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Younger women with symptomatic peripheral arterial disease are at increased risk of depressive symptoms.
J Vasc Surg 2010; 52(3):637-44JV

Abstract

OBJECTIVES

Gender disparities, particularly among young women with cardiovascular disease, are a growing cause for concern. Depression is a prevalent and prognostically important comorbidity in peripheral arterial disease (PAD), but its prevalence has not been described as a function of gender and age. Therefore, we compared depressive symptoms at the time of PAD diagnosis and 6 months later by gender and age in PAD patients.

METHODS

The study enrolled 444 newly diagnosed patients with PAD (32% women) from two Dutch vascular outpatient clinics. Patients' depressive symptoms were assessed with the 10-item Center for Epidemiological Studies Depression Scale (CES-D) at baseline and 6 months later (CES-D scores >or=4 indicate significant depressive symptoms). Logistic regression models were constructed to evaluate the relationship among four gender-age groups (women <65 and >or=65 years; men <65 and >or=65 years [reference category]) and baseline and 6-month follow-up depressive symptoms.

RESULTS

Initially, 33% of women <65 years had significant depressive symptoms, and 6 months later, significant depressive symptoms had developed in 19% of the other younger women. These rates were much higher than other gender-age groups (range at baseline, 11%-16%; 6-month incidence, 6%-10%; P <or= .03). Adjusting for demographics and clinical factors, women <65 years experienced a fourfold greater odds of baseline (odds ratio [OR], 4.3; 95% confidence interval [CI], 2.2-8.7) and follow-up depressive symptoms (OR, 4.1; 95% CI, 2.0-8.4) compared with men >or=65 years, whereas other gender-age groups were not at risk. Additional adjustment for change in the ankle-brachial index did not explain the increased depression risk in younger women (OR, 3.5; 95% CI, 1.2-10.2).

CONCLUSIONS

Significant depressive symptoms are more common in younger women with PAD than in other gender-age groups, both at the time of diagnosis and 6 months later. To eradicate gender-based disparities in PAD, depression screening and monitoring in younger women may be an important direction for future research and intervention.

Authors+Show Affiliations

Center of Research on Psychology in Somatic diseases, Department of Medical Psychology and Neuropsychology, Tilburg University, Tilburg, The Netherlands. k.g.e.smolderen@uvt.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20576397

Citation

Smolderen, Kim G., et al. "Younger Women With Symptomatic Peripheral Arterial Disease Are at Increased Risk of Depressive Symptoms." Journal of Vascular Surgery, vol. 52, no. 3, 2010, pp. 637-44.
Smolderen KG, Spertus JA, Vriens PW, et al. Younger women with symptomatic peripheral arterial disease are at increased risk of depressive symptoms. J Vasc Surg. 2010;52(3):637-44.
Smolderen, K. G., Spertus, J. A., Vriens, P. W., Kranendonk, S., Nooren, M., & Denollet, J. (2010). Younger women with symptomatic peripheral arterial disease are at increased risk of depressive symptoms. Journal of Vascular Surgery, 52(3), pp. 637-44. doi:10.1016/j.jvs.2010.04.025.
Smolderen KG, et al. Younger Women With Symptomatic Peripheral Arterial Disease Are at Increased Risk of Depressive Symptoms. J Vasc Surg. 2010;52(3):637-44. PubMed PMID: 20576397.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Younger women with symptomatic peripheral arterial disease are at increased risk of depressive symptoms. AU - Smolderen,Kim G, AU - Spertus,John A, AU - Vriens,Patrick W, AU - Kranendonk,Steef, AU - Nooren,Maria, AU - Denollet,Johan, Y1 - 2010/06/23/ PY - 2010/02/19/received PY - 2010/04/09/revised PY - 2010/04/11/accepted PY - 2010/6/26/entrez PY - 2010/6/26/pubmed PY - 2010/9/29/medline SP - 637 EP - 44 JF - Journal of vascular surgery JO - J. Vasc. Surg. VL - 52 IS - 3 N2 - OBJECTIVES: Gender disparities, particularly among young women with cardiovascular disease, are a growing cause for concern. Depression is a prevalent and prognostically important comorbidity in peripheral arterial disease (PAD), but its prevalence has not been described as a function of gender and age. Therefore, we compared depressive symptoms at the time of PAD diagnosis and 6 months later by gender and age in PAD patients. METHODS: The study enrolled 444 newly diagnosed patients with PAD (32% women) from two Dutch vascular outpatient clinics. Patients' depressive symptoms were assessed with the 10-item Center for Epidemiological Studies Depression Scale (CES-D) at baseline and 6 months later (CES-D scores >or=4 indicate significant depressive symptoms). Logistic regression models were constructed to evaluate the relationship among four gender-age groups (women <65 and >or=65 years; men <65 and >or=65 years [reference category]) and baseline and 6-month follow-up depressive symptoms. RESULTS: Initially, 33% of women <65 years had significant depressive symptoms, and 6 months later, significant depressive symptoms had developed in 19% of the other younger women. These rates were much higher than other gender-age groups (range at baseline, 11%-16%; 6-month incidence, 6%-10%; P <or= .03). Adjusting for demographics and clinical factors, women <65 years experienced a fourfold greater odds of baseline (odds ratio [OR], 4.3; 95% confidence interval [CI], 2.2-8.7) and follow-up depressive symptoms (OR, 4.1; 95% CI, 2.0-8.4) compared with men >or=65 years, whereas other gender-age groups were not at risk. Additional adjustment for change in the ankle-brachial index did not explain the increased depression risk in younger women (OR, 3.5; 95% CI, 1.2-10.2). CONCLUSIONS: Significant depressive symptoms are more common in younger women with PAD than in other gender-age groups, both at the time of diagnosis and 6 months later. To eradicate gender-based disparities in PAD, depression screening and monitoring in younger women may be an important direction for future research and intervention. SN - 1097-6809 UR - https://www.unboundmedicine.com/medline/citation/20576397/Younger_women_with_symptomatic_peripheral_arterial_disease_are_at_increased_risk_of_depressive_symptoms_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(10)00944-4 DB - PRIME DP - Unbound Medicine ER -