Depression is associated with increased cardiovascular disease, but the underlying mechanisms are not well understood. This study examines associations of depressive symptoms with inflammation and coagulation factors in persons aged >65 years. Blood samples were obtained from 4,268 subjects free of cardiovascular disease (age 72.4 ± 5.5 years, 2,623 women). Inflammation markers were C-reactive protein (CRP), white blood cell (WBC) count, total platelet count, and albumin; coagulation factors included factors VIIc and VIIIc and fibrinogen. Depression was assessed with the Center for Epidemiologic Studies Depression scale, and states of energy depletion with a validated exhaustion index. Statistical adjustments were made for risk factors (age, sex, race, systolic blood pressure, smoking status, diabetes mellitus) and physical measures of frailty (isometric handgrip, timed 15-feet walk test, activity level). Depression was associated with elevated CRP (3.31 ± 0.10 vs 3.51 ± 0.21 mg/L), WBC (6.14 ± 0.03 vs 6.43 ± 0.11 106/L), fibrinogen (319 ± 1 vs 326 ± 3 mg/dl), and factor VIIc (124.6 ± 0.6% vs 127.2 ± 1.3%; all p < 0.05). Exhaustion also was related to elevated inflammation and coagulation markers (p < 0.05). Exhausted men had markedly elevated CRP levels (6.82 ± 2.10 mg/L) versus nonexhausted men (3.05 ± 0.16: p = 0.007). After adjustment for control variables, exhaustion remained associated with albumin (p = 0.033), fibrinogen (p = 0.017), CRP (p = 0.066), and WBC (p = 0.060), whereas associations of depressive symptoms with biochemistry measures lost statistical significance. Thus, depression and exhaustion are associated with low-grade inflammation and elevated coagulation factors in persons aged >65 years.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine