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

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

Author information

1
Department of Psychiatry, Leiden University Medical Center, Postbus 9600, 2300, RC, Leiden, Netherlands. heeresrick@gmail.com.
2
Departments of Internal Medicine and Nephrology, Jeroen Bosch Hospital, Den Bosch, Netherlands.
3
Division of Human Nutrition, Wageningen University, Wageningen, Netherlands.
4
Department of Psychiatry, Leiden University Medical Center, Postbus 9600, 2300, RC, Leiden, Netherlands.

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

PMID:
28081723
PMCID:
PMC5228176
DOI:
10.1186/s40359-016-0170-z
[Indexed for MEDLINE]
Free PMC Article

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