258827 Contributions of major diabetes complications to depression onset in elderly patients with diabetes: An 8-year population-based follow-up study

Tuesday, October 30, 2012

Hsueh-Hsing Pan , Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
Kwua-Yun Wang , Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
Chung-Yi Li , Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
Wen-Hsuan Hou , Department of Physical Medicine and Rehabilitation, E-Da Hospital and I-Shou University, Taiwan, Kaohsiung City, Taiwan
Objectives: To prospectively examine the roles of major diabetes complications in the causation of depression in Taiwan's elderly diabetic population. Methods: A representative sample of elderly diabetic patients (n=160,348) recruited in 2000 were linked to National Health Insurance claims (2000-2007) to identify the episode of primary or secondary diagnoses of depression in both outpatient and inpatient settings. The person-year approach with Poisson assumption was used to estimate the hazard rates. Using Cox proportional hazard regression model, we evaluated the relative risk of depression in relation to selected diabetes complications. The additive effects from major diabetes complications on risk of depression in elderly diabetes were also assessed. Results: The 8-year cumulative risk of depression was 2.48%, representing an incidence density of 4.93 per 1000 patient-years. Hazard ratio (HR) with 95% confidence interval (CI) for the elderly diabetes with lower extremity amputation, hip fracture, and cardiovascular disease were 1.44 (1.01-2.08), 1.33 (1.03-1.71), and 1.20 (1.06-1.35), respectively, and all significantly associated with increased risk of depression. Additionally, we found that the more the complications, the higher the risk of depression onset in elderly diabetes. Conclusion: Major diabetes complications are associated with an increased risk of depression. Further research is needed to look into interventions that can effectively modify the adverse effects from diabetes complications. Additionally, elderly diabetes with major complications should be intensively screened for depression.

Learning Areas:
Chronic disease management and prevention
Public health or related research

Learning Objectives:
Evaluate the roles of major diabetes related complications and hip fracture in the prediction of depression onset in elderly people.

Keywords: Depression, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author on the content I am responsible for because I have been practicing as an attending physician in physical medicine and rehabilitation for more than seven years. Together with my training in public health, I have been conducting a number of epidemiological studies on public health. Meanwhile, I also serve as principal investigator for multiple grants from the National Scientific Council, Taiwan.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.