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Diabetic seniors with depression likely to die earlier

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A new UCLA-led study has found that seniors aged 65 and older with diabetes who are depressed have about double the risk of premature death, compared to individuals of the same age who do not suffer from depression. The findings were published online on May 13 in the Journal of the American Geriatrics Society.

The study authors note that diabetic seniors have about twice the risk of depression, compared to non-diabetics and that depression in itself increases the risk of premature death. They suggest that the higher mortality rate among those with depression could be due to the fact, compared to non-depressed individuals, depressed individuals are less likely to adhere to their prescribed medications, diet, exercise and glucose self-monitoring. The investigators note that the relationship between depression and mortality among diabetics has been assessed by many other studies; however, theirs is the first to specifically compare the phenomenon as it affects those 65 and older with how it affects younger people, explained lead author Lindsay Kimbro, project director in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. She added, “We found that depression mainly increases the risk of mortality among older persons with diabetes. Although depression is an important clinical problem for people of all ages, when you split the different age groups, depression in the younger group doesn’t lead to increased mortality six to seven years later.”

The study group comprised 3,341 people diabetics who were enrolled in the Translating Research Into Action for Diabetes study, which that collected health insurance claims, medical chart review, and phone interviews from 10 health plans in eight states. The investigators reviewed data from individuals aged 65 and older (1,402 diabetics) and those who were aged 18 to 64 (1,939 diabetics); they measured mortality risk as the number of days until death since the time of the interview. The data was controlled for age, gender, race and ethnicity, income, and co-morbidities such as heart and kidney disease associated with diabetes.

Similar to the findings of previous studies, the investigators found that the risk for early death among depressed diabetics was 49% higher than among those without depression. However, the relationship was stronger among seniors. They found a 78% higher mortality risk among individuals 65 and older, compared to non-depressed diabetics within that age group. For the younger diabetics, the effect of depression on their risk for early death was not statistically significant. “Our findings highlight the importance of screening for depression among older adults with diabetes, and of encouraging treatment for those who screen positive,” explained co-author Dr. Carol Mangione, who holds the Geffen School’s Barbara A. Levey, M.D., and Gerald S. Levey, M.D., endowed chair.

The authors noted some shortcomings of the study. They were unable to control for non-medicinal forms of depression treatment, such as therapy and counseling.

Take home message:

This study notes that older diabetics are more likely to be depressed. Help is available to treat depression; thus, if you are depressed—or have a loved one who is depressed—appropriate professional help should be sought.

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