Abstract 4147638: Food Security, Depression, and the Association of Depression with Adherence to Cardiovascular Disease Risk Reduction Measures among Rural Caregivers of Patients with Chronic Diseases

Introduction: Caregivers are at high risk of cardiovascular disease (CVD) and depression compared to non-caregivers. Food security has been suggested to be a risk factor for depression. Depression may be connected to poor self-care. Studies exploring food security, depression and its relationship to adherence to CVD risk reduction measures among rural caregivers are lacking. Aims: To determine: 1) the association between food security and depression in rural caregivers, and 2) the relationship between depression and caregiver burden, and reported adherence to recommended CVD risk reduction measures in rural caregivers of patients with chronic diseases. Method: In this cross-sectional study, 277 rural caregivers (mean age 54 ± 14 years; 76% were female; and 70% were married) provided self-reported data on their sociodemographic factors, food insecurity (US Household Food Security Survey Module), caregiver burden (Zarit Burden Interview), depression (Patient Health Questionnaire-9), and adherence to recommended CVD risk reduction measures (Medical Outcomes Study Specific Adherence Scale). Hierarchical regression analysis was performed. Results: In this study, food insecurity and high depressive symptoms were prevalent in 23% and 25% of rural caregivers, respectively. Food insecurity was associated with higher depressive symptoms ( β = 0.21; p <.01), controlling for covariates. Caregivers who reported higher depressive symptoms had higher caregiver burden ( β = 0.49; p <.01) and poor adherence to recommended CVD risk reduction measures ( β = 0.18; p <.01) compared to those with low or no depressive symptoms, controlling for covariates. Conclusion: In rural caregivers, food insecurity was associated with higher depressive symptoms. Depressive symptoms were negatively associated with adherence to recommended CVD risk reduction behaviors. Greater attention should be given to food security and psychosocial factors to reduce CVD risk in this population.