Depressive symptoms and lower extremity functioning in men and women with peripheral arterial disease

被引:90
作者
McDermott, MM
Greenland, P
Guralnik, JM
Liu, K
Criqui, MH
Pearce, WH
Chan, C
Schneider, J
Sharma, L
Taylor, LM
Arseven, A
Quann, M
Celic, L
机构
[1] Northwestern Univ, Dept Med, Feinberg Sch Med, Chicago, IL 60611 USA
[2] Northwestern Univ, Dept Prevent Med, Feinberg Sch Med, Chicago, IL 60611 USA
[3] Northwestern Univ, Div Vasc Surg, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA
[4] NIA, Lab Epidemiol Demog & Biometry, NIH, Bethesda, MD 20892 USA
[5] Univ Calif San Diego, Dept Family & Prevent Med, San Diego, CA 92103 USA
[6] Northwestern Univ, Evanston Hosp, Div Vasc Surg, Dept Surg, Evanston, IL 60201 USA
[7] Oregon Hlth Sci Med Ctr, Div Vasc Surg, Dept Surg, Portland, OR USA
关键词
depression; peripheral vascular disease; physical functioning;
D O I
10.1046/j.1525-1497.2003.20527.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
OBJECTIVE: Factors associated with impaired functioning in patients with lower extremity peripheral arterial disease (PAD) are not fully understood. The purpose of this study was to determine the relationship between depressive symptoms and objective measures of lower extremity functioning in persons with PAD. DESIGN: Cross-sectional. PATIENTS/PARTICIPANTS: Four hundred twenty-three men and women with PAD identified from 3 Chicago area medical centers. MEASUREMENTS AND MAIN RESULTS: PAD was defined as ankle brachial index (ABI) <0.90. The Geriatric Depression Scale short form (GDS-S) (0-15 scale, 15 = worst) was completed by all participants. A clinically significant number of depressive symptoms was defined as a GDS-S score ≥6. Six-minute walk distance and usual-and fast-pace walking velocity were determined for all participants. A GDS-S score ≥6 was present in 21.7% of participants with PAD. Adjusting for age, increasing numbers of depressive symptoms were associated with an increasing prevalence of leg pain on exertion and rest (P = .004). Adjusting for age, sex, race, ABI, number of comorbidities, current smoking, and antidepressant medications, increasing numbers of depressive symptoms were associated with shorter 6-minute walk distance (P < .001), slower usual-pace walking velocity (P = .005), and slower fast-pace walking velocity (P = .005). These relationships were attenuated slightly after additional adjustment for presence versus absence of leg pain on exertion and rest and severity of exertional leg symptoms. CONCLUSIONS: Among men and women with PAD, the prevalence of a clinically significant number of depressive symptoms is high. Greater numbers of depressive symptoms are associated with greater impairment in lower extremity functioning. Further study is needed to determine whether identifying and treating depressive symptoms in PAD is associated with improved lower extremity functioning.
引用
收藏
页码:461 / 467
页数:7
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