Depressive symptoms and risk of functional decline and death in patients with heart failure

AbstractOBJECTIVESWe sought to examine whether depressive symptoms are associated with poorer prognosis in patients with heart failure.BACKGROUNDDepression is an established risk factor for poor outcome in patients with coronary heart disease (CHD). Little is known of its role in patients with heart failure.METHODSWe prospectively followed 391 patients ≥50 years of age who met criteria for decompensated heart failure on hospital admission. The outcome of the study was death or decline in activities of daily living (ADL) at six months, relative to baseline. Depressive symptoms were measured at baseline by means of the Geriatric Depression Scale, Short-Form, with 6 to 7 symptoms, 8 to 10 symptoms and ≥11 symptoms indicating mild, moderate and severe levels of depressive symptoms, respectively.RESULTSThere was a strong and graded association between the severity of depressive symptoms at baseline and the rate of the combined end point of either functional decline or death at six months. After adjustment for demographic factors, medical history, baseline functional status and clinical severity, patients with ≥11 depressive symptoms, compared with those with