Gait speed is associated with changes in number of depression symptoms in older adults with type 2 diabetes

Abstract

AbstractBackgroundWe examined the longitudinal relationships between motor function and number of depression symptoms, both important predictors of poor health‐related outcomes, including cognitive impairment, in old age. Analyses were based on initially cognitively normal older adults with type 2 diabetes (T2D) participating in the longitudinal Israel Diabetes and Cognitive Decline (IDCD) study.MethodSubjects [n=984; mean age 72 (SD=5); 40.4% female] underwent evaluations of motor functions‐ gait speed, measured by time to walk 3 meters (mean = 4.37 seconds; SD=2.35) and handgrip strength (mean 29 Kg; SD=10), and number of depression symptoms, assessed by the 15‐item version of the Geriatric Depression Scale (GDS) (mean=2, SD=2), at baseline and approximately every 18 months thereafter. Hierarchical Linear Mixed Models (HLMM), adjusting for demographic and cardiovascular risk factors as well as overall cognition, modeled the effects of motor function on repeated GDS scoresResultLower mean gait speed (based on all gait speed measurements) was associated with higher mean GDS scores (p=0.003) (based on all GDS measurements). A greater change in gait speed between measurements was associated with greater degree of change in GDS scores over the study period (p=0.034). Handgrip strength was not associated with number of depression symptoms or with their change over timeConclusionIn older adults with T2D, lower gait speed was associated with a greater number of depression symptoms. The degree of change in walking speed was associated with degree of change in GDS, such that greater increase in 3‐meters' walking time was associated with a greater increase in number of depression symptoms over time. Future studies should examine why gait speed, but not grip strength, was associated with depression. Slower gait speed due to depression, i.e. reverse causality, cannot be ruled out. Whether strategies for improvement of gait speed (e.g. physical activity) are effective in treatment or prevention of depressive symptoms in older adults with T2D merits investigation.