부산대학교 도서관

Depression affects approximately 1.5% of American adults and incidence increases with age (5% of adults over 60). Incidence of dementia and psychiatric diseases also increase with age. Deeper understanding of contributing factors can aid in the prevention and treatment of these disorders. PURPOSE: To identify cardiovascular abnormalities that may underlie these illnesses. METHODS: 2,306 hospital patients were evaluated for cardiovascular and cognitive health. Demographic information, anthropometric values, clinical tests, and diagnostic history were collected. Independent variables were heart rate, blood pressure, and diagnosis of hypertension. Dependent variables were depression, dementia, cerebrovascular accidents, and psychiatric disorders. Descriptive statistics characterized the sample. Logistic regressions tested the effect of the cardiovascular predictors on cerebral and psychological outcomes. Significance was set at P<0.05. RESULTS: 23 patients had depression, 115 were diagnosed with dementia, 92 experienced a cerebrovascular accident, and 161 had a psychiatric illness. Patients with hypertension were diagnosed with depression 120% more frequently (P=0.045); 56% of depressed patients were hypertensive. Among patients with depression, there was a 264% increase in the odds of a dementia diagnosis (P=0.006). In patients with dementia, systolic blood pressure (SBP) was 13mmHg (9%) higher (P<0.001), pulse pressure was 13 mmHg (23%) higher (P<0.001), and heart rate was 7 bpm (8%) lower (P<0.001). Patients with hypertension were diagnosed with dementia 379% more frequently than normotensive patients (P<0.001). A diagnosis of hypertension also corresponded to 436% higher incidence of cerebrovascular accidents (P<0.001). Controlling for age, there was a 2.2-fold increase in the odds of an adverse event in patients with dementia (P=0.005). However, patients with psychiatric disorders had SBP that was 5 mmHg (4%) lower (P=0.018); similarly, pulse pressure was 5 mmHg (7%) lower (P=0.007). CONCLUSIONS: These findings support the hypothesis that cardiovascular deterioration coincides with increased risk for depression and neurocognitive issues. Aerobic exercise training oriented toward improved cardiovascular health likely reduces adverse events and psychological decline. [ABSTRACT FROM AUTHOR]