Disparities in cardiovascular mortality after diagnosed depression among people with disability

Abstract

Abstract Background Persons with depression are more likely to eventually develop CVD or CVD related deaths. Depression history could be said a predictor or marker of cardiometabolic risk. However, potential disparities in cardiovascular mortality after diagnosis depression among people with and without disability rarely haven't been investigated. Methods We conducted a retrospective cohort study with a data set linking the National Disability Database, the Korean National Health Insurance Claims Database, and Cause of Death Database. To identify cases of depression and cardiovascular mortality, we used the ICD-10 code. Results Even after excluding people with brain injury and heart problems, people with disabilities had a 2.82 times higher cardiovascular specific mortality than the non-disabled (6.5 vs 2.3 people per 1000), especially in those with severe disabilities (7.5 vs 2.3 people per 1000). In survival analysis, the median survival time was 78.6 months and 71.6 months in the non-disabled and those with severe disability, respectively (Log-rank, p<.0001). This higher likelihood was more evident for people with severe disability(aHR=2.02, p<.0001), disability due to renal failure (aHR=3.43, p<.0001), speech and language disabilities (aHR=2.67, p<.0001), and hearing disabilities (aHR=2.29, p<.0001). Conclusions Although people with disabilities were known to be in poor health, disparities were found in cardiovascular mortality after depression history, especially in severe disabilities, renal failure, speech and language, and/or hearing disabilities. This emphasizes the importance of regular screening for cardiovascular risk factors in the disabled with depression, and we should do more efforts to develop policies supporting mental and cardiovascular health. Key messages • Patients with disabilities had a higher cardiovascular diseases specific mortality, and had a shorter survival time than the non-disabled. • Patients with severe disabilities, renal failure, speech and language, and/or hearing disabilities had a higher cardiovascular diseases specific mortality.