Chao-Yi Wu1, Lauren Terhorst2,3,4, Jordan F Karp5,6, Elizabeth R Skidmore2,3,7, Juleen Rodakowski2,3. 1. Department of Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, PA chw131@pitt.edu. 2. Department of Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, PA. 3. Clinical and Translational Institute, University of Pittsburgh, Pittsburgh, PA. 4. Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA. 5. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. 6. Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA. 7. Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.
Abstract
OBJECTIVE: We examined whether the trajectory of disability differed between older adults with and without elevated depressive symptoms before and after the onset of diabetes mellitus (DM) over 10 years (2004-2014) and explored difficulties in basic and instrumental activities of daily living between the two groups. RESEARCH DESIGN AND METHODS: A generalized linear mixed-model analysis was conducted using five waves (8th-12th) of Health and Retirement Study (HRS) data. We included 419 older adults who self-reported new DM diagnosis within the previous 2 years and used the Center of Epidemiologic Studies Depression Scale to measure elevated depressive symptoms. Disability was measured by 10 items defined in the HRS data set. RESULTS: The trajectory of disability differed between older adults with and without elevated depressive symptoms after newly diagnosed DM over time. Significant and clinically meaningful between-group differences were found in disability after the onset of DM (waves 10 and 11) but not before the onset of DM (waves 8 and 9). Among older adults with elevated depressive symptoms, disability at pre-DM waves (8 and 9) was significantly less than post-DM waves (10-12). Difficulties with shopping, walking, and dressing were mostly reported by older adults with elevated depressive symptoms. CONCLUSIONS: Older adults with newly diagnosed DM and elevated depressive symptoms have a clinically meaningful and faster disablement trajectory than those without elevated depressive symptoms. Future interventions may take an indicated approach to disability prevention in older adults with newly diagnosed DM, especially in those with a change in depression severity.
OBJECTIVE: We examined whether the trajectory of disability differed between older adults with and without elevated depressive symptoms before and after the onset of diabetes mellitus (DM) over 10 years (2004-2014) and explored difficulties in basic and instrumental activities of daily living between the two groups. RESEARCH DESIGN AND METHODS: A generalized linear mixed-model analysis was conducted using five waves (8th-12th) of Health and Retirement Study (HRS) data. We included 419 older adults who self-reported new DM diagnosis within the previous 2 years and used the Center of Epidemiologic Studies Depression Scale to measure elevated depressive symptoms. Disability was measured by 10 items defined in the HRS data set. RESULTS: The trajectory of disability differed between older adults with and without elevated depressive symptoms after newly diagnosed DM over time. Significant and clinically meaningful between-group differences were found in disability after the onset of DM (waves 10 and 11) but not before the onset of DM (waves 8 and 9). Among older adults with elevated depressive symptoms, disability at pre-DM waves (8 and 9) was significantly less than post-DM waves (10-12). Difficulties with shopping, walking, and dressing were mostly reported by older adults with elevated depressive symptoms. CONCLUSIONS: Older adults with newly diagnosed DM and elevated depressive symptoms have a clinically meaningful and faster disablement trajectory than those without elevated depressive symptoms. Future interventions may take an indicated approach to disability prevention in older adults with newly diagnosed DM, especially in those with a change in depression severity.
Authors: Jeffrey S Gonzalez; Steven A Safren; Enrico Cagliero; Deborah J Wexler; Linda Delahanty; Eve Wittenberg; Mark A Blais; James B Meigs; Richard W Grant Journal: Diabetes Care Date: 2007-05-29 Impact factor: 19.112
Authors: Stefano Volpato; Luigi Ferrucci; Caroline Blaum; Glenn Ostir; Anne Cappola; Linda P Fried; Renato Fellin; Jack M Guralnik Journal: Diabetes Care Date: 2003-01 Impact factor: 19.112