OBJECTIVES: To examine the rates and correlates of depressive symptoms and syndromal depression in people with self-reported heart failure participating in a community study of people aged 70 and older. DESIGN: Cross-sectional. SETTING: Community-based epidemiological study of older people from the continental United States. PARTICIPANTS: Six thousand one hundred twenty-five older people participating in the longitudinal study of Assets and Health Dynamics. Participants had to be born in 1923 or earlier. MEASUREMENTS: The short-form Composite International Diagnostic Interview assessed syndromal depression, and a revised version of the Center for Epidemiologic Studies - Depression scale assessed depressive symptoms. Medical illness was based on self-report. The authors compared the rates of syndromal depression and individual depressive symptoms in people with self-reported heart failure (n = 199) with those in people with other heart conditions (n = 1,856) and with no heart conditions (n = 4,070). RESULTS: Eleven percent of those with heart failure met criteria for syndromal depression, compared with 4.8% of people with other heart conditions and 3.2% of those with no heart conditions. The association between heart failure and depression held even after controlling for disability, reported fatigue and breathlessness, and number of comorbid chronic illnesses. CONCLUSION: Community-living older people with self-reported heart failure were at approximately twice the risk for syndromal depression of the rest of the community. Although fatigue and functional disability were also related to depression in this sample, these variables did not account for the association between syndromal depression and self-reported heart failure.

Yes / Objectives To assess the long-term effect on health and well-being of the Lifestyle Matters programme. Design Qualitative study of a subset of intervention arm participants who participated in the Lifestyle Matters randomised controlled trial (RCT). Setting The intervention took place at community venues within two sites in the UK. Participants A purposeful sample of 13 participants aged between 66 and 88 years from the intervention arm of the RCT were interviewed at 24 months post randomisation. Interviews aimed to understand how participants had used their time in the preceding 2 years and whether the intervention had any impact on their lifestyle choices, participation in meaningful activities and well-being. Intervention Lifestyle Matters is a 4-month occupational therapy intervention, consisting of group and individual sessions, designed to enable community living older people to make positive lifestyle choices and participate in new or neglected activities through increasing self-efficacy. Results Interviews revealed that the majority of interviewed participants were reportedly active at 24 months, with daily routines and lifestyles not changing significantly over time. All participants raised some form of benefit from attending Lifestyle Matters, including an improved perspective on life, trying new hobbies and meeting new friends. A number of intervention participants spoke of adapting to their changing circumstances, but there were significant and lasting benefits for 2 of 13 intervention participants interviewed. Conclusion The majority of those who experienced the Lifestyle Matters intervention reported minor benefits and increases in self-efficacy, but they did not perceive that it significantly improved their health and well-being. The two participants who had experienced major benefits also reported having had life-changing events, suggesting that this intervention is most effective at the time when lifestyle has to be reconsidered if mental well-being is to be sustained. / Medical Research Council grant number (G1001406).