Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: The health, aging, and body composition study

Cinzia Maraldi, Stefano Volpato, Brenda W. Penninx, Kristine Yaffe, Eleanor M. Simonsick, Elsa S. Strotmeyer, Matteo Cesari, Stephen B. Kritchevsky, Sara Perry, Hilsa N. Ayonayon, Marco Pahor

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Cross-sectional studies find an elevated prevalence of depression among subjects with diabetes mellitus (DM). The causal mechanisms and temporal sequence of this association have not been clearly delineated. This study investigated the prospective relationship between DM and depressive symptoms. Methods: The Health, Aging, and Body Composition Study was a cohort study conducted in the metropolitan areas of Memphis, Tenn, and Pittsburgh, Pa. The analysis included 2522 community-dwelling subjects, aged 70 to 79 years, without baseline depressive symptoms. Incident depressed mood was defined as use of antidepressants at follow-up visits or presence of depressive symptoms (score ≥10 on the 10-item Center for Epidemiological Studies Depression scale). Presence of incident depressed mood at 2 consecutive annual clinic visits defined the incidence of recurrent depressed mood. Diabetes mellitus status, glycosylated hemoglobin (HbA1c) level, and DM-related comorbidities were assessed at baseline. Diabetes mellitus status was further characterized as absent, controlled (HbA1c level <7%), or uncontrolled (HbA1c level ≥7%). Discrete time survival analysis was used to estimate depressive events risk. Results: During a mean follow-up of 5.9 years, participants with DM had a higher age-, sex-, race-, and siteadjusted incidence of depressed mood (23.5% vs 19.0%) (P=.02) and recurrent depressed mood (8.8% vs 4.3%) (P<.001) than those without DM. Diabetes mellitus was associated with a 30% increased risk of incident depressed mood (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.07-1.61), which was attenuated after adjustment for DM-related comorbidities (OR, 1.20; CI, 0.97-1.48). A stronger relationship was observed between DM and recurrent depressed mood (OR, 1.91; CI, 1.32-2.76), particularly among participants with poor glycemic control. Conclusion: Among well-functioning older adults, DM is associated with increased risk of depressive symptoms.

Original languageEnglish
Pages (from-to)1137-1144
Number of pages8
JournalArchives of Internal Medicine
Volume167
Issue number11
DOIs
Publication statusPublished - 11 Jun 2007

Cite this

Maraldi, Cinzia ; Volpato, Stefano ; Penninx, Brenda W. ; Yaffe, Kristine ; Simonsick, Eleanor M. ; Strotmeyer, Elsa S. ; Cesari, Matteo ; Kritchevsky, Stephen B. ; Perry, Sara ; Ayonayon, Hilsa N. ; Pahor, Marco. / Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons : The health, aging, and body composition study. In: Archives of Internal Medicine. 2007 ; Vol. 167, No. 11. pp. 1137-1144.
@article{8113285cc81049d0acf4d58584bbf369,
title = "Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: The health, aging, and body composition study",
abstract = "Background: Cross-sectional studies find an elevated prevalence of depression among subjects with diabetes mellitus (DM). The causal mechanisms and temporal sequence of this association have not been clearly delineated. This study investigated the prospective relationship between DM and depressive symptoms. Methods: The Health, Aging, and Body Composition Study was a cohort study conducted in the metropolitan areas of Memphis, Tenn, and Pittsburgh, Pa. The analysis included 2522 community-dwelling subjects, aged 70 to 79 years, without baseline depressive symptoms. Incident depressed mood was defined as use of antidepressants at follow-up visits or presence of depressive symptoms (score ≥10 on the 10-item Center for Epidemiological Studies Depression scale). Presence of incident depressed mood at 2 consecutive annual clinic visits defined the incidence of recurrent depressed mood. Diabetes mellitus status, glycosylated hemoglobin (HbA1c) level, and DM-related comorbidities were assessed at baseline. Diabetes mellitus status was further characterized as absent, controlled (HbA1c level <7{\%}), or uncontrolled (HbA1c level ≥7{\%}). Discrete time survival analysis was used to estimate depressive events risk. Results: During a mean follow-up of 5.9 years, participants with DM had a higher age-, sex-, race-, and siteadjusted incidence of depressed mood (23.5{\%} vs 19.0{\%}) (P=.02) and recurrent depressed mood (8.8{\%} vs 4.3{\%}) (P<.001) than those without DM. Diabetes mellitus was associated with a 30{\%} increased risk of incident depressed mood (odds ratio [OR], 1.31; 95{\%} confidence interval [CI], 1.07-1.61), which was attenuated after adjustment for DM-related comorbidities (OR, 1.20; CI, 0.97-1.48). A stronger relationship was observed between DM and recurrent depressed mood (OR, 1.91; CI, 1.32-2.76), particularly among participants with poor glycemic control. Conclusion: Among well-functioning older adults, DM is associated with increased risk of depressive symptoms.",
author = "Cinzia Maraldi and Stefano Volpato and Penninx, {Brenda W.} and Kristine Yaffe and Simonsick, {Eleanor M.} and Strotmeyer, {Elsa S.} and Matteo Cesari and Kritchevsky, {Stephen B.} and Sara Perry and Ayonayon, {Hilsa N.} and Marco Pahor",
year = "2007",
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doi = "10.1001/archinte.167.11.1137",
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Maraldi, C, Volpato, S, Penninx, BW, Yaffe, K, Simonsick, EM, Strotmeyer, ES, Cesari, M, Kritchevsky, SB, Perry, S, Ayonayon, HN & Pahor, M 2007, 'Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: The health, aging, and body composition study' Archives of Internal Medicine, vol. 167, no. 11, pp. 1137-1144. https://doi.org/10.1001/archinte.167.11.1137

Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons : The health, aging, and body composition study. / Maraldi, Cinzia; Volpato, Stefano; Penninx, Brenda W.; Yaffe, Kristine; Simonsick, Eleanor M.; Strotmeyer, Elsa S.; Cesari, Matteo; Kritchevsky, Stephen B.; Perry, Sara; Ayonayon, Hilsa N.; Pahor, Marco.

