Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes

Sandra A. Black, Kyriakos Markides, Laura A. Ray

Research output: Contribution to journalArticle

390 Citations (Scopus)

Abstract

OBJECTIVE - To examine the separate and combined effects of depression and diabetes on the incidence of adverse health outcomes among older Mexican Americans. RESEARCH DESIGN AND METHODS - Longitudinal data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (EPESE) survey were used to examine the main effects and interaction effects of diabetes and depressive symptoms (measured with the Center for Epidemiologic Study of Depression) or clinical diagnostic criteria (measured with the Composite International Diagnostic Interview Depression Module) on the development of macrovascular complications (including cardiovascular disease, stroke, and kidney disease), microvascular complications (including nephropathy, neuropathy, retinopathy, and amputations), functional disability, and mortality over 7 years in a sample of 2,830 Mexican Americans aged ≥65 years. RESULTS - The interaction of diabetes and depression was found to be synergistic, predicting greater mortality, greater incidence of both macro- and microvascular complications, and greater incidence of disability in activities of daily living, even when controlling for sociodemographic characteristics such as sex, age, education, acculturation, and marital status. Importantly, this interaction was found to predict not only greater incidence but also earlier incidence of adverse events in older adults. CONCLUSIONS - Whether a marker for underlying disease severity, an indicator of diminished self-care motivation, or the result of physiologic changes, the interaction of depression and diabetes has a synergistic effect on the health of older Mexican Americans, increasing the risk for poor outcomes. This is of particular clinical importance because although depression is often underrecognized in older adults, effective treatment is available and can result in improved medical outcomes.

Original languageEnglish (US)
Pages (from-to)2822-2828
Number of pages7
JournalDiabetes Care
Volume26
Issue number10
DOIs
StatePublished - Oct 1 2003

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Type 2 Diabetes Mellitus
Depression
Incidence
Health
Epidemiologic Studies
Acculturation
Sex Education
Mortality
Marital Status
Kidney Diseases
Activities of Daily Living
Self Care
Amputation
Hispanic Americans
Motivation
Research Design
Cardiovascular Diseases
Myocardial Infarction
Interviews
Population

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes. / Black, Sandra A.; Markides, Kyriakos; Ray, Laura A.

In: Diabetes Care, Vol. 26, No. 10, 01.10.2003, p. 2822-2828.

Research output: Contribution to journalArticle

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