Depressive symptoms and six-year cardiovascular mortality in elderly patients with and without heart failure

Objectives. To evaluate whether depressive symptoms ( DS) in elderly patients with heart failure ( HF) in the community is associated with increased mortality. Design. A cohort of 510 elderly patients ( 65-82 years) in a primary healthcare setting with symptoms associated with HF underwent a clinical and echocardiographic examination. A left ventricular ejection fraction ( LVEF) < 40% indicated HF. The mental health index scale was used to screen for DS. Cardiovascular and all-cause mortality was registered over 6 years. Results. After adjustments those with DS had an increased risk ( HR) of 3.0 ( CI 95% 1.6-5.5, p = 0.0001) and 2.2 ( CI 95% 1.3-3.7, p = 0.0004) of cardiovascular and all-cause mortality, respectively. Patients with HF and DS had the highest risk of cardiovascular mortality, HR 15.7 ( CI 95% 4.8-52.2) compared to patients with HF without DS and those with LVEF >= 50% and normal left ventricular diastolic function with and without DS. Conclusion. DS in elderly patients with HF is independently associated with increased mortality. Screening for DS is recommended as part of the clinical routine in managing patients with HF.