Prevalence and course of depression in older people with aortic stenosis undergoing transcatheter aortic valve implantation – a systematic review and meta-analysis
Background Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the inc...
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| Vydané v: | BMC geriatrics Ročník 25; číslo 1; s. 756 - 13 |
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| Hlavní autori: | , , |
| Médium: | Journal Article |
| Jazyk: | English |
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London
BioMed Central
06.10.2025
BioMed Central Ltd Springer Nature B.V BMC |
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| ISSN: | 1471-2318, 1471-2318 |
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| Abstract | Background
Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the increasingly recognized role of depression as a prognostic factor, this systematic review and meta-analysis aimed to derive a global estimate of the prevalence of depression and to examine its course from pre- to post-TAVI.
Methods
We included articles reporting prevalence of depression (diagnosed or assessed using validated instruments) or change in depressive symptoms in people undergoing TAVI. We performed three main meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of assessed depression and (3) standardized mean change (SMC) of depressive symptoms from pre- to post-TAVI.
Results
We included 32 studies in this systematic review, 26 of which were suitable for meta-analysis. The pooled prevalence of diagnosed and assessed depression was 6.0% [95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively. We observed a small, albeit non-significant trend towards a decrease in depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]).
Conclusions
A relevant proportion of people undergoing TAVI experiences depression, and the discrepancy in prevalence estimates of diagnosed and assessed depression indicates a potential under-diagnosis of depression. Disease management strategies should be adapted to include screening for and adequate treatment of depression in this population. Improvement of depressive symptoms after TAVI should not be taken for granted. |
|---|---|
| AbstractList | Background
Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the increasingly recognized role of depression as a prognostic factor, this systematic review and meta-analysis aimed to derive a global estimate of the prevalence of depression and to examine its course from pre- to post-TAVI.
Methods
We included articles reporting prevalence of depression (diagnosed or assessed using validated instruments) or change in depressive symptoms in people undergoing TAVI. We performed three main meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of assessed depression and (3) standardized mean change (SMC) of depressive symptoms from pre- to post-TAVI.
Results
We included 32 studies in this systematic review, 26 of which were suitable for meta-analysis. The pooled prevalence of diagnosed and assessed depression was 6.0% [95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively. We observed a small, albeit non-significant trend towards a decrease in depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]).
Conclusions
A relevant proportion of people undergoing TAVI experiences depression, and the discrepancy in prevalence estimates of diagnosed and assessed depression indicates a potential under-diagnosis of depression. Disease management strategies should be adapted to include screening for and adequate treatment of depression in this population. Improvement of depressive symptoms after TAVI should not be taken for granted. Abstract Background Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the increasingly recognized role of depression as a prognostic factor, this systematic review and meta-analysis aimed to derive a global estimate of the prevalence of depression and to examine its course from pre- to post-TAVI. Methods We included articles reporting prevalence of depression (diagnosed or assessed using validated instruments) or change in depressive symptoms in people undergoing TAVI. We performed three main meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of assessed depression and (3) standardized mean change (SMC) of depressive symptoms from pre- to post-TAVI. Results We included 32 studies in this systematic review, 26 of which were suitable for meta-analysis. The pooled prevalence of diagnosed and assessed depression was 6.0% [95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively. We observed a small, albeit non-significant trend towards a decrease in depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]). Conclusions A relevant proportion of people undergoing TAVI experiences depression, and the discrepancy in prevalence estimates of diagnosed and assessed depression indicates a potential under-diagnosis of depression. Disease management strategies should be adapted to include screening for and adequate treatment of depression in this population. Improvement of depressive symptoms after TAVI should not be taken for granted. BackgroundDepression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the increasingly recognized role of depression as a prognostic factor, this systematic review and meta-analysis aimed to derive a global estimate of the prevalence of depression and to examine its course from pre- to post-TAVI.MethodsWe included articles reporting prevalence of depression (diagnosed or assessed using validated instruments) or change in