Effects of Comorbid Depression and Diabetes Mellitus on Cognitive Decline in Older Mexican Americans.
Effects of Comorbid Depression and Diabetes Mellitus on Cognitive Decline in Older Mexican Americans.
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DOI：
10.1111/jgs.13883
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发表时间：
2016-01
影响因子：
6.3
通讯作者：
Markides KS
中科院分区：
文献类型：
--
作者：
Downer B;Vickers BN;Al Snih S;Raji M;Markides KS
To assess the relationship between comorbid depression and diabetes and cognitive decline among Mexican Americans age 65 and over. Retrospective cohort study with longitudinal analysis. Texas, New Mexico, Colorado, Arizona, and California Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE). Cognition was assessed using the Mini Mental State Examination (MMSE). Depression was defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale. Diabetes was defined as according to self-reported history or taking insulin or oral hypoglycemic medication. Participants with depression and diabetes, depression only, diabetes only, and neither condition declined an average of 6.5, 4.4, 7.8, and 4.2 points on the MMSE, respectively, across the six examination waves. Participants with diabetes or comorbid diabetes and depression declined an average of 0.18 points per year (P<0.01) and 0.25 points per year, respectively, on the MMSE compared to participants with neither condition. Depression was associated with significantly greater cognitive decline (β̂ =−0.11, P<0.05) after excluding participants with baseline cognitive impairment (MMSE≤17). The odds for developing severe cognitive impairment among participants with diabetes increased by 1.08 times per year (95% CI=1.03 – 1.122) and by 1.08 times per year (95% CI=1.01 – 1.15) for participants with comorbid depression and diabetes compared to participants with neither of these conditions. Diabetes and comorbid depression and diabetes are risk factors for cognitive decline among older Mexican Americans. Interventions that reduce the prevalence of depression and diabetes among Mexican Americans may decrease the number of older adults who experience cognitive decline.
