TY - JOUR
T1 - Diabetes, depressive symptoms, and functional disability in African Americans
T2 - the Jackson Heart Study
AU - Kalyani, Rita Rastogi
AU - Ji, Nan
AU - Carnethon, Mercedes
AU - Bertoni, Alain G.
AU - Selvin, Elizabeth
AU - Gregg, Edward W.
AU - Sims, Mario
AU - Golden, Sherita Hill
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/8
Y1 - 2017/8
N2 - 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.
AB - 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.
KW - African Americans
KW - Depression
KW - Diabetes
KW - Functional disability
KW - Racial disparities
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U2 - 10.1016/j.jdiacomp.2017.03.003
DO - 10.1016/j.jdiacomp.2017.03.003
M3 - Article
C2 - 28433449
AN - SCOPUS:85017511571
SN - 1056-8727
VL - 31
SP - 1259
EP - 1265
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
IS - 8
ER -