Disability and Depression Among People with Cardiovascular Diseases: Does Race or Type of Disease Matter?

Abstract

Background: Disability and depression are related in individuals with cardiovascular disease (CVD), but how race/ethnicity or specific CVD types affect this relationship remains unclear.

Objective: To assess the association between three types of disabilities and depression in people with CVD and examine whether race/ethnicity or specific CVD types influence these relationships.

Method: Using the 2013-2018 NHANES dataset, we analyzed 5908 adults with self-reported CVDs. We measured depression using the first eight items of the Patient Health Questionnaire depression scale, ADL disabilities with the Physical Functioning Questionnaire, and seeing and hearing disabilities, using the Disability Questionnaire. We conducted chi-square tests and multivariable logistic regression analyses, including interaction terms for race/ethnicity and CVD type.

Results: 32.5% of our population reported some form of disability, and 11.3% experienced depression. Depression was more common among individuals with ADL, vision, or hearing disabilities. Among those without ADL disabilities, stroke survivors had the highest depression risk, followed by individuals with multiple CVDs. Those with only hypertension and no ADL disability had the lowest risk. However, among individuals with ADL disabilities, those with hypertension had a higher risk of depression than stroke survivors or those with multiple CVDs. Notably, among people with severe visual impairment, those with multiple CVDs were less likely to be depressed than those with only hypertension. In this study, females and single individuals had higher odds of depression, while those who were Black, had higher incomes, had at least a high school education, or were aged 55 and older were less likely. Race/ethnicity was not a significant predictor in adjusted models.

Conclusion: The relationship between disability and depression in people with CVD is complex and varies by CVD type. Healthcare providers should consider disability type and specific CVD conditions when screening for depression and planning interventions.