Elevated Depression Accelerates Disability in Older Adults With Newly Diagnosed Diabetes

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Disability was measured by 5 activities of daily living and 5 instrumental activities of daily living tasks.
Disability was measured by 5 activities of daily living and 5 instrumental activities of daily living tasks.

Older adults who experience elevated depressive symptoms after being newly diagnosed with diabetes show a faster trajectory of disability than those without depression, according to a study published in Diabetes Care.

To examine the trajectory of disability, the current study conducted a mixed model, generalized, linear analysis using 5 waves (8th to 12th) of Health and Retirement Study (HRS) data. Older adults (n=419) who received a new diabetes diagnosis in the past 2 years were included for analysis, which measured elevated depressive symptoms using the Center of Epidemiologic Studies Depression Scale and measured disability using the 10 items listed in the HRS data set.

Significant, clinically meaningful differences were found between participants with and without elevated symptoms of depression after a diabetes diagnosis (t861.3 = -2.21; P =.03 at wave 10, and t829.6 = -2.53; P =.01 at wave 11), but not before diabetes onset (t1277 = -0.61; P =.55 at wave 8, and t1275 =0.56; P =.58 at wave 9). There was no significant difference seen between groups at wave 12 (t877.6 = -1.62; P =.11). The level of disability prediagnosis was significantly lower than post-diagnosis for the participants with elevated symptoms of depression, and a range of difficulties with daily living tasks such as walking, shopping, and dressing were reported.

Study investigators conclude that these findings suggest a need for early intervention with older adults with both depression and newly diagnosed diabetes. “Future interventions should take an indicated approach to disability prevention in older adults with newly diagnosed [diabetes], especially for those with a change in depression severity during the window before and after diagnosis of [diabetes].”

Reference

Wu CY, Terhorst L, Karp JF, Skidmore ER, Rodakowski J. Trajectory of Disability in Older Adults With Newly Diagnosed Diabetes: Role of Elevated Depressive Symptoms [published online August 2, 2018]. Diabetes Care. doi: 10.2337/dc18-0007

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