Comparing cardiovascular disease incidence and prevalence between depressed and non-depressed older persons over time: Cohort differences in the Longitudinal Aging Study Amsterdam

Objective: Previous studies suggest that prevention of cardiovascular disease (CVD) is more difficult in depressed persons. Although the prevalence and incidence of CVD decreased over the past decades, it is uncertain whether this is also true for depressed persons. This study examined whether changes in the prevalence and incidence of CVD differ between depressed and non-depressed older persons. Methods: Longitudinal data from three community-based representative birth cohorts aged 55-65 years of the Longitudinal Aging Study Amsterdam were used; N = 1070 born in 1926-1937, N = 995 born in 1938-1947, N = 1019 born in 1948-1957. The outcome included fatal and non-fatal CVD. Depression was defined as >= 16 points on the Center for Epidemiological Studies Depression Scale or a general practitioner's diagnosis of depression. Data were analysed with for age and sex adjusted logistic regression and cox regression models. Results: Comparing cohort 2 and 3 with cohort 1 in the complete sample, the prevalence of CVD decreased by 2% (OR = 0.98, 95%CI = 0.76-1.26) and 32% (OR = 0.68, 95%CI = 0.52-0.89), respectively, and the three-year incidence of CVD decreased by 6% (OR = 0.94, 95%CI = 0.63-1.41) and 26% (OR = 0.74, 95%CI = 0.48-1.15), respectively. The 13-year incidence of CVD decreased by 19% (HR = 0.81, 95%CI = 0.67-0.99) in cohort 2 compared to cohort 1. These decreases did not differ statistically significantly between depressed and non-depressed respondents (p-values of interaction terms: 0.35-0.98). Conclusion: Substantial decreases in the prevalence and incidence of CVD were observed in depressed and non-depressed older persons. Although this is encouraging, cardiovascular risk remained higher in depressed persons over time, warranting tailored prevention programs for depressed older persons.