Abstract P368: N-Terminal Pro Brain Natriuretic Peptide and Microsize Myocardial Infarctions in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Background: N-terminal pro brain natriuretic peptide (NT-proBNP) has been associated with myocardial infarctions (MI), but less is known about the relationship between NT-proBNP and very small non ST-elevation MIs now routinely detectable with modern troponin assays. Since these “microsize MIs” confer high long-term coronary heart disease (CHD) risks, we examined the association of NT-proBNP with incident acute CHD events, total MIs, and two MI subtypes: microsize and typical MIs. Methods: REGARDS is a national cohort of 30,237 US community-dwelling black and white adults aged ≥45 recruited from 2003 to 2007. Expert-adjudicated outcomes included incident typical MIs (definite/probable MI with peak troponin ≥0.5 μg/L), incident microsize MIs (definite/probable MI with peak troponin <0.5 μg/L), and total incident acute CHD (nonfatal MIs or CHD deaths). Low-level troponin elevations with the peak at least twice the upper limit of normal which did not have a rising and/or falling pattern or which had a non-ischemic cause were not considered MIs. We assembled a case-cohort study comprised of 1) a stratified random sample of participants free of CHD at baseline and not on dialysis (n=849); and 2) all incident acute CHD cases through 12/31/2010. NT-proBNP was measured in case-cohort participants at baseline and was dichotomized on the sample’s median value (73.3 pg/mL). Adjusted weighted Cox proportional hazards regression models examined associations of NT-proBNP and CHD endpoints, controlling for sociodemographics and CHD risk factors. Results: Over a median of 5.9 years follow-up, 139 microsize MIs, 315 typical MIs, and 146 non-MI CHD deaths occurred. NT-proBNP was associated with all CHD outcomes examined (Table). Conclusions: Above-median NT-proBNP was independently and strongly associated with all CHD endpoints with a suggestion of greater risks of incident microsize MI. A better understanding of the pathophysiologic differences between typical and microsize MIs is needed.

Download Full-text

Abstract P316: Prehypertension and Incident Acute Coronary Heart Disease in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽

10.1161/circ.127.suppl_12.ap316 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Stephen P Glasser ◽

Yulia Khodneva ◽

Daniel Lackland ◽

Ronald Prineas ◽

Monika Safford

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Racial Differences ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Cox Proportional Hazards Models ◽

Chd Risk ◽

Regards Study ◽

Chd Risk Factors

Objective: The independent prognostic value of prehypertension (preHTN) for incident coronary heart disease (CHD) remains unsettled. Using the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study, we examined associations between preHTN and incident acute CHD and CVD death. Methods: REGARDS includes 30,239 black and white community-dwelling adults age 45 and older at baseline. Recruitment occurred from 2003-7, with baseline interviews and in-home data collection for physiologic measures. Follow-up is conducted by telephone every 6 months to detect events and deaths, which are adjudicated by experts. Systolic BP was categorized into <120 mmHg (n=4385), 120-129 mmHg (n=4000), 130-139 (n=2066), and hypertension was categorized into controlled (<140/90 mmHg on treatment) (n=8378), and uncontrolled (>140/90 mmHg) (n=5364). Incident acute CHD was defined as definite or probable myocardial infarction (MI) or acute CHD death. CVD death was defined as acute CHD, stroke, heart failure or other cardiovascular disease related. Cox proportional hazards models estimated the hazard ratios (HR) for incident CHD by BP categories, adjusting for sociodemographics and CHD risk factors. Results: The 23,393 participants free of CHD at baseline were followed for a median of 4.4 years. Mean age was 64.1, 58% were women and 42% were black. There was a significant interaction between sex and BP categories, therefore analyses were stratified by sex. There were 252 non-fatal and fatal acute CHD events among women and 407 among men. Among women, compared with SBP<120 mmHg, BP categories above SBP 120 mmHg were associated with incident CHD (adjusted HR for SBP120-129 mmHg=1.94 {95% CI 1.04-3.62]; SBP 130-139 mmHg=1.92 {0.95-3.87}; controlled HTN=2.16 {1.25-3.75}; uncontrolled HTN=3.25 {1.87-5.65}) in fully adjusted models. Among men, only uncontrolled HTN was associated with incident CHD (HR=1.55 {1.11-2.17}). Conclusion: In this sample, preHTN may be associated with incident CHD among women but not men.