depressive symptoms in people undergoing TAVI. We performed three main meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of assessed depression and (3) standardized mean change (SMC) of depressive symptoms from pre- to post-TAVI.ResultsWe included 32 studies in this systematic review, 26 of which were suitable for meta-analysis. The pooled prevalence of diagnosed and assessed depression was 6.0% [95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively. We observed a small, albeit non-significant trend towards a decrease in depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]).ConclusionsA relevant proportion of people undergoing TAVI experiences depression, and the discrepancy in prevalence estimates of diagnosed and assessed depression indicates a potential under-diagnosis of depression. Disease management strategies should be adapted to include screening for and adequate treatment of depression in this population. Improvement of depressive symptoms after TAVI should not be taken for granted. Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the increasingly recognized role of depression as a prognostic factor, this systematic review and meta-analysis aimed to derive a global estimate of the prevalence of depression and to examine its course from pre- to post-TAVI.BACKGROUNDDepression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the increasingly recognized role of depression as a prognostic factor, this systematic review and meta-analysis aimed to derive a global estimate of the prevalence of depression and to examine its course from pre- to post-TAVI.We included articles reporting prevalence of depression (diagnosed or assessed using validated instruments) or change in depressive symptoms in people undergoing TAVI. We performed three main meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of assessed depression and (3) standardized mean change (SMC) of depressive symptoms from pre- to post-TAVI.METHODSWe included articles reporting prevalence of depression (diagnosed or assessed using validated instruments) or change in depressive symptoms in people undergoing TAVI. We performed three main meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of assessed depression and (3) standardized mean change (SMC) of depressive symptoms from pre- to post-TAVI.We included 32 studies in this systematic review, 26 of which were suitable for meta-analysis. The pooled prevalence of diagnosed and assessed depression was 6.0% [95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively. We observed a small, albeit non-significant trend towards a decrease in depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]).RESULTSWe included 32 studies in this systematic review, 26 of which were suitable for meta-analysis. The pooled prevalence of diagnosed and assessed depression was 6.0% [95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively. We observed a small, albeit non-significant trend towards a decrease in depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]).A relevant proportion of people undergoing TAVI experiences depression, and the discrepancy in prevalence estimates of diagnosed and assessed depression indicates a potential under-diagnosis of depression. Disease management strategies should be adapted to include screening for and adequate treatment of depression in this population. Improvement of depressive symptoms after TAVI should not be taken for granted.CONCLUSIONSA relevant proportion of people undergoing TAVI experiences depression, and the discrepancy in prevalence estimates of diagnosed and assessed depression indicates a potential under-diagnosis of depression. Disease management strategies should be adapted to include screening for and adequate treatment of depression in this population. Improvement of depressive symptoms after TAVI should not be taken for granted. Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the increasingly recognized role of depression as a prognostic factor, this systematic review and meta-analysis aimed to derive a global estimate of the prevalence of depression and to examine its course from pre- to post-TAVI. We included articles reporting prevalence of depression (diagnosed or assessed using validated instruments) or change in depressive symptoms in people undergoing TAVI. We performed three main meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of assessed depression and (3) standardized mean change (SMC) of depressive symptoms from pre- to post-TAVI. We included 32 studies in this systematic review, 26 of which were suitable for meta-analysis. The pooled prevalence of diagnosed and assessed depression was 6.0% [95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively. We observed a small, albeit non-significant trend towards a decrease in depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]). A relevant proportion of people undergoing TAVI experiences depression, and the discrepancy in prevalence estimates of diagnosed and assessed depression indicates a potential under-diagnosis of depression. Disease management strategies should be adapted to include screening for and adequate treatment of depression in this population. Improvement of depressive symptoms after TAVI should not be taken for granted. Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the increasingly recognized role of depression as a prognostic factor, this systematic review and meta-analysis aimed to derive a global estimate of the prevalence of depression and to examine its course from pre- to post-TAVI. We included articles reporting prevalence of depression (diagnosed or assessed using validated instruments) or change in depressive symptoms in people undergoing TAVI. We performed three main meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of assessed depression and (3) standardized mean change (SMC) of depressive symptoms from pre- to post-TAVI. We included 32 studies in this systematic review, 26 of which were suitable for meta-analysis. The pooled prevalence of diagnosed and assessed depression was 6.0% [95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively. We observed a small, albeit non-significant trend towards a decrease in depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]). A relevant proportion of people undergoing TAVI experiences depression, and the discrepancy in prevalence estimates of diagnosed and assessed depression indicates a potential under-diagnosis of depression. Disease management strategies should be adapted to include screening for and adequate treatment of depression in this population. Improvement of depressive symptoms after TAVI should not be taken for granted. Background Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes. Given the rising number of older people with aortic stenosis in need of transcatheter aortic valve implantation (TAVI) and the increasingly recognized role of depression as a prognostic factor, this systematic review and meta-analysis aimed to derive a global estimate of the prevalence of depression and to examine its course from pre- to post-TAVI. Methods We included articles reporting prevalence of depression (diagnosed or assessed using validated instruments) or change in depressive symptoms in people undergoing TAVI. We performed three main meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of assessed depression and (3) standardized mean change (SMC) of depressive symptoms from pre- to post-TAVI. Results We included 32 studies in this systematic review, 26 of which were suitable for meta-analysis. The pooled prevalence of diagnosed and assessed depression was 6.0% [95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively. We observed a small, albeit non-significant trend towards a decrease in depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]). Conclusions A relevant proportion of people undergoing TAVI experiences depression, and the discrepancy in prevalence estimates of diagnosed and assessed depression indicates a potential under-diagnosis of depression. Disease management strategies should be adapted to include screening for and adequate treatment of depression in this population. Improvement of depressive symptoms after TAVI should not be taken for granted. Keywords: Depression, Psychocardiology, Aortic valve stenosis, Transcatheter aortic valve replacement, Meta-analysis, Systematic review |
| ArticleNumber | 756 |
| Audience | Academic |
| Author | Lohner, Valerie Maschke, Verena Mons, Ute |
| Author_xml | – sequence: 1 givenname: Verena surname: Maschke fullname: Maschke, Verena email: verena.maschke@uk-koeln.de organization: Department of Cardiology, Cardiovascular Epidemiology of Aging, Faculty of Medicine and University Hospital Cologne, University of Cologne – sequence: 2 givenname: Ute surname: Mons fullname: Mons, Ute organization: Department of Cardiology, Cardiovascular Epidemiology of Aging, Faculty of Medicine and University Hospital Cologne, University of Cologne – sequence: 3 givenname: Valerie surname: Lohner fullname: Lohner, Valerie organization: Department of Cardiology, Cardiovascular Epidemiology of Aging, Faculty of Medicine and University Hospital Cologne, University of Cologne |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/41053659$$D View this record in MEDLINE/PubMed |
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Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery... Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery outcomes.... Background Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery... BackgroundDepression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for cardiac surgery... Abstract Background Depression is the most prevalent psychiatric disorder in older people with cardiovascular disease and an independent risk factor for... |
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| SubjectTerms | Aged Aged patients Aged, 80 and over Aging Analysis Aortic stenosis Aortic valve Aortic valve stenosis Aortic Valve Stenosis - diagnosis Aortic Valve Stenosis - epidemiology Aortic Valve Stenosis - psychology Aortic Valve Stenosis - surgery Cardiovascular disease Cardiovascular diseases Care and treatment Complications and side effects Content analysis Cross-sectional studies Depression Depression - diagnosis Depression - epidemiology Depression - psychology Depression in old age Depression, Mental Ethnicity Geriatrics/Gerontology Gerontology Heart surgery Heart valve replacement Humans Medicine Medicine & Public Health Mental depression Meta-analysis Older people Prevalence Prognosis Psychocardiology Rehabilitation Risk factors Sample size Statistics Strategic planning (Business) Systematic Review Thoracic surgery Transcatheter aortic valve replacement Transcatheter Aortic Valve Replacement - psychology Transcatheter Aortic Valve Replacement - trends |
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| Title | Prevalence and course of depression in older people with aortic stenosis undergoing transcatheter aortic valve implantation – a systematic review and meta-analysis |
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