DEPRESSION AND RISK OF CORONARY HEART-DISEASE IN ELDERLY MEN AND WOMEN - NEW-HAVEN EPESE, 1982-1991

Background: Results of several recent studies suggest that depression is predictive of incident coronary disease. However, few studies have examined this relationship in the elderly, the age at which most coron ary heart disease (CHD) becomes clinically manifest. Methods and Resul ts: Data are from the New Haven, Conn, cohort (N = 2812) of the Establ ished Populations for the Epidemiologic Studies of the Elderly project . Baseline information on depressive symptoms and CHD risk factors was collected during an in-person interview in 1982. Nonfatal myocardial infarctions were identified through monitoring of admissions to local hospitals and were validated by medical chart review. Cause of death w as obtained from death certificates for all deceased participants. Out comes were defined as CHD deaths (n = 255) and total incident CHD even ts (n = 391) between January 1, 1982, and December 31, 1991. There was no association between depressive symptoms and CHD outcomes in men. A mong women, depressive symptoms were associated with an age-adjusted r elative risk of 1.03 (per unit increase on the symptom scale) for CHD mortality (P = .001) and total CHD incidence (P = .002). These associa tions were largely unaffected by adjustment for established CHD risk f actors but were reduced to nonsignificant levels after additional adju stment for impaired physical function. Additional analysis showed a si gnificant association for depressive symptoms among women who had no p hysical function impairments or who survived at least 3 years without an event. Conclusion: Depressive symptoms may not be independent risk factors for CHD outcomes in elderly populations in general but may inc rease risk among relatively healthy older women.