The mutual association between dyspnea and depressive symptoms in older adults: a 4-year prospective study

Abstract

Objectives: dyspnea in daily living (DDL), night-time dyspnea (NTD) and depression are common symptoms in older people. However, how changes in dyspnea may influence and be influenced by modifications in depressive symptoms, so far has not been fully evaluated. We aimed to estimate the extent to which both DDL and NTD could be mutually associated to depressive symptoms in older adults with chronic conditions.

Methods: this prospective study includes 2322 community-dwelling individuals aged ≥65 years enrolled in the Progetto Veneto Anziani (Pro.V.A.). At baseline and after 4.4 years, we evaluated the following parameters: DDL, assessed by the Medical Research Council dyspnea scale (MRC); self-reported NTD, assessed by personal interview; depressive symptoms, assessed using the Geriatric Depression Scale (GDS). The strength of the association between dyspnea and depression over the follow-up was evaluated through logistic regression and estimated by odds ratios and 95%Confidence Intervals (95%CI). Corrected risk ratios (RR) were then approximated from odds ratios.

Results: GDS changes over the follow-up positively correlated with MRC changes (β = 0.938). Individuals with baseline DDL or NTD and those with incident/worsening DDL showed higher risk of developing or worsening depressive symptoms compared with their counterparts (RR = 3.36 [95%CI 2.11-5.06] for incident depression in people with worsening DDL). Incident or persistent depression increased more than twice the risk of developing DDL and NTD (for incident depression RR = 2.33 [95%CI 1.85-2.83] for DDL, and RR = 2.01 [95%CI 1.27-3.11] for NTD).

Conclusions: older people may benefit from a comprehensive evaluation of respiratory and psychological symptoms, which seem to be related to each other in advanced age.

Keywords:

• Dyspnea
• depression
• older age
• prospective study

Acknowledgements

The authors would like to express our appreciation to all the interviewers, nurses, and physicians who in any way were involved in the study.

Disclosure Statement

The authors report no conflict of interest.

Additional information

Funding

The data collection phase of the PRO.V.A. study was supported by the Fondazione Cassa di Risparmio di Padova e Rovigo; the University of Padova; the Veneto Region’s Local Health and Social Care Services No. 15 and No. 18 (Azienda Unità Locale Socio Sanitaria 15 and 18); and a grant from the Veneto Regional Authority (Ricerca Sanitaria Finalizzata n.156/03). The data analysis phase was financed by a grant from the University of Padova (Population aging - economics, health, retirement and the welfare state - POPA_EHR).