Association between CHADS(2) score, depressive symptoms, and quality of life in a general population

BACKGROUND: To investigate the association between CHADS(2) score, depressive symptoms, and quality of life in a large general population from China. METHODS: A cross-sectional study of 11,956 permanent residents of Liaoning Province in China ≥ 35 years of age was conducted between January and August 2013 (response rate 85.3%). All participants completed a questionnaire, had a physical examination, and underwent blood examination. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9), while the quality of life (QoL) was measured using the World Health Organization Quality of Life Brief Scale (WHOQOL-BREF). RESULTS: With increasing CHADS(2) score, the prevalence of depressive symptoms increased from 4.9 to 27.8% (P < 0.001), and all scores of WHOQOL-BREF decreased significantly (all Ps < 0.001). After adjusting for confounding risk factors, subjects with CHADS(2) score ≥ 3 had higher risk of depressive symptoms than those with CHADS(2) score = 0 (all Ps < 0.05). Also, CHADS(2) score was negatively associated with all scores of WHOQOL-BREF (all Ps < 0.001). Furthermore, subjects with any item in CHADS(2) had higher prevalence of depressive symptoms (all Ps < 0.001). Heart failure and stroke remained independently associated with depressive symptoms after adjusting for confounding risk factors and other items (Ps < 0.001), while heart failure, age ≥ 75 years, diabetes mellitus, and stroke were all independently negatively associated with the total score of WHOQOL-BREF (all Ps < 0.05). CONCLUSIONS: The CHADS(2) score is significantly associated with depressive symptoms and impaired quality of life in the general population.