Comorbid depression in elderly with type 2 diabetes

peer reviewed ; Aim: To evaluate the potential correlation between depression and type 2 diabetes mellitus (DM2) in patients aged 65 years and over accessing primary health care (PHC) units. Methods: During the last semester of 2008, 109 elderly patients with DM2 (mean age 74.86, sd = 5.72) were examined by GP trainees in PHC practices. Demographics, BMI, waist circumference, fasting blood glucose (FBG), HbA1c and medicine treatment were queried. Dietary and drug therapy compliance and weekly physical activity in recreational time were investigated; expended energy was measured using Metabolic Equivalents (METs). Depression was assessed with the 15-item Geriatric Depression Scale (GDS-15) and mental health was evaluated with the General Health Questionnaire – 12 (GHQ-12). For comparison purposes, a short interview comprising the GDS-15 and GHQ-12 was performed in 52 non diabetic, randomly selected patients. The two groups were properly adjusted for sex and age. Results: Moderate (GDS-15 scores 6–8) and severe depression (GDS-15 >9) were found in 33.9% and 17.4% of the diabetics respectively. Female patients seemed to have better FBG values (r = 0.33, p = 0.006) and more controlled HbA1c (<7%, r = 0.37, p = 0.003). However, only males with regular HbA1c showed significantly lower BMI (Mdn = 27.72, U = 128.00, p <0.001) and waist circumference (Mean = 91.84 cm, t = 3.32, p = 0.002). Diabetics without depression signs were triply likely to do moderate weekly exercise compared with depressed ones (OR = 3.01, 95%CI = 1.36–6.57). Lower GDS-15 and GHQ-12 scores were correlated with more scarce therapy compliance (r = 0.46, p <0.001; r = 0.43, p <0.001 respectively). Diabetics seemed to be 2.83 times more likely to suffer from moderate depression compared with the control patients (95%CI = 1.19–6.68). Conclusions: The findings of our study suggest that moderate depression is a common underlying comorbidity in DM2, affecting aspects of its management such as the physical activity and compliance of medical ...