Role of Late-Life Depression in the Association of Subclinical Cardiovascular Disease With All-Cause Mortality: Cardiovascular Health Study

Nicole M. Armstrong; Michelle C. Carlson; Qian Li Xue; Jennifer Schrack; Mercedes R. Carnethon; Paulo H.M. Chaves; Alden L. Gross

doi:10.1177/0898264317744921

Role of Late-Life Depression in the Association of Subclinical Cardiovascular Disease With All-Cause Mortality: Cardiovascular Health Study

Nicole M. Armstrong^*, Michelle C. Carlson, Qian Li Xue, Jennifer Schrack, Mercedes R. Carnethon, Paulo H.M. Chaves, Alden L. Gross

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Objectives: To evaluate whether late-life depression mediates the association of subclinical cardiovascular disease (CVD) with all-cause mortality. Method: Using data from 3,473 Cardiovascular Health Study participants, the Cox proportional hazards model was used to examine the direct and indirect (via late-life depression) effects of the association between baseline subclinical CVD and all-cause mortality with weights derived from multivariable logistic regression of late-life depression on subclinical CVD. Results: Subclinical CVD led to a higher risk of all-cause mortality (hazard ratio [HR] = 1.51, 95% confidence interval, [CI] = [1.42, 1.94]). Total effect of subclinical CVD on all-cause mortality was decomposed into direct (HR = 1.41, 95% CI = [1.37, 1.58]) and indirect (HR = 1.07, 95% CI = [1.01, 1.23]) effects; 16.3% of the total effect of subclinical CVD on all-cause mortality was mediated by late-life depression. Discussion: Late-life depression accounts for little, if any, of the association between subclinical CVD, a risk factor of all-cause mortality, and all-cause mortality.

Original language	English (US)
Pages (from-to)	652-666
Number of pages	15
Journal	Journal of aging and health
Volume	31
Issue number	4
DOIs	https://doi.org/10.1177/0898264317744921
State	Published - Apr 1 2019

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: N.M.A. was supported by fellowship from the Epidemiology and Biostatistics of Aging Training Grant (5T32AG000247). This research was supported by contracts HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grants U01HL080295 and U01HL130114 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 from the National Institute on Aging (NIA). A full list of principal Cardiovascular Health Study (CHS) investigators and institutions can be found at CHS-NHLBI.org. The sponsor did not play any direct role in the design, methods, subject recruitment, data collections, analysis, and preparation of the article.

Keywords

depression
mortality
subclinical cardiovascular disease

ASJC Scopus subject areas

Health(social science)
Life-span and Life-course Studies
Sociology and Political Science

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "Role of Late-Life Depression in the Association of Subclinical Cardiovascular Disease With All-Cause Mortality: Cardiovascular Health Study",

abstract = "Objectives: To evaluate whether late-life depression mediates the association of subclinical cardiovascular disease (CVD) with all-cause mortality. Method: Using data from 3,473 Cardiovascular Health Study participants, the Cox proportional hazards model was used to examine the direct and indirect (via late-life depression) effects of the association between baseline subclinical CVD and all-cause mortality with weights derived from multivariable logistic regression of late-life depression on subclinical CVD. Results: Subclinical CVD led to a higher risk of all-cause mortality (hazard ratio [HR] = 1.51, 95% confidence interval, [CI] = [1.42, 1.94]). Total effect of subclinical CVD on all-cause mortality was decomposed into direct (HR = 1.41, 95% CI = [1.37, 1.58]) and indirect (HR = 1.07, 95% CI = [1.01, 1.23]) effects; 16.3% of the total effect of subclinical CVD on all-cause mortality was mediated by late-life depression. Discussion: Late-life depression accounts for little, if any, of the association between subclinical CVD, a risk factor of all-cause mortality, and all-cause mortality.",

keywords = "depression, mortality, subclinical cardiovascular disease",

author = "Armstrong, {Nicole M.} and Carlson, {Michelle C.} and Xue, {Qian Li} and Jennifer Schrack and Carnethon, {Mercedes R.} and Chaves, {Paulo H.M.} and Gross, {Alden L.}",

note = "Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: N.M.A. was supported by fellowship from the Epidemiology and Biostatistics of Aging Training Grant (5T32AG000247). This research was supported by contracts HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grants U01HL080295 and U01HL130114 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 from the National Institute on Aging (NIA). A full list of principal Cardiovascular Health Study (CHS) investigators and institutions can be found at CHS-NHLBI.org. The sponsor did not play any direct role in the design, methods, subject recruitment, data collections, analysis, and preparation of the article. Publisher Copyright: {\textcopyright} The Author(s) 2017.",

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T2 - Cardiovascular Health Study

AU - Armstrong, Nicole M.

AU - Carlson, Michelle C.

AU - Xue, Qian Li

AU - Schrack, Jennifer

AU - Carnethon, Mercedes R.

AU - Chaves, Paulo H.M.

AU - Gross, Alden L.

N1 - Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: N.M.A. was supported by fellowship from the Epidemiology and Biostatistics of Aging Training Grant (5T32AG000247). This research was supported by contracts HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grants U01HL080295 and U01HL130114 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 from the National Institute on Aging (NIA). A full list of principal Cardiovascular Health Study (CHS) investigators and institutions can be found at CHS-NHLBI.org. The sponsor did not play any direct role in the design, methods, subject recruitment, data collections, analysis, and preparation of the article. Publisher Copyright: © The Author(s) 2017.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Objectives: To evaluate whether late-life depression mediates the association of subclinical cardiovascular disease (CVD) with all-cause mortality. Method: Using data from 3,473 Cardiovascular Health Study participants, the Cox proportional hazards model was used to examine the direct and indirect (via late-life depression) effects of the association between baseline subclinical CVD and all-cause mortality with weights derived from multivariable logistic regression of late-life depression on subclinical CVD. Results: Subclinical CVD led to a higher risk of all-cause mortality (hazard ratio [HR] = 1.51, 95% confidence interval, [CI] = [1.42, 1.94]). Total effect of subclinical CVD on all-cause mortality was decomposed into direct (HR = 1.41, 95% CI = [1.37, 1.58]) and indirect (HR = 1.07, 95% CI = [1.01, 1.23]) effects; 16.3% of the total effect of subclinical CVD on all-cause mortality was mediated by late-life depression. Discussion: Late-life depression accounts for little, if any, of the association between subclinical CVD, a risk factor of all-cause mortality, and all-cause mortality.

AB - Objectives: To evaluate whether late-life depression mediates the association of subclinical cardiovascular disease (CVD) with all-cause mortality. Method: Using data from 3,473 Cardiovascular Health Study participants, the Cox proportional hazards model was used to examine the direct and indirect (via late-life depression) effects of the association between baseline subclinical CVD and all-cause mortality with weights derived from multivariable logistic regression of late-life depression on subclinical CVD. Results: Subclinical CVD led to a higher risk of all-cause mortality (hazard ratio [HR] = 1.51, 95% confidence interval, [CI] = [1.42, 1.94]). Total effect of subclinical CVD on all-cause mortality was decomposed into direct (HR = 1.41, 95% CI = [1.37, 1.58]) and indirect (HR = 1.07, 95% CI = [1.01, 1.23]) effects; 16.3% of the total effect of subclinical CVD on all-cause mortality was mediated by late-life depression. Discussion: Late-life depression accounts for little, if any, of the association between subclinical CVD, a risk factor of all-cause mortality, and all-cause mortality.

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Role of Late-Life Depression in the Association of Subclinical Cardiovascular Disease With All-Cause Mortality: Cardiovascular Health Study

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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