardiovascul c2011 Mar a500-50 v973 a

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 ± 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.

10aAged10aAged, 80 and over10aCardiovascular Diseases10aDepression10aEpidemiologic Methods10aFemale10aHumans10aMale10aMotor Activity10aPsychiatric Status Rating Scales10aUnited States1 aWin, Sithu1 aParakh, Kapil1 aEze-Nliam, Chete, M1 aGottdiener, John, S1 aKop, Willem, J1 aZiegelstein, Roy, C uhttps://chs-nhlbi.org/node/1270