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Depression is not associated with diabetes control in minority elderly.

ABSTRACT: We investigated the longitudinal association of depression, with and without cognitive dysfunction, with hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein (LDL) in a predominantly minority cohort.There were 613 participants. Presence of depression was defined by a score ?7 on the Short-CARE depression scale. We tested participants for executive dysfunction using the Color Trails Test (CTT), part 2, and for memory dysfunction using the total recall task of the Selective Reminding Test (TR-SRT). We classified performance in these tests as abnormal based on standardized score cutoffs (<16th percentile and one standard deviation below the sample mean). Random effects models were used to compare repeated measures of the diabetes control measures between those with depression versus those without depression and ever versus never cognitively impaired.Baseline depression was present in 36% of participants. Over a median follow-up of 2 years, depression was not related to worse HbA1c, SBP, or LDL. The presence of (1) abnormal performance on a test of executive function and depression (n=57) or (2) abnormal performance on a test of verbal recall and depression (n=43) was also not associated with clinically significant worse change in diabetes control.Depression, with or without low performance in tests of executive function and memory, may not affect clinically significant measures of diabetes control in the elderly.

SUBMITTER: Palta P

PROVIDER: S-EPMC4310458 | biostudies-literature | 2014 Nov-Dec

REPOSITORIES: biostudies-literature

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Depression is not associated with diabetes control in minority elderly.

Palta Priya P Golden Sherita Hill SH Teresi Jeanne A JA Palmas Walter W Trief Paula P Weinstock Ruth S RS Shea Steven S Manly Jennifer J JJ Luchsinger Jose A JA

Journal of diabetes and its complications 20140701 6

<h4>Aims</h4>We investigated the longitudinal association of depression, with and without cognitive dysfunction, with hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein (LDL) in a predominantly minority cohort.<h4>Methods</h4>There were 613 participants. Presence of depression was defined by a score ≥7 on the Short-CARE depression scale. We tested participants for executive dysfunction using the Color Trails Test (CTT), part 2, and for memory dysfunction using the ...[more]

PMID: 25156987

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Project description:BackgroundAlthough exercise seems to be beneficial for type 2 diabetes mellitus (T2DM) patients, there is limited research elucidating the optimal accessible indices of adiposity and insulin resistance for identifying elderly T2DM patients with poor glycemic control, which could be improved by performing regular exercise.MethodsA community-based, cross-sectional study was conducted with 918 Chinese elderly individuals with T2DM in Zhejiang. Relevant risk factors for poor glycemic control, as determined using glycated haemoglobin A1c (HbA1c)?>?7%, were explored using logistic regression analyses and included body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), fasting blood glucose (FBG), triglycerides (TGs), total cholesterol (TC), the product of fasting triglycerides and glucose (TyG), visceral adiposity index (VAI), lipid accumulation product (LAP), TyG-BMI, and TyG-WC. Comparisons of the risk factors' ability to discriminate poor glycemic control as well as their optimal cutoff values were determined using receiver operating characteristic (ROC) analyses, and then the extent of poor glycemic control risk reduction through regular exercise was examined using multivariate logistic regression analyses.ResultsThe overall poor glycemic control rate was 49.3%. The factors associated with poor glycemic control included FBG?>?3.869, TyG?>?8.73, TyG-BMI?>?222.45, and TyG-WC?>?713.48 in logistic regression analyses. The optimal cutoff points of FBG, TyG, TyG-WC, and TyG-BMI in discriminating poor glycemic control were 7.38, 9.22, 813.33, and 227.77, and their corresponding areas under the ROC curves were 0.864(0.840-0.886), 0.684(0.653-0.714), 0.604(0.571-0.635), and 0.574(0.541-0.606), respectively. Occasional and regular exercise reduced the odds ratios (95% confidence interval) of poor glycemic control to 0.187 (0.063-0.557) and 0.183 (0.059-0.571) for subjects with TyG-WC?>?813.33 (p?=?0.008), to 0.349 (0.156-0.782) and 0.284 (0.123-0.652) for subjects with TyG?>?9.22 (p?=?0.011), and to 0.390 (0.175-0.869) and 0.300(0.130-0.688) for subjects with TyG-BMI?>?227.77 (p?=?0.017), respectively, after adjusting for multiple confounding factors.ConclusionAmong elderly individuals with T2DM, poor glycemic control risk might be identified using indices calculated from FBG, TG, BMI, and WC measurements, which are indicative of adiposity and insulin resistance. TyG-WC seems to be an accessible and useful indicator to identify which elderly T2DM patients would benefit from performing regular exercise to achieve good glycemic control.

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Depression is not associated with diabetes control in minority elderly.

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Depression is not associated with diabetes control in minority elderly.

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