TY - JOUR
T1 - Depression, hypertension, and comorbidity
T2 - Disentangling their specific effect on disability and cognitive impairment in older subjects
AU - Scuteri, Angelo
AU - Spazzafumo, Liana
AU - Cipriani, Luca
AU - Gianni, Walter
AU - Corsonello, Andrea
AU - Cravello, Luca
AU - Repetto, Lazzaro
AU - Bustacchini, Silvia
AU - Lattanzio, Fabrizia
AU - Sebastiani, Maurizio
PY - 2011/5
Y1 - 2011/5
N2 - We aimed to demonstrate that depression and hypertension are associated independently of each other with disability and cognitive impairment in older subjects and that such an association is not attributable to number and severity of comorbidities. An observational study was performed on elderly patients admitted to the Hospital Network of the Italian National Research Center on Aging (INRCA) from January 2005 to December 2006. Depression was defined according to 15-item geriatric depression scale (GDS) score; physical disability according to activities of daily living (ADL) and instrumental activities of daily living (IADL) scores; cognitive impairment on the mini-mental state examination (MMSE) test; the number and severity of comorbidities by means of physician-administered cumulative illness rating scale (CIRS). Among 6180 older subjects (age = 79.3 ± 5.8 years; 47% men), 48.3% were normotensive, 21.8% normotensive depressed, 21.7% hypertensive, and 8.2% hypertensive and depressed. Both depression and hypertension remained significantly associated with functional disability and cognitive impairment. When controlling for age, gender, the number and severity of comorbidities, hypertension was associated with a significantly higher likelihood of having functional disability or cognitive impairment only in the presence of depression (odds ratio = OR = 2.02, 95% confidence interval = 95%CI = 1.60-2.54, p<0.001 for functional disability; OR = 2.21, 95%CI = 1.79-2.74, p<0.001 for cognitive impairment) as compared to normotensive controls without depression. We conclude that depression per se' or co-occurrence of hypertension and depression is associated with higher functional disability and cognitive impairment in older subjects. This effect is not attributable to the number or to the severity of comorbidities.
AB - We aimed to demonstrate that depression and hypertension are associated independently of each other with disability and cognitive impairment in older subjects and that such an association is not attributable to number and severity of comorbidities. An observational study was performed on elderly patients admitted to the Hospital Network of the Italian National Research Center on Aging (INRCA) from January 2005 to December 2006. Depression was defined according to 15-item geriatric depression scale (GDS) score; physical disability according to activities of daily living (ADL) and instrumental activities of daily living (IADL) scores; cognitive impairment on the mini-mental state examination (MMSE) test; the number and severity of comorbidities by means of physician-administered cumulative illness rating scale (CIRS). Among 6180 older subjects (age = 79.3 ± 5.8 years; 47% men), 48.3% were normotensive, 21.8% normotensive depressed, 21.7% hypertensive, and 8.2% hypertensive and depressed. Both depression and hypertension remained significantly associated with functional disability and cognitive impairment. When controlling for age, gender, the number and severity of comorbidities, hypertension was associated with a significantly higher likelihood of having functional disability or cognitive impairment only in the presence of depression (odds ratio = OR = 2.02, 95% confidence interval = 95%CI = 1.60-2.54, p<0.001 for functional disability; OR = 2.21, 95%CI = 1.79-2.74, p<0.001 for cognitive impairment) as compared to normotensive controls without depression. We conclude that depression per se' or co-occurrence of hypertension and depression is associated with higher functional disability and cognitive impairment in older subjects. This effect is not attributable to the number or to the severity of comorbidities.
KW - Cognitive impairment
KW - Comorbidity
KW - Depression in the elderly
KW - Disability in the elderly
KW - Hypertension
UR - http://www.scopus.com/inward/record.url?scp=79953086057&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79953086057&partnerID=8YFLogxK
U2 - 10.1016/j.archger.2010.04.002
DO - 10.1016/j.archger.2010.04.002
M3 - Article
C2 - 20416961
AN - SCOPUS:79953086057
VL - 52
SP - 253
EP - 257
JO - Archives of Gerontology and Geriatrics
JF - Archives of Gerontology and Geriatrics
SN - 0167-4943
IS - 3
ER -