Duration of diabetes and its association with depression in later life: The Health In Men Study (HIMS)
Duration of diabetes and its association with depression in later life: The Health In Men Study (HIMS)
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DOI：
10.1016/j.maturitas.2016.01.003
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发表时间：
2016-04-01
期刊：
影响因子：
4.9
通讯作者：
Flicker, Leon
中科院分区：
文献类型：
--
作者：
Almeida, Osvaldo P.;McCaul, Kieran;Flicker, Leon
目的：检查糖尿病和糖尿病持续时间是否是晚年抑郁症的直接或间接原因。研究设计和方法：对 5462 名 70-89 岁男性的社区样本进行横断面研究。患有“当前抑郁症”的男性在简略老年抑郁量表（GDS-15）上得分为 7 分或以上，而患有“曾经抑郁症”的男性要么当前患有抑郁症，要么报告了过去抑郁症的病史或治疗情况。通过自我报告病史、空腹血糖>= 7 mmol/L (126 mg/dL)、或使用胰岛素或降血糖药物来确定是否存在糖尿病。糖尿病的病程取决于自我报告。其他测量因素包括年龄、出生地、教育程度、吸烟史和 FRAIL 量表。 结果：糖尿病与曾经（OR = 1.49，95％CI = 1.25，1.76）和当前抑郁症（OR = 1.94，95％CI = 1.15，2.48）的比值比（OR）增加相关。糖尿病病程与当前抑郁症风险之间的关联呈 J 形，对于 = 30，比值比为 1.92 (95%CI=1.44, 2.54)、1.56 (95%CI=0.89, 2.75)、2.49 (95%CI=1.16, 5.32) 和 3.13 (95%CI=1.28, 7.63)与没有糖尿病的老年男性相比，有多年的糖尿病史。在针对其他测量因素调整分析后，这些关联的强度减弱，但曲线的形状没有改变。结构方程模型显示，虚弱介导了糖尿病病程与抑郁症之间的一些关联（约 15%），并且是样本中抑郁症的强有力预测因素。 结论：在老年男性中，糖尿病诊断的生存时间与抑郁症风险之间的关系呈“J 形”。虚弱介导了糖尿病和抑郁症之间的一些关联，尽管其他未测量的因素也可能发挥作用。引入有效减少糖尿病相关并发症的策略也可能有助于降低老年男性患抑郁症的风险。 (C) 2016 Elsevier Ireland Ltd. 保留所有权利。
Objective: To examine if diabetes and duration of diabetes are direct or indirect causes of depression in later life.Research design and methods: Cross-sectional study of a community-derived sample of 5462 men aged 70-89 years. Men with 'current depression' scored 7 or more on the abbreviated Geriatric Depression Scale (GDS-15), whereas men with 'ever depression' were either currently depressed or reported history or treatment for past depression. The presence of diabetes was established by self-reported history, fasting glucose >= 7 mmol/L (126 mg/dL), or use of insulin or hypoglycemic drugs. Duration of diabetes relied on self-report. Other measured factors included age, place of birth, education, smoking history, and the FRAIL scale.Results: Diabetes was associated with increased odds ratio (OR) of ever (OR=1.49, 95%CI=1.25, 1.76) and current depression (OR=1.94, 95%CI=1.15, 2.48). The association between duration of diabetes and risk of current depression was J-shaped' with odds ratios of 1.92 (95%CI=1.44, 2.54),1.56 (95%CI=0.89, 2.75), 2.49 (95%CI=1.16, 5.32) and 3.13 (95%CI=1.28, 7.63) for = 30 years of diabetes history compared with older men without diabetes. The strength of these associations was attenuated after the analyses were adjusted for other measured factors, but the shape of the curve did not change. Structural equation modeling showed that frailty mediated some of the association between diabetes duration and depression (about 15%) and was a strong predictor of depression in the sample.Conclusions: In older men, the association between time lived with the diagnosis of diabetes and the risk of depression is 'J-shaped'. Frailty mediates some of the association between diabetes and depression, although other unmeasured factors are also likely to play a role. The introduction of strategies that are effective at decreasing diabetes-related complications may also contribute to decrease the risk of depression among older men. (C) 2016 Elsevier Ireland Ltd. All rights reserved.