Download Full-text

Association of Brain Natriuretic Peptide With Mortality in Exceptionally Long-Lived Families

Innovation in Aging ◽

10.1093/geroni/igaa057.681 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 211-211

Author(s):

Allison Kuipers ◽

Robert Boudreau ◽

Mary Feitosa ◽

Angeline Galvin ◽

Bharat Thygarajan ◽

...

Keyword(s):

Older Adults ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Sex Education ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Time To Event ◽

Healthy Older Adults ◽

Secondary Analyses

Abstract Natriuretic peptides are produced within the heart and released in response to increased chamber wall tension and heart failure (HF). N-Terminal prohormone Brain Natriuretic Peptide (NT-proBNP) is a specific natriuretic peptide commonly assayed in persons at risk for HF. In these individuals, NT-proBNP is associated with future disease prognosis and mortality. However, its association with mortality among healthy older adults remains unknown. Therefore, we determined the association of NT-proBNP with all-cause mortality over a median follow-up of 10 years in 3253 individuals free from HF at baseline in the Long Life Family Study, a study of families recruited for exceptional longevity. We performed cox proportional hazards analysis (coxme in R) for time-to event (mortality), adjusted for field center, familial relatedness, age, sex, education, smoking, alcohol, physical activity, BMI, diabetes, hypertension, and cancer. In addition, we performed secondary analyses among individuals (N=2457) within the normal NT-proBNP limits at baseline (<125pg/ml aged <75 years; <450pg/ml aged ≥75 years). Overall, individuals were aged 32-110 years (median 67 years; 44% male), had mean NT-proBNP of 318.5 pg/ml (median 91.0 pg/ml) and 1066 individuals (33%) died over the follow-up period. After adjustment, each 1 SD greater baseline NT-proBNP was associated with a 1.30-times increased hazard of mortality (95% CI: 1.24-1.36; P<0.0001). Results were similar in individuals with normal baseline NT-proBNP (HR: 1.21; 95% CI: 1.11-1.32; P<0.0001). These results suggest that NT-proBNP is a strong and specific biomarker for mortality in older adults independent of current health status, even in those with clinically-defined normal NT-proBNP.

Download Full-text

Abstract P030: Variations in Cardiovascular Risk Among Different Clinical Presentations of Metabolic Syndrome in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Circulation ◽

10.1161/circ.125.suppl_10.ap030 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Todd M Brown ◽

Joshua Richman ◽

Vera Bittner ◽

Cora E Lewis ◽

Jenifer Voeks ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Racial Differences ◽

Central Obesity ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Next Of Kin ◽

Cox Proportional Hazards Models ◽

Chd Risk ◽

The Individual

Background: Some individuals classified as having metabolic syndrome (MetSyn) are centrally obese while others are not with unclear implications for cardiovascular (CV) risk. Methods: REGARDS is following 30,239 individuals ≥45 years of age living in 48 states recruited from 2003-7. MetSyn risk factors were defined using the AHA/NHLBI/IDF harmonized criteria with central obesity being defined as ≥88 cm in women and ≥102 cm in men. Participants with and without central obesity were stratified by whether they met >2 or ≤2 of the other 4 MetSyn criteria, resulting in the creation of 4 groups. To ascertain CV events, participants are telephoned every 6 months with expert adjudication of potential events following national consensus recommendations and based on medical records, death certificates, and interviews with next-of-kin or proxies. Acute coronary heart disease (CHD) was defined as definite or probable myocardial infarction or acute CHD death. To determine the association between these 4 groups and incident acute CHD, we constructed Cox proportional hazards models in those free of CHD at baseline by race/gender group, adjusting for sociodemographic variables. Results: A total of 20,018 individuals with complete data on MetSyn components were free of baseline CHD. Mean age was 64+/−9 years, 58% were women, and 42% were African American. Over a mean follow-up of 3.4 (maximum 5.9) years, there were 442 acute CHD events. In the non-centrally obese with>2 other risk factors, risk for CHD was higher for all but AA men, though significant only for white men. In contrast, in the centrally obese with >2 other risk factors, risk was doubled for women, but only non-significantly and modestly increased for men. Only AA women with central obesity and ≤2 other risk factors had increased CHD risk (Table). Conclusion: The CHD risk associated with the MetSyn varies by the presence of central obesity as well as the race and gender of the individual.

