Cavanagh, Casey E.

Background Associations between depression, incident heart failure (HF), and mortality are well documented in predominately White samples. Yet, there are sparse data from racial minorities, including those who are women, and depression is underrecognized and undertreated in the Black population. Thus, we examined associations between baseline depressive symptoms, incident HF, and all‐cause mortality across 10 years. Methods and Results We included Jackson Heart Study (JHS) participants with no history of HF at baseline (n=2651; 63.9% women; median age, 53 years). Cox proportional hazards models tested if the risk of incident HF or mortality differed by clinically significant depressive symptoms at baseline (Center for Epidemiological Studies–Depression scores ≥16 versus <16). Models were conducted in the full sample and by sex, with hierarchical adjustment for demographics, HF risk factors, and lifestyle factors. Overall, 538 adults (20.3%) reported high depressive symptoms (71.0% were women), and there were 181 cases of HF (cumulative incidence, 0.06%). In the unadjusted model, individuals with high depressive symptoms had a 43% greater risk of HF ( P =0.035). The association remained with demographic and HF risk factors but was attenuated by lifestyle factors. All‐cause mortality was similar regardless of depressive symptoms. By sex, the unadjusted association between depressive symptoms and HF remained for women only ( P =0.039). The fully adjusted model showed a 53% greater risk of HF for women with high depressive symptoms ( P =0.043). Conclusions Among Black adults, there were sex‐specific associations between depressive symptoms and incident HF, with greater risk among women. Sex‐specific management of depression may be needed to improve cardiovascular outcomes.

Direct care workers (e.g., certified nursing assistants [CNAs]) employed in long-term care (LTC) are particularly vulnerable to the experience of burnout, yet they have received relatively less research attention compared to Licensed Practical Nurses and Registered Nurses. Within the burnout literature, evidence suggests that the deployment of certain coping strategies influences levels of burnout. The current study examined the extent to which coping (e.g., problem-focused, emotion-focused, and dysfunctional coping) and cognitive emotion regulation strategies (e.g., positive reappraisal) predicted burnout after controlling for covariates (age, sleep duration). Fifty-six CNAs were surveyed at four skilled nursing facilities in the United States. Dysfunctional coping was significantly associated with emotional exhaustion and depersonalization. Among cognitive emotion regulation strategies, positive reappraisal was significantly associated with depersonalization. Shorter sleep duration was associated with significantly greater depersonalization. Findings suggest the need to develop interventions for CNAs aimed at reducing dysfunctional coping strategies and increasing sleep duration.