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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Vydáno v:	Journal of diabetes and its complications Ročník 31; číslo 8; s. 1259 - 1265
Hlavní autoři:	Kalyani, Rita Rastogi, Ji, Nan, Carnethon, Mercedes, Bertoni, Alain G., Selvin, Elizabeth, Gregg, Edward W., Sims, Mario, Golden, Sherita Hill
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Elsevier Inc 01.08.2017 Elsevier Limited
Témata:	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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Abstract	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.
AbstractList	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. Abstract Aims 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. Methods We examined 2,989 African Americans(AAs) in the Jackson Heart Study who had diabetes and depressive symptoms(CES-D) assessed at baseline. Functional disability was 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. Results Prevalence of 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,physical activity, cardiovascular comorbidities,and hsCRP, the association of depressive symptoms alone(OR = 2.19,95% CI 1.66-2.90) and both diabetes and depressive symptoms(OR = 2.80,1.90-4.12) with functional disability was significant, but not for diabetes alone(OR = 1.22,0.92-1.62), compared to neither. No significant interaction of diabetes and depressive symptoms was found. In regression analyses including diabetes and depressive symptoms together, functional disability was increased with depressive symptoms(OR = 2.23,1.76-2.81) but not diabetes(OR = 1.24,0.97-1.57). Conclusions 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. 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.AIMSTo 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.METHODSWe 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).RESULTSPrevalence 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.CONCLUSIONSFunctional 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. Aims 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. Methods 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. Results 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). Conclusions 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.
Author	Golden, Sherita Hill Gregg, Edward W. Sims, Mario Selvin, Elizabeth Carnethon, Mercedes Bertoni, Alain G. Kalyani, Rita Rastogi Ji, Nan
AuthorAffiliation	3 Department of Preventive Medicine-Epidemiology, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611 USA 1 Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, Maryland 21287 USA 2 Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 333, Baltimore, Maryland 21287 USA 4 Department of Epidemiology and Prevention Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157 USA 6 Department of Medicine, University of Mississippi Medical Center, Jackson Medical Mall Suite 701, 350 W. Woodrow Wilson Drive, Jackson, MS 39213 USA 5 Centers for Disease Control, Division of Diabetes Translation; 4770 Buford Hwy., NE Mailstop K-10, Atlanta, GA 30341 USA
AuthorAffiliation_xml	– name: 2 Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 333, Baltimore, Maryland 21287 USA – name: 3 Department of Preventive Medicine-Epidemiology, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611 USA – name: 5 Centers for Disease Control, Division of Diabetes Translation; 4770 Buford Hwy., NE Mailstop K-10, Atlanta, GA 30341 USA – name: 4 Department of Epidemiology and Prevention Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157 USA – name: 6 Department of Medicine, University of Mississippi Medical Center, Jackson Medical Mall Suite 701, 350 W. Woodrow Wilson Drive, Jackson, MS 39213 USA – name: 1 Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, Maryland 21287 USA
Author_xml	– sequence: 1 givenname: Rita Rastogi surname: Kalyani fullname: Kalyani, Rita Rastogi email: rrastogi@jhmi.edu organization: Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA – sequence: 2 givenname: Nan surname: Ji fullname: Ji, Nan email: nancyji0702@gmail.com organization: Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA – sequence: 3 givenname: Mercedes surname: Carnethon fullname: Carnethon, Mercedes email: carnethon@northwestern.edu organization: Department of Preventive Medicine-Epidemiology, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA – sequence: 4 givenname: Alain G. surname: Bertoni fullname: Bertoni, Alain G. email: abertoni@wfubmc.edu organization: Department of Epidemiology and Prevention Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA – sequence: 5 givenname: Elizabeth surname: Selvin fullname: Selvin, Elizabeth email: lselvin@jhsph.edu organization: Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA – sequence: 6 givenname: Edward W. surname: Gregg fullname: Gregg, Edward W. email: edg7@cdc.gov organization: Centers for Disease Control, Division of Diabetes Translation, 4770 Buford Hwy., NE Mailstop K-10, Atlanta, GA 30341, USA – sequence: 7 givenname: Mario surname: Sims fullname: Sims, Mario email: msims2@umc.edu organization: Department of Medicine, University of Mississippi Medical Center, Jackson Medical Mall Suite 701, 350 W. Woodrow Wilson Drive, Jackson, MS 39213, USA – sequence: 8 givenname: Sherita Hill surname: Golden fullname: Golden, Sherita Hill email: sahill@jhmi.edu organization: Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA
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Snippet	To investigate the degree to which comorbid depression contributes to the relationship of diabetes with functional disability in African Americans (AAs), a... Abstract Aims To investigate the degree to which comorbid depression contributes to the relationship of diabetes with functional disability in African... Aims To investigate the degree to which comorbid depression contributes to the relationship of diabetes with functional disability in African Americans (AAs),...
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SubjectTerms	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
Title	Diabetes, depressive symptoms, and functional disability in African Americans: the Jackson Heart Study
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