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Senior Citizen Health & Medicine
Senior Citizens Who Experience Depression More
Likely to Get Diabetes
2 million older adults experience depression, 15.3%
of those over 65 have diabetes
April 24, 2007 - Older adults who have had symptoms
of depression - whether those symptoms occurred once, increased or
remained steady over a 10-year period - may be more likely to develop
diabetes than those without depressive symptoms, according to a report
in the April 23 issue of Archives of Internal Medicine, one of the
JAMA/Archives journals.
Previous research suggests that high levels of
symptoms of depression, including irritability and trouble sleeping, are
associated with increased risk of development of type 2 diabetes,
according to background information in the article.
However, with few exceptions, most of the studies
have defined symptoms of depression based on a single survey filled out
by participants. Given the episodic nature of depression and depressive
symptoms, a single self-report of symptoms may not fully characterize
the association between depressive symptoms and diabetes, the authors
write.
Mercedes R. Carnethon, Ph.D., of Feinberg School of
Medicine, Northwestern University, Chicago, and colleagues followed a
group of 4,681 participants age 65 and older (average age 72.7)
who did not have diabetes at the beginning of the study in 1989.
Each year for 10 years, the participants were
evaluated for the presence of 10 symptoms of depression, including those
related to mood, irritability, calorie intake, concentration and sleep.
Symptoms were scored on a scale of zero to 30, with
scores of eight or higher indicating high levels of symptoms.
Sociodemographic characteristics, clinical measures including height and
weight, and information about medication use that would indicate the
development of diabetes were also updated annually.
> At the beginning of the study, the average
depressive symptom score was 4.5, and one-fifth of participants had a
score of eight or higher.
> During the follow-up period, scores increased by
at least five points in nearly half the participants, and 234
individuals developed diabetes.
> Rates of diabetes were higher among those with a
score of eight or higher, compared with those who had scores below
eight.
In this sample of older adults, a single report of
high depressive symptoms, an increase in symptoms with time and
persistently high symptoms over time are each associated with an excess
incidence of diabetes, the authors write.
Furthermore, increasing symptoms with time are
associated with incident diabetes beyond initial high depressive
symptoms and the association between increasing scores and incident
diabetes was strongest among those with initially low baseline scores.
These associations were not explained by
considering other risk factors for diabetes, including physical
activity, smoking and body mass index. The pathophysiologic mechanism
for this association remains unclear, the authors write.
Our findings in this population of older adults
are of particular public health importance because there are 35 million
U.S. adults older than 65 years, they conclude.
Because an estimated 2 million older adults
experience depression or a related illness and 15.3 percent of those
over 65 have diabetes, findings from this study of a novel and highly
prevalent risk factor for diabetes have important implications for a
substantial subset of our population.
Editor's Note: This study was supported by
contracts from the National Heart, Lung, and Blood Institute, National
Institutes of Health, with additional contribution from the National
Institute of Neurological Disorders and Stroke; in part by a career
development award from the National Heart, Lung, and Blood Institute;
and by an unrestricted grant from Amgen Inc.
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