Download Full-text

Abstract P041: Serum Magnesium and the Incidence of Coronary Heart Disease Over 20 Years of Follow-up: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.137.suppl_1.p041 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Mary R Rooney ◽

Jeffrey R Misialek ◽

Alvaro Alonso ◽

Aaron R Folsom ◽

Erin D Michos ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Proportional Hazards ◽

Serum Magnesium ◽

A Priori ◽

Cox Proportional Hazards ◽

Chd Risk ◽

Chd Risk Factors ◽

Aric Study

Introduction: Low serum magnesium (Mg) levels have been associated with increased coronary heart disease (CHD) risk, likely acting through pathways such as hypertension, hyperglycemia or inflammation. An early (1998) ARIC paper evaluated this association, based on 319 events, and identified a sex-interaction whereby the inverse Mg-CHD association was stronger among women than men. Nearly 2,000 events have occurred since the prior publication. Hence, we sought to update the analysis. Hypothesis: We hypothesized serum Mg would be inversely and independently associated with long-term risk of CHD. Methods: A total of 14,465 ARIC study participants without CHD at visit 1 (baseline) were included. Serum Mg was measured at visit 1 (1987-89) and visit 2 (1990-92). Incident CHD events were identified through 2014 using annual telephone calls, hospital discharge lists and death certificates, and were adjudicated by physician review. Multivariable Cox proportional hazards regression models were used. Serum Mg was categorized into quintiles based on mean visit 1 and 2 concentrations. Based on prior findings in ARIC suggesting an interaction, we decided a priori to provide sex-stratified results. Results: Participants at baseline were mean±SD age 54±6y, 57% were women and 27% black. Serum Mg was 1.62±0.14 mEq/L overall, 1.62±0.14 mEq/L among women and 1.63±0.14 mEq/L among men. Over a median follow-up of 25 years, 1,939 CHD cases were identified. Overall, serum Mg was inversely and monotonically associated with CHD risk after adjustment for demographics, lifestyle factors and other CHD risk factors (Table, p-trend<0.001). The association was stronger among women (HR Q5 vs Q1=0.63) than men (HR=0.83), but the sex-interaction was not statistically significant (p>0.05). Conclusions: In this large community-based cohort, serum Mg was inversely associated with CHD risk. This association was slightly stronger among women than men. Further research is needed to understand if increasing Mg levels is a useful target for CHD prevention.

Download Full-text

Abstract 12: Skeletal Muscle Density, Not Size, is Beneficially Associated With Incident Coronary Heart Events: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽

10.1161/circ.141.suppl_1.12 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Jonathan Unkart ◽

John Bellettiere ◽

Britta A Larsen ◽

Michael H Criqui ◽

Chantal A Vella ◽

...

Keyword(s):

Skeletal Muscle ◽

Proportional Hazards ◽

Spinal Column ◽

Cox Proportional Hazards ◽

Muscle Size ◽

Muscle Area ◽

Muscle Density ◽

Ethnic Study ◽

Chd Risk ◽

Chd Risk Factors

Introduction: Fat infiltration into muscle reduces muscle density and increases the risk for metabolic dysfunction, mobility disability and mortality. We assessed abdominal muscle density and muscle area in relation to incident coronary heart disease (CHD) events. Methods: Adults (mean age 64.6 ± 9.6) from the Multi-Ethnic Study of Atherosclerosis body composition ancillary study had computed tomography (CT)-derived measures of muscle density, muscle area and visceral fat at the L2-L4 spinal column levels between 2002-05 and were followed for incident events. Using sex-stratified Cox proportional hazards regression, associations of muscle density and muscle area (in the same model) with CHD events were assessed using restricted cubic splines with adjustment for confounders including visceral adiposity and BMI. Results: After 10.3±2.9 years of follow up, 924 males had 70 CHD (7.6%) events and 945 females had 44 CHD (4.7%) events. Muscle density was higher in males (44.5±4.9 HU) than females (40.1±5.2 HU), as was muscle area (116.7±23.9 vs. 80.4±23.9 cm 2 , respectively). Among males, and in mutually adjusted models, each incremental SD of muscle density was inversely associated with CHD (HR=0.67; 95%CI=0.49-0.92), while each SD of muscle area was associated with higher risk of CHD (HR=1.75; 95%CI=1.34-2.28; Figure). Overall patterns were similar but less strong among females for density (HR=0.79; 95%CI=0.50-1.22) and area (HR=1.17; 95%CI=0.79-1.73). Conclusions: Greater muscle density is associated with lower CHD risk, while greater muscle size is associated with increased CHD risk. These associations were independent of traditional CHD risk factors and measures of visceral and total body adiposity. Quantity and quality of skeletal muscle may represent distinct aspects of aging and physical functioning that are important in heart health.

