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

• Main Authors: Miriam Ximenes Pinho, Osvladir Custodio, Marcia Makdisse, Manes Erlichman, Jose Antonio Gordillo, Vera Laet, Maria José Carvalho, Antônio Carlos Carvalho
• Format: Article
• Language: English
• Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2006-12-01
• Series: Einstein (São Paulo)
• Subjects: Depression; Aged; Life change events; Stress; Coronary arteriosclerosis
• Online Access: http://www.einstein.br/revista/arquivos/PDF/403-Einstein_vol4_n4_2006_p321.pdf

Objective: To describe the prevalence of depressive symptoms inelderly patients with coronary artery disease and to compare theclinical and socio-demographic characteristics between depressedand non-depressed patients. The study also investigates the presenceof psychosocial stressors in patients with depressive symptoms.Methods: A prospective cross-sectional study of 80 elderly patientswith coronary artery disease. Main measures used: GeriatricDepression Scale and interview; echocardiography (ejection fraction);the New York Heart Association Functional Class and the CanadianCardiovascular Society Functional Class. The statistical analysis wasperformed by the following: Student t test, chi-square, Fisher exacttest and Mann-Whitney test. Results: The prevalence rate ofdepressive symptoms was 31%. Depressed patients were youngerthan the non-depressed ones (mean age: 75.5 and 79.3 years, p =0.019, respectively). The socio-demographic variables (sex, schoolingand 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-depressedgroups. The psychosocial stressors were predominant (56%), andamong them, “problems related to primary support group” was themost frequently reported (92.8%). Physical stressors were found in46% of participants and among them, the most frequently reportedwere unrelated to the cardiac disease. Conclusion: The prevalencerate of depressive symptoms was high in this group of patients,but the objective evaluation of the cardiac function was notassociated to depressive symptoms. On the other hand, the patientperception of the cause of their depressive symptoms was mostlyrelated to psychosocial stressors, and problems related to primarysupport group was the most-endorsed category. Depressed elderlypatients have a higher cardiac morbidity and mortality. Our findingssuggest that an assessment of the patient’s psychosocial riskfactors should be an essential part of the global evaluation of thehealth status and therapeutic intervention as much as the cardiacfunction itself.