Association Between Depressive Symptoms and Comorbidities Among Elderly Diabetic Individuals in China

Abstract

Background: Diabetic individuals are at an increased risk of mental illness and comorbidities. However, the precise association between depressive symptoms and comorbidity remains uncertain. Our study aimed to investigate this relationship among elderly Chinese diabetic patients.

Methods: Data from the China Health and Retirement Longitudinal Study (CHARLS) in 2020 were utilized for the cross-sectional analysis. Depressive status was defined as the dependent variable, while the presence, number, and type of comorbidities served as independent variables. Logistic regression analyses were performed, adjusting for potential demographic factors, and health status and functioning factors.

Results: Our findings indicate that diabetic patients with complications are more likely to experience depression. With the exception for dyslipidemia (OR = 1.195, 95% CI: 0.969, 1.475), individuals with hypertension, heart disease, stroke, kidney disease, memory-related disease, or arthritis/rheumatism were prone to develop depressive status in the fully adjusted model. After adjusting for covariates, diabetic patients with memory-related diseases exhibited the most pronounced association with depressive symptoms (OR = 2.673, 95% CI: 1.882, 3.797). Furthermore, an increasing number of depression-related comorbidities strengthened the association (p < 0.05). Sensitivity analysis revealed that there were no significant differences stratified by gender or marital status (p < 0.05).

Conclusions: In the elderly diabetic population in China, the presence, number, and type of comorbidities were independently associated with depressive symptoms. Diabetic patients with memory-related diseases displayed the highest likelihood of experiencing depressive status. These findings underscore the importance of implementing effective strategies for multimorbidity management in diabetic patients.

Keywords: CHARLS; comorbidity; depressive symptoms; diabetes mellitus.

FIGURE 1

Flowchart of this study's individuals selection.

FIGURE 2

Association between depression with each diabetic comorbidity. Model 1: no adjustment; Model 2: adjusted for demographic background factors (including age, gender, residential area, education, marital status, and health insurance); Model 3: adjusted as per Model 2 and with health status and functioning factors (including smoking and drinking status, regular exercise, and cognitive scores). *p < 0.05. 95% CI: 95% confidence interval; OR: odds ratio.

FIGURE 3

Association between the status, number of comorbidities related to depression and depression. ORs were adjusted for age, gender, residential area, education, marital status, health insurance, smoking and drinking status, regular exercise, and cognitive scores. *p < 0.05. 95% CI: 95% confidence interval; OR: odds ratio.