Cited by 587Diabetes Management and EducationAging, Health, and DisabilityHealth disparities and outcomes

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Depression Predicts Increased Incidence of Adverse Health Outcomes in Older Mexican Americans With Type 2 Diabetes

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Black, Sandra A., Markides, Kyriakos S., Ray, Laura A.·2003·Diabetes Care

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Abstract

OBJECTIVE—To examine the separate and combined effects of depression and diabetes on the incidence of adverse health outcomes among older Mexican Americans. RESEARCH DESIGN AND METHODS—Longitudinal data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (EPESE) survey were used to examine the main effects and interaction effects of diabetes and depressive symptoms (measured with the Center for Epidemiologic Study of Depression) or clinical diagnostic criteria (measured with the Composite International Diagnostic Interview Depression Module) on the development of macrovascular complications (including cardiovascular disease, stroke, and kidney disease), microvascular complications (including nephropathy, neuropathy, retinopathy, and amputations), functional disability, and mortality over 7 years in a sample of 2,830 Mexican Americans aged ≥65 years. RESULTS—The interaction of diabetes and depression was found to be synergistic, predicting greater mortality, greater incidence of both macro- and microvascular complications, and greater incidence of disability in activities of daily living, even when controlling for sociodemographic characteristics such as sex, age, education, acculturation, and marital status. Importantly, this interaction was found to predict not only greater incidence but also earlier incidence of adverse events in older adults. CONCLUSIONS—Whether a marker for underlying disease severity, an indicator of diminished self-care motivation, or the result of physiologic changes, the interaction of depression and diabetes has a synergistic effect on the health of older Mexican Americans, increasing the risk for poor outcomes. This is of particular clinical importance because although depression is often underrecognized in older adults, effective treatment is available and can result in improved medical outcomes.

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Authors: Black, S. A., Markides, K. S., & Ray, L. A.
Affiliations: University of Maryland, Baltimore (US)
The University of Texas Medical Branch at Galveston (US)
ORCID: Black, Sandra A.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2003-10-01
Volume: 26
Issue: 10
Pages: 2822-2828
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.26.10.2822
OpenAlex: W2091420496
Cited by: 587
References: 39
Citations by year: 2026: 6 · 2025: 6 · 2024: 12 · 2023: 13 · 2022: 10 · 2021: 16 · 2020: 25 · 2019: 24 · 2018: 25 · 2017: 25 · 2016: 50 · 2015: 30 · 2014: 34 · 2013: 40 · 2012: 44
FWCI: 14.24
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Aging (AG 10939, R01AG010939)
National Institute of Diabetes and Digestive and Kidney Diseases (DK51261)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Social Sciences › Health › Health disparities and outcomes
Keywords: depression, type 2 diabetes, older Mexican Americans, adverse health effects, macrovascular complications, microvascular complications, mortality, functional disability, activities of daily living, cardiovascular disease, stroke, kidney disease, neuropathy, retinopathy, amputation
MeSH terms: Aged, Depression, Diabetes Mellitus, Type 2, Disability Evaluation, Female, Humans, Longitudinal Studies, Male, Predictive Value of Tests, Incidence, Prevalence, Multivariate Analysis, Mexican Americans

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Depression Predicts Increased Incidence of Adverse Health Outcomes in Older Mexican Americans With Type 2 Diabetes

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