Depressive symptoms in elderly adults with hypotension: different associations with positive and negative affect

Background: The association of hypotension with depression in the elderly is controversial. The aim of this study was to examine the relationship between hypotension and depression in the elderly, focusing on symptom manifestations of depression in the hypotensive group.

Methods: This study was a community-based, cross-sectional study that included 962 elderly adults aged 65years or older without cognitive impairment; analysis focused on subjects who were not taking antihypertensive drugs (n=480). The Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) was used for the evaluation of depression. Participants were classified into 10th percentile groups by blood pressure level. The risks of depression were evaluated by logistic regression in the various blood pressure groups and were compared using a reference group whose blood pressure was within the 40-59th percentile range. To explore symptomatology, logistic regression analyses were performed between the lowest 10th percentile blood pressure group and the reference group to obtain the odds ratio for each item on the SGDS-K.

Results: Participants with systolic blood pressure in the lowest 10th percentile range were at increased odds of depression when compared with the reference group after adjustment for possible confounders (adjusted odds ratio 3.33, 95% confidence interval 1.47-7.84). Of the depressive symptoms, significant differences were found between the systolic hypotension group and the reference group for the depression items of 'satisfied with life', 'feel life is empty', 'in good spirits', 'wonderful to be alive' and 'full of energy'.

Conclusions: Hypotension was related to depression, specifically to low positive affect in the elderly. Aged people with hypotension and depressed mood should be monitored carefully.