March 5, 2012
The authors undertook the current study to investigate whether the high rates of depression seen in older HIV-positive adults are associated with the number and types of comorbidities. The researchers used a non-parametric test of association and multiple regression analysis to analyze data from the Research on Older Adults with HIV study. ROAH collected self-reported health data on approximately 1,000 New York City men and women, age 50 and older, living with HIV; these individuals provided data on health challenges experienced in the past year and depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D]).
The team found that the correlation between CES-D scores and number of comorbidities was significant (r=0.24). Depression remained a significant covariate of the number of comorbid conditions in multivariate analyses, in addition to female gender, inadequate income, history of drug and alcohol use, AIDS diagnosis, and self-rated health.
"Correlations of depression with specific comorbidities varied," the researchers reported. "Significant correlations with sensory loss and dermatological problems were observed." While significant correlations existed with heart and respiratory conditions as well as fractures, "the directionality of these cross-sectional relationships is uncertain."
"The findings suggest the need for further longitudinal research to understand how high rates of depressive symptoms are related to comorbidities," the authors concluded. "Focused clinical care that strives to prevent the collapse of the immune system must evolve into an effective treatment strategy for multimorbidities, where HIV is but one of many other chronic illnesses. If the management of depression continues to be a low priority, the older person with HIV may experience an avoidable reduction in life expectancy."