Kidney dysfunction, systemic inflammation and mental well-being in elderly post-myocardial infarction patients

BMC Psychol. 2017 Jan 12;5(1):1. doi: 10.1186/s40359-016-0170-z.

Abstract

Background: The aim was to investigate whether mild kidney dysfunction and low-grade inflammation in post-myocardial infarction patients are independently associated with markers of mental well-being (i.e. depressive and apathy symptoms, and dispositional optimism).

Methods: In post-myocardial infarction patients, kidney function was assessed by estimated glomerular filtration rate (eGFR) calculated from the combined CKD-EPI formula based on serum levels of both creatinine and cystatine C. Systemic inflammation was assessed using high sensitivity C-reactive protein (hs-CRP) levels. The 15-item Geriatric Depression Scale (GDS-15), the 3-item apathy subscale and the 4-item optimism questionnaire (4Q) were used to measure mental well-being and were analyzed using linear multivariable regression analysis.

Results: Of the 2355 patients, mean age was 72.3 (range 63-84) years and 80.1% were men. After multivariable adjustment, a poorer kidney function was associated with more depressive symptoms (β = -0.084, p < 0.001), more apathy symptoms (β = -0.101, p < 0.001), and less dispositional optimism (β = 0.072, p = 0.002). Moreover, higher levels of hs-CRP were associated with more depressive symptoms (β = 0.051, p = 0.013), more apathy symptoms (β = 0.083, p < 0.001) and less dispositional optimism (β = -0.047 p = 0.024). Apathy showed the strongest independent relation with both low eGFR and high hs-CRP.

Conclusions: In post-myocardial infarction patients, impaired kidney function and systemic inflammation showed a stronger association with apathy than with depressive symptoms and dispositional optimism.

Keywords: Apathy; Depressive symptoms; Dispositional optimism; Kidney dysfunction; Myocardial infarction; Systemic inflammation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Apathy
  • Cross-Sectional Studies
  • Depressive Disorder / epidemiology
  • Female
  • Humans
  • Inflammation / epidemiology
  • Inflammation / psychology*
  • Kidney Diseases / epidemiology
  • Kidney Diseases / psychology*
  • Male
  • Mental Health*
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / psychology*
  • Optimism