TY - JOUR
T1 - Effects of Comorbid Depression and Diabetes Mellitus on Cognitive Decline in Older Mexican Americans
AU - Downer, Brian
AU - Vickers, Benjamin N.
AU - Al Snih, Soham
AU - Raji, Mukaila
AU - Markides, Kyriakos S.
N1 - Funding Information:
This work was supported by National Institute on Aging Contracts 5T32 AG000270–16 (to BD and BNV), 5R01 AG010939–20 (to MR, SAS, and KSM), and P30 AG024832 (to SAS). Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.
Publisher Copyright:
© 2016, the Authors Journal compilation.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Objectives To assess the relationship between comorbid depression, diabetes mellitus (DM), and cognitive decline in Mexican Americans aged 65 and older. Design Retrospective cohort study with longitudinal analysis. Setting Texas, New Mexico, Colorado, Arizona, and California. Participants Hispanic Established Populations for the Epidemiologic Study of the Elderly. Measurements Cognition was assessed using the Mini-Mental State Examination (MMSE). Depression was defined as a score of 16 or greater on the Center for Epidemiologic Studies Depression Scale. DM was defined as according to self-reported history or taking insulin or oral hypoglycemic medication. Results Participants with depression and DM declined an average of 6.5 points on the MMSE; depression only, 4.4 points; DM only, 7.8 points; and neither condition, 4.2 points across the six examination waves. Participants with DM declined an average of 0.18 more points on the MMSE per year (P =.001) than those with neither DM nor depression, and those with comorbid DM and depression declined 0.25 more points per year (P =.002). Depression was associated with significantly greater cognitive decline (β^ = -0.11, P =.05) after excluding participants with baseline cognitive impairment (MMSE score ≤17). Participants with DM were 1.08 (95% CI = 1.03-1.12) times as likely as those with neither DM nor depression, and those with comorbid DM and depression were 1.08 (95% CI = 1.01-1.15) times as likely as those with neither DM nor depression to develop severe cognitive impairment per year. Conclusion DM and comorbid depression and DM are risk factors for cognitive decline in older Mexican Americans. Interventions that reduce the prevalence of depression and DM in Mexican Americans may decrease the number of older adults who experience cognitive decline.
AB - Objectives To assess the relationship between comorbid depression, diabetes mellitus (DM), and cognitive decline in Mexican Americans aged 65 and older. Design Retrospective cohort study with longitudinal analysis. Setting Texas, New Mexico, Colorado, Arizona, and California. Participants Hispanic Established Populations for the Epidemiologic Study of the Elderly. Measurements Cognition was assessed using the Mini-Mental State Examination (MMSE). Depression was defined as a score of 16 or greater on the Center for Epidemiologic Studies Depression Scale. DM was defined as according to self-reported history or taking insulin or oral hypoglycemic medication. Results Participants with depression and DM declined an average of 6.5 points on the MMSE; depression only, 4.4 points; DM only, 7.8 points; and neither condition, 4.2 points across the six examination waves. Participants with DM declined an average of 0.18 more points on the MMSE per year (P =.001) than those with neither DM nor depression, and those with comorbid DM and depression declined 0.25 more points per year (P =.002). Depression was associated with significantly greater cognitive decline (β^ = -0.11, P =.05) after excluding participants with baseline cognitive impairment (MMSE score ≤17). Participants with DM were 1.08 (95% CI = 1.03-1.12) times as likely as those with neither DM nor depression, and those with comorbid DM and depression were 1.08 (95% CI = 1.01-1.15) times as likely as those with neither DM nor depression to develop severe cognitive impairment per year. Conclusion DM and comorbid depression and DM are risk factors for cognitive decline in older Mexican Americans. Interventions that reduce the prevalence of depression and DM in Mexican Americans may decrease the number of older adults who experience cognitive decline.
KW - Mexican Americans
KW - cognitive aging
KW - depression
KW - diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=84961347203&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84961347203&partnerID=8YFLogxK
U2 - 10.1111/jgs.13883
DO - 10.1111/jgs.13883
M3 - Article
C2 - 26782859
AN - SCOPUS:84961347203
SN - 0002-8614
VL - 64
SP - 109
EP - 117
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 1
ER -