Diabetes Mellitus as a Risk Factor for Development of Depressive Symptoms in a Population-Based Cohort of Older Mexican Americans

作者：Garcia Maria E^*; Lee Anne; Neuhaus John; Gonzalez Hector; To Tu My; Haan Mary N

来源：Journal of the American Geriatrics Society, 2016, 64(3): 619-624.

DOI：10.1111/jgs.14019

• diabetes
• depression
• Hispanic health
• geriatrics
• vulnerable populations

ObjectivesTo determine whether diabetes mellitus increases depressive symptoms in older Latinos in a population-based cohort.
DesignProspective cohort study.
ParticipantsIndividuals from the Sacramento Latino Study on Aging aged 60 and older in 1998-99 and followed annually until 2008 (N=1,586).
MeasurementsDiabetes mellitus was defined according to self-report, fasting blood glucose of 126mg/dL or greater, glycosylated hemoglobin of 6.5% or greater, or diabetic medication use. Depressive symptoms were defined as Center for Epidemiologic Studies Depression Scale (CES-D) score of 16 or greater or use of antidepressant medication. Multistate Markov modeling was used to assess the effects of time-dependent diabetes mellitus on transitions between three states over time: low CES-D score (normal), high CES-D score or treated (depressed), and death. Bivariate analyses identified covariates significantly associated with any transition, including sex and baseline measures of age, education, body mass index, hypertension, and stroke.
ResultsIn a fully adjusted model, participants with diabetes mellitus had a 35% higher rate of developing depressive symptoms or starting treatment with an antidepressant (hazard ratio (HR)=1.35, 95% confidence interval (CI)=1.13-1.62). Time-dependent diabetes mellitus was associated with a lower rate of regression from depressed to normal (HR=0.72, 95% CI=0.59-0.88) and a 2.3 greater rate pf progression from depressed to death (HR=2.31, 95% CI=1.57-3.40).
ConclusionDiabetes mellitus increased the risk of developing depressive symptoms in older Mexican Americans. Older Latinos with diabetes mellitus should be screened for depressive symptoms and prioritized for close follow-up, potentially through greater reliance on team-based models of care.

• 出版日期2016-3