A combination of depression and decreased physical function further worsens the prognosis of patients with chronic cardiovascular disease
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Abstract
Background: Patients with Cardiovascular Disease (CVD) have high rates of depression and decreased physical function. In addition, the physical function has been reported to decline in patients with depression. However, there is no clear relationship between depression and physical function in patients with CVD. Moreover, the effects of the combination of depression and decreased physical function on prognosis are unclear. This study was performed to clarify the relationship between depression and physical function, in the prognosis of patients with CVD.
Methods: The study population consisted of 472 patients with chronic CVD. We investigated depression by Hospital Anxiety and Depression Scale (HADS), and physical function by grip strength, quadriceps isometric strength, gait speed, and 6-Minute Walking Distance (6MWD). The prognosis was investigated in patients divided into three groups according to HADS and physical function.
Results: Among the 472 patients, 109 (23.1%) had depressive tendency according to HADS. An analysis of covariance, all physical function showed significantly low values in combination with depressive tendency. Kaplan–Meier analysis followed by Bonferroni’s multiple comparison test revealed that the incidences of all-cause mortality and readmission due to heart failure were significantly higher in patients with depressive and decreased 6MWD than in those with only one feature. In cox proportional hazards analysis, only the combination of depressive tendency and decreased 6MWD further increased the risk of all-cause mortality and readmission due to heart failure.
Conclusions: Depressive tendency is associated with decreased physical function, and their combination is associated with poor prognosis in patients with chronic CVD.
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