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Depression severity linked to chronic diabetes complications among older patients
Older adults with diabetes were more likely to report moderate or severe depression when living with chronic complications, including retinopathy, neuropathy and end-stage renal disease requiring dialysis, according to recent findings.
“The more severe depressive symptoms there were, the greater the tendency we observed for diabetic microangiopathies and macroangiopathies,” Kaya Ishizawa, MD, PhD, of the Diabetes Center at Tokyo Women’s Medical University School of Medicine, and colleagues wrote. “Odds ratios for diabetic complications, except for gangrene, significantly increased with [Patient Health Questionnaire-9] scores.”
In a cross-sectional study, Ishizawa and colleagues analyzed data from 4,283 patients aged at least 65 years with diabetes participating in the Diabetes Study from the Center of Tokyo Women’s Medical University, an ongoing, observational cohort study (1,657 men; mean age, 73 years; 3.9% with type 1 diabetes). Participants completed a self-administered questionnaire, including items on subjective symptoms associated with diabetic microangiopathy, the frequency of clinical visits due to vascular diseases (heart diseases, stroke or gangrene), hospitalization and the Patient Health Questionnaire-9 (PHQ-9), to measure depressive symptoms (response rate, 91.9%). Depression scores were categorized as 0 to 4 points (no depression), 5 to 9 points (mild depression) or 10 points or more (moderate or severe depression). Researchers used logistic regression analysis to measure the association between severity of depression and diabetic complications.
Within the cohort, 2,975 patients (69.5%) had no depression, 842 (19.7%) had mild depression and 466 (10.9%) had moderate or severe depression. After adjustment for age, sex, smoking status and HbA1c, higher PHQ-9 scores were associated with increased ORs for retinopathy, symptoms related to peripheral polyneuropathy and autonomic neuropathy, and ESRD requiring dialysis (P < .05 for all). When compared with participants who had no depression, participants with mild depression had an OR of 1.2 for developing retinopathy (95% CI, 1-1.44) and an OR of 1.79 for developing ESRD requiring dialysis (95% CI, 0.87-3.69); for those with moderate or severe depression, the OR increased to 1.93 for developing retinopathy (95% CI, 1.53-2.44) and to 5.12 for dialysis (95% CI, 2.62-10). – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.