Older Women with Diabetes and Depression Have Twice the Risk of Death

Both problems linked to unhealthy behaviors such as smoking, poor diet and a sedentary lifestyle

Jan. 3, 2011 – Older women suffering with diabetes and depression have a significantly increased risk of death from heart disease, as well as an increased death risk from all causes, over a six-year period, according to a report in the January issue of Archives of General Psychiatry, one of theJAMA/Archives journals.

Depression affects almost 15 million U.S. adults each year and more than 23.5 million U.S. adults have diabetes, according to the report. About 20 to 25 percent of patients with diabetes also have depression – nearly twice as many as those without diabetes. Diabetes and its complications are leading causes of death around the world.

A study of 78,282 older women – aged 54 to 79 – was conducted in 2000 by An Pan, Ph.D., of the Harvard School of Public Health, Boston, and her colleagues. The women were participants in the Nurses Health Study.

The women were classified as having depression if they reported being diagnosed with the condition, were treated with antidepressant medications or scored high on an index measuring depressive symptoms. Reports of type 2 diabetes were confirmed using a supplementary questionnaire.

During six years of follow-up, 4,654 of the women died, including 979 who died from cardiovascular disease.

Compared with women who did not have either condition, the results were:
   ● those with depression had a 44 percent increased risk of death,
   ● those with diabetes had a 35 percent increased risk of death and
   ● those with both conditions had approximately twice the risk of death.

When considering only deaths from cardiovascular disease,
   ● women with diabetes had a 67 percent increased risk,
   ● women with depression had a 37 percent increased risk and
   ● women with both had a 2.7-fold increased risk.

"The underlying mechanisms of the increased mortality risk associated with depression in patients with diabetes remains to be elucidated," the authors write.

"It is generally suggested that depression is associated with poor glycemic control, an increased risk of diabetes complications, poor adherence to diabetes management by patients and isolation from the social network."

In addition, diabetes and depression are both linked to unhealthy behaviors such as smoking, poor diet and a sedentary lifestyle, and depression could trigger changes in the nervous system that adversely affect the heart.

"Considering the size of the population that could be affected by these two prevalent disorders, further consideration is required to design strategies aimed to provide adequate psychological management and support among those with longstanding chronic conditions, such as diabetes," the authors conclude.

This study was supported by a National Institutes of Health grant.

Read below to learn more about Diabetes, Depression and Depression in the Elderly

About Diabetes (MedlinePlus NIH)

Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With Type 1 diabetes, your body does not make insulin. With Type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.

Symptoms of Type 2 diabetes may include fatigue, thirst, weight loss, blurred vision and frequent urination. Some people have no symptoms. A blood test can show if you have diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your glucose level and take medicine if prescribed.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

>> More about diabetes at MedlinePlus

About Depression (MedlinePlus NIH)

Depression is a serious medical illness that involves the brain. It's more than just a feeling of being "down in the dumps" or "blue" for a few days. If you are one of the more than 20 million people in the United States who have depression, the feelings do not go away. They persist and interfere with your everyday life. Symptoms can include

   ● Sadness
   ● Loss of interest or pleasure in activities you used to enjoy
   ● Change in weight
   ● Difficulty sleeping or oversleeping
   ● Energy loss
   ● Feelings of worthlessness
   ● Thoughts of death or suicide

Depression can run in families, and usually starts between the ages of 15 and 30. It is much more common in women. Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorderin the winter. Depression is one part of bipolar disorder.

There are effective treatments for depression, including antidepressants and talk therapy. Most people do best by using both.

NIH: National Institute of Mental Health

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