Download Full-text

Abstract P227: Depressive Symptoms and Incident CHD among African Americans and Whites: The Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study

Circulation ◽

10.1161/circ.127.suppl_12.ap227 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Mario Sims ◽

Nicole Redmond ◽

Yulia Khodneva ◽

Raegan Durant ◽

Jewell Halanych ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Depressive Symptoms ◽

African Americans ◽

Racial Disparities ◽

Racial Differences ◽

Community Dwelling ◽

Chd Risk ◽

Regards Study ◽

Chd Risk Factors

Objectives: African Americans (AA) have higher risk for coronary heart disease (CHD) outcomes than Whites. This racial disparity has been attributed to differences in risk factors such as hypertension, diabetes, smoking, and inactivity. Depression has been associated with CHD risk, both through behavioral factors and possibly through more direct mechanisms. Yet, the role of depressive symptoms in racial disparities in risk of CHD is not clear. Using the REGARDS Study, we examined the association between depressive symptoms and incident CHD. Hypothesis: Depressive symptoms are associated with incident CHD among AA, but not Whites. Methods: REGARDS is a national cohort of US community-dwelling adults aged >45 recruited from 2003 to 2007. Longitudinal associations of depressive symptoms with incident acute CHD (fatal CHD or nonfatal myocardial infarction or coronary revascularization) by race were examined among 24,261 participants (AA = 10,265; Whites =13,996) free of CHD at baseline, and observed through 12/31/09. Baseline depressive symptoms were defined by the 4-item Centers for Epidemiological Studies Depression Scale (CES-D), with continuous scores (0-12 range) dichotomized as normal (<4) or depressive symptoms (≥4). We estimated multivariable Cox proportional hazards models of incident CHD with depressive symptoms, adjusting for sociodemographics, CHD risk factors and health behaviors. Results: Overall mean follow-up was 4.2+1.5 years, CHD incidence was 8.3 events per 1000 person-years (n=366 events) among AA and 8.8 events per 1000 person-years (n=613 events) among Whites, p=0.0015. Depressive symptoms were more prevalent among AA (13.1%) than among Whites (8.5%), p<0.001. There was a significant interaction between race and depressive symptoms, thus models were stratified on race. After adjustment for age, sex, marital status and region, depressive symptoms were significantly associated with incident CHD among AA (HR 1.57 {95% CI 1.18-2.09}) but not among Whites (HR 1.11 {0.80-1.56}). After adding education, income, physical activity, smoking, alcohol consumption, diabetes, BMI, CRP, systolic blood pressure, cholesterol, albuminuria, use of blood pressure or statin medications, the relationship for AA was modestly attenuated but still significant (HR 1.35 {95% CI 1.01-1.81}). Conclusions: Depressive symptoms were associated with risk of incident CHD among AA but not Whites. Efforts to reduce racial disparities in CHD may need to address environmental and psychosocial factors that place AA at higher risk.

Download Full-text

Abstract 3742: Elevated Brain Natriuretic Peptide and C-reactive Protein Interactively Increased Cardiovascular and All-cause Mortality Risk in Hemodialysis Patients

Circulation ◽

10.1161/circ.116.suppl_16.ii_851 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Kyuichi Furuhashi ◽

Hideki Ishii ◽

Hiroshi Takahashi ◽

Toru Aoyama ◽

Takanobu Toriyama ◽

...

