Age-related differences in the effect of psychological distress on mortality

Type D personality in younger versus older patients with cardiac arrhythmias

J. Denollet, F.B. Tekle, P.H. van der Voort, M. Alings, K.C. van den Broek

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

Background.
Mixed findings in biobehavioral research on heart disease may partly be attributed to age-related differences in the prognostic value of psychological distress. This study sought to test the hypothesis that Type D (distressed) personality contributes to an increased mortality risk following implantable cardioverter defibrillator (ICD) treatment in younger patients but not in older patients.
Methods.
The Type D Scale (DS14) was used to assess general psychological distress in 455 younger (≤70 y, ) and 134 older (>70 y, ) ICD patients. End points were all-cause mortality and cardiac death after a median follow-up of 3.2 years. Results. Older patients had more advanced heart failure and a higher mortality rate ( %) than younger patients ( %), . Cardiac resynchronization therapy (CRT), but not Type D personality, was associated with increased mortality in older patients. Among younger patients, however, Type D personality was associated with an adjusted hazard ratio = 1.91 (95% CI 1.09–3.34) and 2.26 (95% CI 1.16–4.41) for all-cause and cardiac mortality; other predictors were increasing age, CRT, appropriate shocks, ACE-inhibitors, and smoking.
Conclusion.
Type D personality was independently associated with all-cause and cardiac mortality in younger ICD patients but not in older patients. Cardiovascular research needs to further explore age-related differences in psychosocial risk.
Original languageEnglish
Article number246035
JournalBioMed Research International
Volume2013
DOIs
Publication statusPublished - 2013

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Implantable cardioverter defibrillators
Cardiac resynchronization therapy
Implantable Defibrillators
Angiotensin-Converting Enzyme Inhibitors
Hazards
Cause of Death

Cite this

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title = "Age-related differences in the effect of psychological distress on mortality: Type D personality in younger versus older patients with cardiac arrhythmias",
abstract = "Background. Mixed findings in biobehavioral research on heart disease may partly be attributed to age-related differences in the prognostic value of psychological distress. This study sought to test the hypothesis that Type D (distressed) personality contributes to an increased mortality risk following implantable cardioverter defibrillator (ICD) treatment in younger patients but not in older patients. Methods. The Type D Scale (DS14) was used to assess general psychological distress in 455 younger (≤70 y, ) and 134 older (>70 y, ) ICD patients. End points were all-cause mortality and cardiac death after a median follow-up of 3.2 years. Results. Older patients had more advanced heart failure and a higher mortality rate ( {\%}) than younger patients ( {\%}), . Cardiac resynchronization therapy (CRT), but not Type D personality, was associated with increased mortality in older patients. Among younger patients, however, Type D personality was associated with an adjusted hazard ratio = 1.91 (95{\%} CI 1.09–3.34) and 2.26 (95{\%} CI 1.16–4.41) for all-cause and cardiac mortality; other predictors were increasing age, CRT, appropriate shocks, ACE-inhibitors, and smoking. Conclusion. Type D personality was independently associated with all-cause and cardiac mortality in younger ICD patients but not in older patients. Cardiovascular research needs to further explore age-related differences in psychosocial risk.",
author = "J. Denollet and F.B. Tekle and {van der Voort}, P.H. and M. Alings and {van den Broek}, K.C.",
note = "open access",
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doi = "10.1155/2013/246035",
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journal = "BioMed Research International",
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Age-related differences in the effect of psychological distress on mortality : Type D personality in younger versus older patients with cardiac arrhythmias. / Denollet, J.; Tekle, F.B.; van der Voort, P.H.; Alings, M.; van den Broek, K.C.

In: BioMed Research International, Vol. 2013, 246035, 2013.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Age-related differences in the effect of psychological distress on mortality

T2 - Type D personality in younger versus older patients with cardiac arrhythmias

AU - Denollet, J.

AU - Tekle, F.B.

AU - van der Voort, P.H.

AU - Alings, M.

AU - van den Broek, K.C.

N1 - open access

PY - 2013

Y1 - 2013

N2 - Background. Mixed findings in biobehavioral research on heart disease may partly be attributed to age-related differences in the prognostic value of psychological distress. This study sought to test the hypothesis that Type D (distressed) personality contributes to an increased mortality risk following implantable cardioverter defibrillator (ICD) treatment in younger patients but not in older patients. Methods. The Type D Scale (DS14) was used to assess general psychological distress in 455 younger (≤70 y, ) and 134 older (>70 y, ) ICD patients. End points were all-cause mortality and cardiac death after a median follow-up of 3.2 years. Results. Older patients had more advanced heart failure and a higher mortality rate ( %) than younger patients ( %), . Cardiac resynchronization therapy (CRT), but not Type D personality, was associated with increased mortality in older patients. Among younger patients, however, Type D personality was associated with an adjusted hazard ratio = 1.91 (95% CI 1.09–3.34) and 2.26 (95% CI 1.16–4.41) for all-cause and cardiac mortality; other predictors were increasing age, CRT, appropriate shocks, ACE-inhibitors, and smoking. Conclusion. Type D personality was independently associated with all-cause and cardiac mortality in younger ICD patients but not in older patients. Cardiovascular research needs to further explore age-related differences in psychosocial risk.

AB - Background. Mixed findings in biobehavioral research on heart disease may partly be attributed to age-related differences in the prognostic value of psychological distress. This study sought to test the hypothesis that Type D (distressed) personality contributes to an increased mortality risk following implantable cardioverter defibrillator (ICD) treatment in younger patients but not in older patients. Methods. The Type D Scale (DS14) was used to assess general psychological distress in 455 younger (≤70 y, ) and 134 older (>70 y, ) ICD patients. End points were all-cause mortality and cardiac death after a median follow-up of 3.2 years. Results. Older patients had more advanced heart failure and a higher mortality rate ( %) than younger patients ( %), . Cardiac resynchronization therapy (CRT), but not Type D personality, was associated with increased mortality in older patients. Among younger patients, however, Type D personality was associated with an adjusted hazard ratio = 1.91 (95% CI 1.09–3.34) and 2.26 (95% CI 1.16–4.41) for all-cause and cardiac mortality; other predictors were increasing age, CRT, appropriate shocks, ACE-inhibitors, and smoking. Conclusion. Type D personality was independently associated with all-cause and cardiac mortality in younger ICD patients but not in older patients. Cardiovascular research needs to further explore age-related differences in psychosocial risk.

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