In: Archives of Internal Medicine, Vol. 167, No. 11, 11.06.2007, p. 1137-1144.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons

T2 - The health, aging, and body composition study

AU - Maraldi, Cinzia

AU - Volpato, Stefano

AU - Penninx, Brenda W.

AU - Yaffe, Kristine

AU - Simonsick, Eleanor M.

AU - Strotmeyer, Elsa S.

AU - Cesari, Matteo

AU - Kritchevsky, Stephen B.

AU - Perry, Sara

AU - Ayonayon, Hilsa N.

AU - Pahor, Marco

PY - 2007/6/11

Y1 - 2007/6/11

N2 - Background: Cross-sectional studies find an elevated prevalence of depression among subjects with diabetes mellitus (DM). The causal mechanisms and temporal sequence of this association have not been clearly delineated. This study investigated the prospective relationship between DM and depressive symptoms. Methods: The Health, Aging, and Body Composition Study was a cohort study conducted in the metropolitan areas of Memphis, Tenn, and Pittsburgh, Pa. The analysis included 2522 community-dwelling subjects, aged 70 to 79 years, without baseline depressive symptoms. Incident depressed mood was defined as use of antidepressants at follow-up visits or presence of depressive symptoms (score ≥10 on the 10-item Center for Epidemiological Studies Depression scale). Presence of incident depressed mood at 2 consecutive annual clinic visits defined the incidence of recurrent depressed mood. Diabetes mellitus status, glycosylated hemoglobin (HbA1c) level, and DM-related comorbidities were assessed at baseline. Diabetes mellitus status was further characterized as absent, controlled (HbA1c level <7%), or uncontrolled (HbA1c level ≥7%). Discrete time survival analysis was used to estimate depressive events risk. Results: During a mean follow-up of 5.9 years, participants with DM had a higher age-, sex-, race-, and siteadjusted incidence of depressed mood (23.5% vs 19.0%) (P=.02) and recurrent depressed mood (8.8% vs 4.3%) (P<.001) than those without DM. Diabetes mellitus was associated with a 30% increased risk of incident depressed mood (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.07-1.61), which was attenuated after adjustment for DM-related comorbidities (OR, 1.20; CI, 0.97-1.48). A stronger relationship was observed between DM and recurrent depressed mood (OR, 1.91; CI, 1.32-2.76), particularly among participants with poor glycemic control. Conclusion: Among well-functioning older adults, DM is associated with increased risk of depressive symptoms.

AB - Background: Cross-sectional studies find an elevated prevalence of depression among subjects with diabetes mellitus (DM). The causal mechanisms and temporal sequence of this association have not been clearly delineated. This study investigated the prospective relationship between DM and depressive symptoms. Methods: The Health, Aging, and Body Composition Study was a cohort study conducted in the metropolitan areas of Memphis, Tenn, and Pittsburgh, Pa. The analysis included 2522 community-dwelling subjects, aged 70 to 79 years, without baseline depressive symptoms. Incident depressed mood was defined as use of antidepressants at follow-up visits or presence of depressive symptoms (score ≥10 on the 10-item Center for Epidemiological Studies Depression scale). Presence of incident depressed mood at 2 consecutive annual clinic visits defined the incidence of recurrent depressed mood. Diabetes mellitus status, glycosylated hemoglobin (HbA1c) level, and DM-related comorbidities were assessed at baseline. Diabetes mellitus status was further characterized as absent, controlled (HbA1c level <7%), or uncontrolled (HbA1c level ≥7%). Discrete time survival analysis was used to estimate depressive events risk. Results: During a mean follow-up of 5.9 years, participants with DM had a higher age-, sex-, race-, and siteadjusted incidence of depressed mood (23.5% vs 19.0%) (P=.02) and recurrent depressed mood (8.8% vs 4.3%) (P<.001) than those without DM. Diabetes mellitus was associated with a 30% increased risk of incident depressed mood (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.07-1.61), which was attenuated after adjustment for DM-related comorbidities (OR, 1.20; CI, 0.97-1.48). A stronger relationship was observed between DM and recurrent depressed mood (OR, 1.91; CI, 1.32-2.76), particularly among participants with poor glycemic control. Conclusion: Among well-functioning older adults, DM is associated with increased risk of depressive symptoms.

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U2 - 10.1001/archinte.167.11.1137

DO - 10.1001/archinte.167.11.1137

M3 - Article

VL - 167

SP - 1137

EP - 1144

JO - Archives of Internal Medicine

JF - Archives of Internal Medicine

SN - 0003-9926

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