Abstract
BackgroundThe prevalence of depression increases among the elderly with chronic medical conditions like diabetes. Hence, the purpose of this study was to determine predictors of depressive symptomatology in Medicare enrolled elderly population with type 2 diabetes mellitus.MethodsA prospective cohort study was conducted by administrating health risk assessment questionnaire to elderly (≥65 years) with type 2 diabetes. Responses were linked with administrative claim's data. Data were obtained from elderly with type 2 diabetes who were enrolled in Medicare Health Maintenance Organization (HMO) in southeastern United States. The instrument collected information related to demographics, health status, medication use, and healthcare service utilization prior to enrollment. Responses were combined with the administrative claims data of HMO to obtain information on actual utilization of healthcare resources. The Short Form Center for Epidemiologic Studies Depression scale was used to assess depressive symptoms. Multivariable logistic regression analyses were conducted to determine predictor variables.ResultsOf 792 respondents, about 17% had depressive symptoms. Almost 96% of patients were using 1 or more antidiabetic medications. Overall, increased risk of depression was associated with lower health related quality of life (HRQoL) (OR: 0.97; 95% CI: 0.96–0.98) and higher impairments in instrumental activities of daily living (IADLs) (OR: 1.31; 95% CI: 1.14–0.52) in elderly patients. Poor health related quality of life (OR: 0.97, 95%CI: 0.95–0.99) was associated with higher risk of depression in patients on insulin therapy.ConclusionImpairments in daily activities and lower HRQoL were predictors of depressive symptomatology in elderly with diabetes. Determinants of depression varied according to pharmacotherapeutic class of antidiabetic medications.
Highlights
The prevalence of depression increases among the elderly with chronic medical conditions like diabetes
The study population consisted of elderly patients with type 2 diabetes mellitus in the southeastern United States who were enrolled in a Medicare Health Maintenance Organization (HMO)
The sample consisted of 792 elderly patients with type 2 diabetes mellitus
Summary
The prevalence of depression increases among the elderly with chronic medical conditions like diabetes. The purpose of this study was to determine predictors of depressive symptomatology in Medicare enrolled elderly population with type 2 diabetes mellitus. An elderly population in the United States is associated with maximum utilization of healthcare resources [2]. Depression is growing concern in the United States afflicting around 19 million Americans annually [3]. Research has reported that approximately 30% of individuals with diabetes have depressive symptomatology and 10% suffer from major depression [6]. Both diabetes and depression were major contributors of functional disability in the elderly population [7]. Co-morbid depression in diabetes patients accounted for 4.5 times higher healthcare expenditure than those without depression [8]
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