Abstract
BackgroundIn order to elucidate the complex relationship between co-occurring depression and anxiety with cardiac autonomic function in the elderly, this study examined the correlation between cardiac vagal control (CVC) and pre-defined, theoretical factors from the Hospital Anxiety and Depression Scale (HADS).MethodsThree hundred fifty-four randomly selected Chinese male subjects aged ≥65 years and living in the community were enrolled. CVC was measured using a frequency-domain index of heart rate variability.ResultsConfirmatory factor analysis showed that the flat tripartite model of HADS provided a modest advantage in model fit when compared with other theoretical factor solutions. In the flat tripartite model, there was a significant negative association between anhedonic depression and CVC. In contrast, autonomic anxiety showed a significant positive correlation with CVC. In the hierarchical tripartite model, negative affectivity was not directly associated with CVC; instead, it had positive and negative indirect effects on CVC via autonomic anxiety and anhedonic depression, respectively. As scores for negative affectivity increased, these specific indirect effects diminished.ConclusionsAmong competing models of co-occurring depression and anxiety, constructs from tripartite models demonstrate fair conformity with the data but unique and distinct correlations with CVC. Negative affectivity may determine the relationship of anhedonic depression and autonomic anxiety with CVC. Separating affective symptoms under the constructs of the tripartite models helps disentangle complex associations between co-occurring depression and anxiety with CVC.
Highlights
In order to elucidate the complex relationship between co-occurring depression and anxiety with cardiac autonomic function in the elderly, this study examined the correlation between cardiac vagal control (CVC) and pre-defined, theoretical factors from the Hospital Anxiety and Depression Scale (HADS)
In the analysis of conditional indirect effect, we found that the positive contribution to CVC from autonomic anxiety was present only when scores of negative affectivity were low
Individual associations between CVC and factors of theory-based models of HADS have been delineated among elderly males in the community
Summary
In order to elucidate the complex relationship between co-occurring depression and anxiety with cardiac autonomic function in the elderly, this study examined the correlation between cardiac vagal control (CVC) and pre-defined, theoretical factors from the Hospital Anxiety and Depression Scale (HADS). It is well known that depression influences the development of cardiovascular disease in several ways [1,2,3,4]. There are gender differences in cardiovascular disease and comorbid depression [5]. Cardiac vagal control (CVC) reflects the extent to which the tonic vagal activity influences the heart [13]. High resting CVC and a high capacity for withdrawing CVC during environmental demand are thought to facilitate physical and psychological function. Low resting CVC and a low capacity for withdrawing CVC are thought to predict poor outcomes. CVC exerts regulatory control over attentional and emotional systems as well as behavioral flexibility [15,16]
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