Keyword(s):

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Mortality Risk ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

C Reactive Protein ◽

Reactive Protein ◽

Risk Of Mortality ◽

All Cause Mortality ◽

Serum Crp

Background: It has been established that elevated brain natriuretic peptide (BNP) and C-reactive protein (CRP) levels are increasingly associated with cardiovascular (CV) morbidity. We examined the prognostic usefulness of combining BNP and CRP for predicting CV mortality in hemodialysis (HD) patients. Methods: Plasma BNP and serum CRP were measured consecutively in 500 HD patients. These patients were divided into 4 groups according to plasma BNP levels; Quartile 1 (Q1): < 45 ng/L, Q2: 145–266 ng/L, Q3: 267– 628 ng/L, and Q4: >628 ng/L, and serum CRP levels; Q1: <0.09 mg/dl, Q2: 0.09 – 0.27 mg/dl, Q3: 0.27–1.17mg/dl and Q4: >1.17mg/dl, respectively. All patients were followed up for 8 years. Results: On Cox proportional hazards analysis, hazard ratio (HR) of elevated BNP levels was 3.93 (95%CI 2.06 –7.52 for Q4 vs Q1) for CV mortality and 3.51 (95%CI 2.18 –5.64 for Q4 vs Q1) for all-cause mortality, respectively (both p<0.0001). Similarly, HR of elevated CRP levels was 6.00 (95%CI 2.89 –12.45) for CV mortality and 8.19 (95%CI 4.53–14.77) for all-cause mortality, respectively (both p<0.0001). In the setting of combination of BNP and CRP, the risk of CV mortality was 23.6-fold in the highest quartile on both BNP and CRP compared with the lowest quartile on both BNP and CRP. Similarly, the risk of mortality was 45.3-fold (Figure ). These variables were significant after adjustment for other CV risk factors. Conclusions: Elevated BNP and CRP interactively increased CV and all-cause mortality risk in HD patients. The combination of BNP and CRP is useful for risk stratification in HD patients because the combination of these variables is more closely related to outcome than either variable alone.

Download Full-text

Urinary N-terminal pro–B-type natriuretic peptide as a biomarker for cardiovascular events in a general Japanese population: the Hisayama Study

Environmental Health and Preventive Medicine ◽

10.1186/s12199-021-00970-0 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Keisuke Yamasaki ◽

Jun Hata ◽

Tomomi Ide ◽

Takuya Nagata ◽

Satoko Sakata ◽

...

Keyword(s):

Cardiovascular Risk ◽

Natriuretic Peptide ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Cox Proportional Hazards Model ◽

Coefficient Of Determination ◽

Serum Concentrations ◽

Adjusted Risk

Abstract Background Epidemiological evidence has shown that serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations, a diagnostic biomarker for heart failure, are positively associated with cardiovascular risk. Since NT-proBNP in serum is excreted in urine, it is hypothesized that urinary NT-proBNP concentrations are correlated with serum concentrations and linked with cardiovascular risk in the general population. Methods A total of 3060 community-dwelling residents aged ≥ 40 years without history of cardiovascular disease (CVD) were followed up for a median of 8.3 years (2007–2015). Serum and urinary concentrations of NT-proBNP at baseline were compared. The hazard ratios (HRs) and their 95% confidence intervals (CIs) for the association between NT-proBNP concentrations and the risk of developing CVD were computed using the Cox proportional hazards model. Results The median values (interquartile ranges) of serum and urinary NT-proBNP concentrations at baseline were 56 (32–104) pg/mL and 20 (18–25) pg/mL, respectively. There was a strong quadratic correlation between the serum and urinary concentrations of NT-proBNP (coefficient of determination [R2] = 0.72): urinary concentrations of 20, 27, and 43 pg/mL were equivalent to serum concentrations of 55, 125, and 300 pg/mL, respectively. During the follow-up period, 170 subjects developed CVD. The age- and sex-adjusted risk of CVD increased significantly with higher urinary NT-proBNP levels (P for trend < 0.001). This association remained significant after adjustment for traditional cardiovascular risk factors (P for trend = 0.009). The multivariable-adjusted risk of developing CVD almost doubled in subjects with urinary NT-proBNP of ≥ 43 pg/mL as compared to those with urinary NT-proBNP of ≤ 19 pg/mL (HR 2.07, 95% CI 1.20–3.56). Conclusions The present study demonstrated that urinary NT-proBNP concentrations were well-correlated with serum concentrations and were positively associated with cardiovascular risk. Given that urine sampling is noninvasive and does not require specially trained personnel, urinary NT-proBNP concentrations have the potential to be an easy and useful biomarker for detecting people at higher cardiovascular risk.

