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DOI: 10.18413/2658-6533-2023-9-4-0-10

Features of the psychological deficit profile of elderly patients with age-associated comorbid cardiopathology

Background: With increasing age, there is an increased likelihood of cognitive impairment, anxiety-depressive syndrome among patients with comorbid arterial hypertension (AH) and coronary heart disease (CHD), which are rarely analysed among the above population, and psychological deficit states are mostly considered separately for patients with AH and for patients with CHD. The aim of the study: To study the features of the psychological deficit profile of elderly patients with age-associated comorbid cardiopathology. Materials and methods: During inpatient treatment of 60-74-year-old patients, cognitive impairment, anxiety and depression were studied in 212 patients with isolated hypertension, 208 patients with isolated coronary artery disease and 223 patients with comorbid hypertension and coronary heart disease (AH+CHD). Cognitive dysfunction was assessed on the Mini-Mental-State-Examination scale, depression and anxiety – on the Hospital anxiety and depression scale (HADS). Results: In patients with isolated AH, the average MMSE score was 24.7±0.3, isolated CHD – 21.3±0.2 and comorbid AH and CHD – 14.2±0.2 with a statistically significant difference in all groups (p<0.001), indicating moderate severity of cognitive impairment, mild dementia and moderate dementia, respectively. The above proves a more pronounced negative effect of comorbid hypertension and coronary heart disease on the deterioration of mental function of the examined patients. The value of the average score of the anxiety level reached 8.4±0.2, respectively; 9.1±0.2 and 11.2±0.3 points with a significant difference between the groups. The level of anxiety in 60-74-year-old patients with isolated hypertension and CHD corresponded to subclinical anxiety, but with comorbid hypertension and CHD – pronounced anxiety. According to the HADS-D scale, the average depression level score in the selected clinical groups was 8.7±0.3; 9.6±0.2 and 11.5±0.4 points, respectively, with a significant difference in all cases. Depression parameters in 60-74-year-old patients with isolated hypertension and isolated coronary artery disease showed the presence of subclinical depression in contrast to representatives with comorbid hypertension and coronary artery disease, where it corresponded to clinically pronounced depression. Conclusion: Comorbid AH and CHD have the most negative impact on the psychological deficit profile of elderly patients than the presence of isolated AH or CHD.

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