Association of sociodemographic characteristics, cardiovascular symptoms and psychosocial stressors in elderly depressed patients with coronary artery disease

Author(s)

Pinho, Miriam Ximenes ; Custodio, Osvladir ; Makdisse, Marcia ; Erlichman, Manes ; Gordillo, Jose Antonio ; Laet, Vera ; Carvalho, Maria Jose ; Carvalho, Antonio Carlos

• Document type: Journal article
• Source: Einstein (São Paulo); v. 4, n. 4, p. 6-pg., 2006-10-01.

Abstract

Objective: To describe the prevalence of depressive symptoms in elderly patients with coronary artery disease and to compare the clinical and socio-demographic characteristics between depressed and non-depressed patients. The study also investigates the presence of psychosocial stressors in patients with depressive symptoms. Methods: A prospective cross-sectional study of 80 elderly patients with coronary artery disease. Main measures used: Geriatric Depression Scale and interview; echocardiography (ejection fraction); the New York Heart Association Functional Class and the Canadian Cardiovascular Society Functional Class. The statistical analysis was performed by the following: Student t test, chi-square, Fisher exact test and Mann-Whitney test. Results: The prevalence rate of depressive symptoms was 31%. Depressed patients were younger than the non-depressed ones (mean age: 75.5 and 79.3 years, p = 0.019, respectively). The socio-demographic variables (sex, schooling and income) and the clinical variables (previous myocardial infarction, cardiac function, severity of heart failure symptoms and angina) showed no difference between the depressed and non-depressed groups. The psychosocial stressors were predominant (56%), and among them, "problems related to primary support group" was the most frequently reported (92.8%). Physical stressors were found in 46% of participants and among them, the most frequently reported were unrelated to the cardiac disease. Conclusion: The prevalence rate of depressive symptoms was high in this group of patients, but the objective evaluation of the cardiac function was not associated to depressive symptoms. On the other hand, the patient perception of the cause of their depressive symptoms was mostly related to psychosocial stressors, and problems related to primary support group was the most-endorsed category. Depressed elderly patients have a higher cardiac morbidity and mortality. Our findings suggest that an assessment of the patient's psychosocial risk factors should be an essential part of the global evaluation of the health status and therapeutic intervention as much as the cardiac function itself. (AU)