Depression and chronic heart failure in the elderly: An intriguing relationship

Ilaria Liguori, Gennaro Russo, Francesco Curcio, Giuseppe Sasso, David Della-Morte, Gaetano Gargiulo, Flora Pirozzi, Francesco Cacciatore, Domenico Bonaduce, Pasquale Abete, Gianluca Testa

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

Chronic heart failure and depressive disorders have a high prevalence and incidence in the elderly. Several studies have shown how depression tends to exacerbate coexisting chronic heart failure and its clinical outcomes and vice versa, especially in the elderly. The negative synergism between chronic heart failure and depression in the elderly may be approached only taking into account the multifaceted pathophysiological characteristics underlying both these conditions, such as behavioural factors, neurohormonal activation, inflammatory mediators, hypercoagulability and vascular damage. Nevertheless, the pathophysiological link between these two conditions is not well established yet. Despite the high prevalence of depression in chronic heart failure elderly patients and its negative prognostic value, it is often unrecognized especially because of shared symptoms. So the screening of mood disorders, using reliable questionnaires, is recommended in elderly patients with chronic heart failure, even if cannot substitute a diagnostic interview by mental health professionals. In this setting, treatment of depression requires a multidisciplinary approach including: psychotherapy, antidepressants, exercise training and electroconvulsive therapy. Pharmacological therapy with SSRIs, despite conflicting results, improves quality of life but does not guarantee better outcomes. Exercise training is effective in improving quality of life and prognosis but at the same time cardiac rehabilitation services are vastly underutilized.

Original languageEnglish (US)
Pages (from-to)451-459
Number of pages9
JournalJournal of Geriatric Cardiology
Volume15
Issue number6
StatePublished - 2018
Externally publishedYes

Keywords

  • Chronic heart failure
  • Depression
  • Elderly

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cardiology and Cardiovascular Medicine

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