Key result
Subclinical cardiovascular disease was associated with a higher risk of all-cause mortality (HR 1.51; 95% CI 1.42-1.94), with late-life depression mediating only 16.3% of this effect.
Why the study?
Does late-life depression mediate the association between subclinical cardiovascular disease and all-cause mortality?
Cohort (n=3,473)
Does late-life depression mediate the association between subclinical cardiovascular disease and all-cause mortality?
Late-life depression accounts for only a small fraction of the increased mortality risk associated with subclinical cardiovascular disease.
Subclinical CVD was associated with higher mortality largely independent of depression; leaves open alternative pathways for prospective study.
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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Armstrong et al. (2017) conducted a cohort in Subclinical cardiovascular disease (n=3,473). Subclinical cardiovascular disease vs. No subclinical cardiovascular disease was evaluated on All-cause mortality (HR 1.51, 95% CI 1.42-1.94). Subclinical cardiovascular disease was associated with a higher risk of all-cause mortality (HR 1.51; 95% CI 1.42-1.94), with late-life depression mediating only 16.3% of this effect.
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