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Type 2 diabetes, change in depressive symptoms over time, and cerebral small vessel disease – Longitudinal data of the AGES-Reykjavik Study
- Source :
- Diabetes Care, Diabetes Care, 43(8), 1781-1787. American Diabetes Association
- Publication Year :
- 2020
- Publisher :
- American Diabetes Association, 2020.
-
Abstract
- OBJECTIVE Type 2 diabetes has been associated with depression. However, the underlying pathophysiological mechanisms remain unknown. Cerebral small vessel disease, a consequence of diabetes, may lead to depression. Therefore, we evaluated whether cerebral small vessel disease mediates the association between type 2 diabetes and higher depressive symptoms. RESEARCH DESIGN AND METHODS We used longitudinal data from the population-based Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, with examinations from 2002 to 2006 and 5 years later. Type 2 diabetes was defined as self-reported history of type 2 diabetes, use of blood glucose–lowering drugs, or fasting blood glucose level ≥7.0 mmol/L. Cerebral small vessel disease load was quantified in a composite score based on MRI-defined presence of high white matter hyperintensity volume, low total brain parenchyma volume, and subcortical infarcts, cerebral microbleeds, and large perivascular spaces. The 5-year change in the 15-item Geriatric Depression Scale score (GDS-15) was measured between baseline and follow-up. RESULTS Included were 2,135 individuals without dementia and baseline depression (baseline age 74.5 [SD 4.6] years, 1,245 women [58.3%], and 197 [9.2%] with diabetes). The GDS-15 score increased 0.4 (SD 1.6) points over time. Baseline diabetes was associated with a greater increase in the GDS-15 score (β = 0.337; 95% CI 0.094; 0.579), adjusted for age, sex, education, and cardiovascular risk factors. Baseline cerebral small vessel disease and change of cerebral small vessel disease statistically significantly mediated a part of this association. CONCLUSIONS Type 2 diabetes is associated with a greater increase in depressive symptoms score over 5 years, and cerebral small vessel disease partly explains this association.
- Subjects :
- Male
Research design
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Population
Iceland
030209 endocrinology & metabolism
Disease
Type 2 diabetes
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Diabetes mellitus
Internal medicine
Internal Medicine
medicine
Humans
Dementia
Longitudinal Studies
030212 general & internal medicine
Epidemiology/Health Services Research
education
POPULATION
SCALE
Depression (differential diagnoses)
Aged
Aged, 80 and over
RISK
Advanced and Specialized Nursing
education.field_of_study
HYPERTENSION
Depression
business.industry
DEMENTIA
Brain
Organ Size
ASSOCIATION
medicine.disease
Magnetic Resonance Imaging
Diabetes Mellitus, Type 2
Cerebral Small Vessel Diseases
Cardiology
Female
Geriatric Depression Scale
business
STANDARDS
Subjects
Details
- ISSN :
- 01495992
- Database :
- OpenAIRE
- Journal :
- Diabetes Care, Diabetes Care, 43(8), 1781-1787. American Diabetes Association
- Accession number :
- edsair.doi.dedup.....3c6a99265bafde57a341a6634159fa2b