Department of Family Medicine and Public Health Sciences, Institute of Gerontology, Wayne State University, Detroit, MI 48202, USA.
Int Psychogeriatr. 2013 May;25(5):833-41. doi: 10.1017/S1041610212002062. Epub 2013 Jan 7.
To describe and examine the distribution, disability, and treatment associated with comorbid cardiovascular disease and major depressive disorder (CVD/MDD) among middle-aged and older ethnic/racial groups in the United States.
Cross-sectional data from a national probability sample of household resident adults (18 years and older; N = 16,423) living in the 48 coterminous United States were analyzed. We defined comorbid CVD/MDD as the presence of CVD (e.g. diabetes, hypertension, heart disease, and stroke) among adults who met MDD criteria at or after age 50 years.
Two-thirds of middle-aged and older American adults meeting criteria major depression at or after age 50 years also reported a diagnosis of comorbid CVD. Blacks were most likely to meet our comorbid CVD/MDD (74.4%) criteria. The disease burden of depression was also highest among Black respondents. Differences in treatment due to race/ethnicity and comorbidity were not statistically significant.
Our findings indicate that among middle-aged and older US adults meeting MDD criteria more than half would also report a comorbid CVD. Comorbid CVD/MDD rates varied between the considered ethnic/race groups. Functional impairment associated with comorbid CVD/MDD was higher than MDD alone; however, depression care rates did not differ remarkably. Among middle-aged and older adults meeting MDD criteria, comorbid CVD may be the rule rather than the exception.
描述并检查美国中老年族裔/种族群体中合并心血管疾病和重度抑郁症（CVD/MDD）的分布、残疾和治疗情况。
对居住在 48 个毗邻美国的家庭成年居民（18 岁及以上；N=16423）的全国概率样本的横断面数据进行分析。我们将合并 CVD/MDD 定义为 50 岁及以上符合 MDD 标准的成年人中存在 CVD（例如糖尿病、高血压、心脏病和中风）。
三分之二的中老年美国成年人在 50 岁及以上时符合重度抑郁症标准，同时也报告了合并 CVD 的诊断。黑人最有可能符合我们的合并 CVD/MDD（74.4%）标准。黑人受访者的抑郁疾病负担也最高。由于种族/民族和合并症而导致的治疗差异在统计学上没有显著意义。
我们的研究结果表明，在美国中老年成年人中，超过一半的符合 MDD 标准的成年人也会报告合并 CVD。合并 CVD/MDD 的发生率在考虑的族裔/种族群体之间存在差异。合并 CVD/MDD 引起的功能障碍高于单纯 MDD，但抑郁护理率没有显著差异。在符合 MDD 标准的中老年成年人中，合并 CVD 可能是常见现象而非例外。
