Older women suffering with diabetes and depression have a significantly increased risk of death from heart disease, as well as an increased death risk from all causes, over a six-year period, according to a report in the January issue of AMA/Archives journals.
Depression affects almost 15 million U.S. adults each year and more than 23.5 million U.S. adults have diabetes, according to the report. About 20 to 25 % of patients with diabetes also have depression – nearly twice as many as those without diabetes. Diabetes and its complications are leading causes of death around the world.
A study of 78,282 older women – aged 54 to 79 – was conducted in 2000 by An Pan, Ph.D., of the Harvard School of Public Health, Boston, and her colleagues.
The women were classified as having depression if they reported being diagnosed with the condition, were treated with antidepressant medications or scored high on an index measuring depressive symptoms. Reports of type 2 diabetes were confirmed using a supplementary questionnaire.
During six years of follow-up, 4,654 of the women died, including 979 who died from cardiovascular disease.
Compared with women who did not have either condition, the results were:
● those with depression had a 44 percent increased risk of death,
● those with diabetes had a 35 percent increased risk of death and
● those with both conditions had approximately twice the risk of death.
● those with depression had a 44 percent increased risk of death,
● those with diabetes had a 35 percent increased risk of death and
● those with both conditions had approximately twice the risk of death.
When considering only deaths from cardiovascular disease,
● women with diabetes had a 67 percent increased risk,
● women with depression had a 37 percent increased risk and
● women with both had a 2.7-fold increased risk.
● women with diabetes had a 67 percent increased risk,
● women with depression had a 37 percent increased risk and
● women with both had a 2.7-fold increased risk.
"It is generally suggested that depression is associated with poor glycemic control, an increased risk of diabetes complications, poor adherence to diabetes management by patients and isolation from the social network."
In addition, diabetes and depression are both linked to unhealthy behaviors such as smoking, poor diet and a sedentary lifestyle, and depression could trigger changes in the nervous system that adversely affect the heart.
"Considering the size of the population that could be affected by these two prevalent disorders, further consideration is required to design strategies aimed to provide adequate psychological management and support among those with longstanding chronic conditions, such as diabetes," the authors conclude.
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