Diabetes, depressive symptoms, and functional disability in African Americans: the Jackson Heart Study

To investigate the degree to which comorbid depression contributes to the relationship of diabetes with functional disability in African Americans (AAs), a population at high-risk for complications. We examined 2989 African Americans (AAs) in the Jackson Heart Study who had diabetes and depressive s...

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Vydané v:Journal of diabetes and its complications Ročník 31; číslo 8; s. 1259 - 1265
Hlavní autori: Kalyani, Rita Rastogi, Ji, Nan, Carnethon, Mercedes, Bertoni, Alain G., Selvin, Elizabeth, Gregg, Edward W., Sims, Mario, Golden, Sherita Hill
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Elsevier Inc 01.08.2017
Elsevier Limited
Predmet:
Activities of Daily Living
Adult
African Americans
Aged
Atherosclerosis
Cardiovascular disease
Cohort Studies
Comorbidity
Cost of Illness
Cross-Sectional Studies
Depression
Depressive Disorder, Major - epidemiology
Depressive Disorder, Major - ethnology
Diabetes
Diabetes Mellitus - epidemiology
Diabetes Mellitus - ethnology
Diabetes Mellitus - psychology
Disability
Disabled Persons - psychology
Endocrinology & Metabolism
Female
Follow-Up Studies
Functional disability
Health Status Disparities
Heart
Humans
Male
Mental depression
Middle Aged
Mississippi - epidemiology
Prevalence
Psychiatric Status Rating Scales
Racial disparities
Self Report
United States > US
African Americans
Depression
Diabetes
Racial disparities
Functional disability
racial disparities
depression
functional disability
diabetes
ISSN:1056-8727, 1873-460X, 1873-460X
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Shrnutí:To investigate the degree to which comorbid depression contributes to the relationship of diabetes with functional disability in African Americans (AAs), a population at high-risk for complications. We examined 2989 African Americans (AAs) in the Jackson Heart Study who had diabetes and depressive symptoms (CES-D) assessed at baseline. Overall functional disability was defined as the inability to perform at least one task of daily living. Multivariable logistic regression models explored the association of diabetes and depressive symptoms with functional disability. Prevalence of overall functional disability was highest with both diabetes and depressive symptoms (54%), similar with diabetes alone (31%) or depressive symptoms alone (33%), and lowest with neither (15%). Adjusting for demographics, smoking, BMI, cardiovascular comorbidities, and hsCRP, the association of depressive symptoms alone (OR=2.30,95% CI 1.75–3.03) and both diabetes and depressive symptoms (OR=2.75,1.88–4.04) with overall functional disability was significant, but not for diabetes alone (OR=1.26,0.95–1.67), compared to neither. In regression analyses including any diabetes and any depressive symptoms together in models, the main effect of depressive symptoms but not diabetes was associated with overall functional disability, and the interaction term was not significant (p-value=0.84). Functional disability was highest among AAs who have both diabetes and depressive symptoms; the latter was a stronger contributor. Future studies should explore mechanisms underlying functional disability in diabetes, particularly the role of depression.
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ISSN:1056-8727
1873-460X
1873-460X
DOI:10.1016/j.jdiacomp.2017.03.003