Download Full-text

Anhedonia as a Potential Risk Factor of Alzheimer’s Disease in a Community-Dwelling Elderly Sample: Results from the ZARADEMP Project

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041370 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1370

Author(s):

David Vaquero-Puyuelo ◽

Concepción De-la-Cámara ◽

Beatriz Olaya ◽

Patricia Gracia-García ◽

Antonio Lobo ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Potential Risk ◽

Proportional Hazards ◽

Univariate Analysis ◽

Population Sample ◽

Public Health Problem ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Major Public Health Problem

(1) Introduction: Dementia is a major public health problem, and Alzheimer’s disease (AD) is the most frequent subtype. Clarifying the potential risk factors is necessary in order to improve dementia-prevention strategies and quality of life. Here, our purpose was to investigate the role of the absence of hedonic tone; anhedonia, understood as the reduction on previous enjoyable daily activities, which occasionally is underdetected and underdiagnosed; and the risk of developing AD in a cognitively unimpaired and non-depressed population sample. (2) Method: We used data from the Zaragoza Dementia and Depression (ZARADEMP) project, a longitudinal epidemiological study on dementia and depression. After excluding subjects with dementia, a sample of 2830 dwellers aged ≥65 years was followed for 4.5 years. The geriatric mental state examination was used to identify cases of anhedonia. AD was diagnosed by a panel of research psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. A multivariate survival analysis and Cox proportional hazards regression model were performed, and the analysis was controlled by an analysis for the presence of clinically significant depression. (3) Results: We found a significant association between anhedonia cases and AD risk in the univariate analysis (hazard ratio (HR): 2.37; 95% CI: 1.04–5.40). This association persisted more strongly in the fully adjusted model. (4) Conclusions: Identifying cognitively intact individuals with anhedonia is a priority to implement preventive strategies that could delay the progression of cognitive and functional impairment in subjects at risk of AD.

Download Full-text

The Joint Effects of Loneliness and Depression on Mortality: Does Gender Matter?

Innovation in Aging ◽

10.1093/geroni/igaa057.1034 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 323-323

Author(s):

Ted Kheng Siang Ng ◽

Abhijit Visaria ◽

Angelique W M Chan ◽

Kheng Siang Ted Ng

Keyword(s):

Los Angeles ◽

Mortality Risk ◽

Proportional Hazards ◽

Depression Scale ◽

Well Being ◽

Joint Effect ◽

Epidemiologic Studies ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Increased Risk

Abstract Loneliness and depression are both associated with an increased risk of all-cause mortality among older adults. However, the evidence on the joint effect of loneliness and depression is scarce. Furthermore, previous research has rarely examined the modifying effects of gender. We investigated these questions using the Panel on Health and Aging of Singaporean Elderly, a nationally-representative cohort study of community-dwelling older Singaporean adults aged 60 and above, conducted in 2009 with two follow-up waves in 2011 and 2015 (N=4536). We operationalized six groups based on three categories of loneliness measured using the 3-item University of California, Los Angeles (UCLA) loneliness scale: always lonely, sometimes lonely, and never lonely; Two categories of depressive symptom scores were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D) scale: depressed and not depressed. Cox proportional hazards models were employed to estimate the mortality risks for each group, with an extensive set of covariates. Due to significant differences in the prevalence of loneliness and depression in different genders, we conducted gender-stratified analyses. Compared to being not depressed and never lonely, women who were depressed and sometimes lonely and who were not depressed but always lonely had a higher mortality risk. Men who were not depressed but sometimes lonely had a higher mortality risk. We conclude that loneliness appears to be the predominant construct in conferring excess mortality risk. Health policies and interventions addressing the factors common and unique to each gender may improve psychological well-being at older ages, thereby extending the lifespan.

Download Full-text