The Relationship Between Frailty And Depression In Elderly Hypertensive Patients

Hypertension is a chronic disease,and the rate of disease increases with age.The incidence of hypertension is related to factors such as genetic factors,dietary differences,mental stress and so on.Elderly patients with high blood pressure with age,degenerative changes in the body,dysfunction of various organs,less external social activities,low ability to resist external stimuli,poor psychological adjustment ability,is in the negative emotion for a long time,the above factors are very prone to depression.Frailty is an important syndrome of old age syndrome,which is caused by an organism's degenerative changes and a variety of chronic diseases that increase the vulnerability of the body.Research shows that living alone,widowhood,anxiety,sleep disorders,and poor nutritional status are easy to occur among the weak elderly.Blood routine and blood biochemistry are the routine examination items for the hospitalized patients.Blood routine includes white blood cells,hemoglobin and so on.blood biochemistry including total protein,bilirubin,triglyceride and so on.There is a study that shows that white blood cells and hemoglobin are associated with the frailty.The total protein is an indicator of the frailty of the elderly.At present,there are few studies on the combination of depression and frailty in elderly patients with hypertension.Objective:The purpose of this study was to collect social factors such as living alone,widowhood,anxiety and nutritional status in elderly hospitalized patients with hypertension and depression,And the blood routine and blood biochemical data of patients admitted to hospital.Predicting the influence of debilitating factors on depression in elderly patients with hypertension.Then these indicators are used to help assess the risk of depression in elderly hypertensive patients,and patients are made early clinical diagnosis and early treatment.Methods:The general demographic data of 220 elderly patients with hypertension were collected in Chengde Central Hospital from June 2016 to June 2017,including age,sex,marriage and living conditions.The early morning venous blood of the patients was collected,including red blood cells(RBC),white blood cells(WBC)and other blood routine data.Blood biochemical data including fasting blood glucose(Glu),triglyceride(TG),total cholesterol(TC),total bilirubin(TBIL),aspartate aminotransferase(AST)and so on.On the second day of admission were assessed including Hamilton Depression Scale(HAMD-24),Frailty Rating Scale(FRAIL),Hamilton Anxiety Scale(HAMA-14),Pittsburgh sleep quality index(PSQI),Short form Mini Nutritional Assessment(MNA-SF).All patients were divided into depression group and non-depression group according to HAMD-24.The count data were represented by the number of cases,and the differences between the groups were compared with the chi square test.The measurement data were expressed in?x±s,and the differences between the groups were compared by t test.All data were analyzed with a statistical difference(P<0.05)for the debilitating Spearman correlation analysis.Logistic regression analysis was carried out with the variables of depression as the dependent variable and the variables of chi square test and t test as independent variables.Results:1 The average age of 220 hospitalized elderly hypertensive patients was 73.94±7.90 years.106 cases were in the non-depression group,accounting for 48.18% of the total cases,with an average age of 73.17±8.71 years,and 114 cases in the depression group,accounting for 51.82% cases,with an average age74.65±7.04 years.The depression group was assessed as 67 cases of frailty patients,accounting for 58.77% of the depression group.2 Two groups of patients were compared.There were no statistical difference in age,body mass index,24 hour diastolic blood pressure,sex,smoking and drinking(P>0.05).There were statistical difference in 24 hour systolic blood pressure(24hSBP),marital status,single living condition and living place(P<0.05).3 Two groups of patients were compared and analyzed,there were no significant difference in ACEI,ARB,beta blocker and calcium channel blocker(P>0.05);but there were significant difference in frailty,anxiety,sleep disorder and nutritional status(P<0.05).4 Two groups of patients were compared and analyzed,there were no significant difference in Glu,ALT,AST,ALB,DBIL,TC,TG,HDL-C,LDL-C,MCV and PLT(P>0.05);but there were significant differences in TP,TBIL,WBC,RBC and Hb(P < 0.05).5 Spearman correlation analysis of frailty in elderly depressive patients with hypertension,there were no significant difference in Living in rural areas,TBIL,RBC,Hb(P>0.05);but there were significant differences in 24 hours systolic blood pressure(24hSBP),widowhood,solitude,depression,anxiety,sleep disorders,malnutrition,TP,WBC(P < 0.05).The frailty was negatively correlated with 24 hour systolic blood pressure(24hSBP)and TP.The frailty was positively related to widowhood,solitude,depression,anxiety,sleep disorder,malnutrition,and WBC.6 Multiple factor Logistic regression analysis of depression in elderly hospitalized hypertensive patients,there were no significant difference in Malnutrition,widowhood,living in rural areas,TBIL,RBC,Hb(P>0.05);but there were significant differences in frailty,24 h SBP,anxiety,sleep disorders,solitary,TP,WBC.The risk factors for depression in elderly patients with hypertension are frailty(OR=3.728;CI:1.487~9.346),24hSBP(OR=3.988;CI:1.582~10.057),anxiety(OR=12.073;CI:4.834~30.154),sleep disorders(OR=7.899;CI:3.098~20.136),malnutrition(OR=2.725;CI:1.045~7.102),solitary(OR=4.271;CI:1.015~ 17.971),TP(OR=4.717;CI:1.528~14.556)decreased,WBC increased(OR=2.631;CI:1.065~6.498).Conclusion:1 The frailty in elderly hypertensive patients with depression was associated to 24 hour systolic blood pressure,widowed,living alone,depression,anxiety,sleep disorders,malnutrition,TP,WBC.The lower the 24 h systolic pressure,the lower TP and elevated WBC are more to frailty.More serious widows,solitude,depression,anxiety,sleep disorders,and nutrition patients are more vulnerable to frailty.2 The risk factors of depression in elderly patients with hypertension are 24 hour systolic blood pressure,frailty,anxiety,sleep disorder,malnutrition,solitary,lower TP and elevated WBC.3 Depression was associated with frailty in elderly hospitalized hypertensive patients.Frailty is the more serious,the more prone to depression.