Department of Cardiology, Faculty of Medicine, Kindai University, 377-2, Ohnohigashi, Osakasayama 5898511, Japan.
Department of Forensic Medicine, Faculty of Medicine, Kindai University, 377-2, Ohnohigashi, Osakasayama 5898511, Japan.
Eur J Cardiovasc Nurs. 2023 May 25;22(4):392-399. doi: 10.1093/eurjcn/zvac064.
Psychological distress is associated with poor prognosis in patients with cardiovascular disease (CVD). However, factors related to psychological distress in elderly patients with CVD are less understood. We aim to investigate the rate of psychological distress in elderly patients with CVD in comparison with that of patients without CVD and to examine the clinical, socio-economic, and lifestyle factors associated with this condition.
Data from a nationwide population-based study in Japan of patients aged ≥60 years were extracted, and 1:1 propensity score matching was conducted of patients with and without CVD. Psychological distress was assessed using the K6 scale, on which a score ≥6 was defined as psychological distress. Of the 24 388 matched patients, the rate of psychological distress was significantly higher among patients with CVD compared with those without CVD (29.8 vs. 20.5%, P < 0.0001). The multivariate analysis revealed that female sex, comorbidities, except for hypertension, current smoking status, daily sleep duration of <6 vs. ≥8 h, home renter vs. owner, retired status, having a walking disability, and lower monthly household expenditure were independently associated with psychological distress. Walking disability was observed to be in greatest association with psychological distress (odds ratio 2.69, 95% confidence interval 2.46-2.93).
Elderly patients with CVD were more likely to have psychological distress compared with those without CVD. Multiple factors, including clinical, socio-economic, and lifestyle variables, were associated with psychological distress. These analyses may help healthcare providers to identify high-risk patients with psychological distress in a population of older adults with CVD.
心理困扰与心血管疾病（CVD）患者的预后不良有关。然而，老年人 CVD 患者心理困扰的相关因素了解较少。我们旨在调查老年 CVD 患者心理困扰的发生率，并与无 CVD 的患者进行比较，并探讨与该疾病相关的临床、社会经济和生活方式因素。
从日本一项全国性的≥60 岁患者人群研究中提取数据，并对有和无 CVD 的患者进行 1:1 倾向评分匹配。使用 K6 量表评估心理困扰，得分≥6 定义为心理困扰。在 24388 对匹配患者中，CVD 患者的心理困扰发生率明显高于无 CVD 患者（29.8%比 20.5%，P<0.0001）。多变量分析显示，女性、除高血压以外的合并症、当前吸烟状况、每日睡眠时间<6 小时与≥8 小时、租房者与房主、退休状态、步行障碍以及每月家庭支出较低与心理困扰独立相关。步行障碍与心理困扰的相关性最大（比值比 2.69，95%置信区间 2.46-2.93）。
与无 CVD 的患者相比，老年 CVD 患者更有可能出现心理困扰。多种因素，包括临床、社会经济和生活方式变量，与心理困扰相关。这些分析可能有助于医疗保健提供者在老年 CVD 人群中识别有心理困扰风险的高危患者。
