Abstract 3658: The Prevalence of Depression and Anxiety among Persons Aged 45 Years and Older by Cardiovascular disease Status, 2006
Depression and anxiety commonly occur after nonfatal cardiovascular events. It is imperative to learn the extent of depression and anxiety among middle-aged and elder adults with cardiovascular disease at the population level. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, telephone survey of non-institutionalized adults. In 2006, an Anxiety and Depression Module (ADM) was administered in 38 States, Puerto Rico, the US Virgin Islands, and the District of Columbia. Eight ADM questions were adapted from the validated Patient Health Questionnaire 8. A standardized summary depression severity score from the eight questions was dichotomized as ≥10 or <10. A score ≥10 has been shown to have an 88% sensitivity and specificity for major depression. Two questions assessed lifetime diagnosis of depressive and anxiety disorders. Cardiovascular disease (CVD) was assessed using three questions on coronary heart disease (including angina and myocardial infarction) and stroke. The analysis was performed using SUDAAN 9.0 to account for the complex sampling design of BRFSS. Adjusted prevalence ratio (APR) was obtained by the LOGLINK procedure after adjustment for age, sex, race/ethnicity, education level, marital status and employment status. Results showed among persons aged 45 years and older (n=129,499), the prevalence of a CVD history was 15.3% (95% CI=14.9%-15.7%). The prevalence of CHD and stroke was 12.4% (95% CI=12.0%-12.7%) and 5.0% (95% CI=4.8%-5.2%), respectively. The prevalence of a current depression severity score ≥10 was 7.7% (95% CI=7.3%-8.0%). The prevalence of a lifetime diagnosis of depressive and anxiety disorders was 16.2% (95% CI=15.8%-16.6%) and 11.0% (95% CI=10.6%-11.3%) respectively. Persons with a CVD history were more likely to have a depression severity score ≥10 (15.8% vs. 7.1%, APR [95% CI] = 1.69 [1.54 –1.85]) or have a lifetime diagnosis of depressive (22.3% versus 15.1%, APR [95% CI] = 1.56 [1.45–1.67]) or anxiety disorders (16.6% versus 10.0%, APR [95% CI] = 1.46 [1.37–1.54]). The findings underscore the importance of assessing mental health status in chronic care and management of cardiovascular disease.