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Vincent Chin-Hung Chen,1,2 Tsu-Nai Wang,3 Ming-Chia Hsieh,4 Shih-Yong Chou,1 Meng-Chih Lee,5,6 Roger S McIntyre,7 Mong-Liang Lu,8 Yin-To Liao,9,10 Chih-Jung Yeh11,12 1Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; 2School of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan; 4U Come Joint Clinic, Taichung, Taiwan; 5Department of Family Medicine, Taichung Hospital, Taichung, Taiwan; 6College of Management, Chaoyang University of Technology, Taichung, Taiwan; 7University of Toronto, Toronto, ON, Canada; 8Department of Psychiatry, Wan-Fang Hospital and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 9Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan; 10Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 11Institute of Population Health Sciences, National Health Research Institutes, Taipei, Taiwan; 12School of Public Health, Chung Shan Medical University, Taichung, TaiwanCorrespondence: Yin-To Liao, Email je2tezy@yahoo.com.tw Chih-Jung Yeh, School of Public Health, Chung Shan Medical University, No. 110, Section 1, Jianguo N. Road, Taichung, 402, Taiwan, Tel +886-4-24730022x12183, Fax +886-4-23248179, Email alexyeh@csmu.edu.twPurpose: Diabetes mellitus (DM) increases the risk of cardiovascular and all-cause mortality. The coexistence of depression and DM is associated with an increased risk of DM complications and functional morbidity. The independent effect of depression on mortality in patients with DM is unclear, and relevant Asian studies have provided inconsistent results. Accordingly, this study assessed the independent and additive effects of DM and depression on mortality in a nationally representative cohort of older adults in Taiwan over a 10-year observation period.Patients and Methods: A total of 5041 participants aged 50 years or older were observed between 1996 and 2007. We defined depression as a score of ≥ 8 on the 10-item Center for Epidemiologic Studies Depression (CES-D 10) scale. Additionally, we defined participants as having type 2 DM if they had received a diagnosis of type 2 DM from a health-care provider. Cox proportional hazard models were applied to analyze predictors of mortality in depression and DM comorbidity groups.Results: During the 10-year follow-up period, 1637 deaths were documented. After adjustment for potential confounders, the hazard ratios for mortality in participants with both depression and DM, DM only, and depression only were 2.47 (95% confidence interval [CI]: 2.02– 3.03), 1.95 (95% CI: 1.63– 2.32), and 1.23 (95% CI: 1.09– 1.39), respectively.Conclusion: The co-occurrence of depression with DM in Asian adults increased overall mortality rates. Our results indicate that the increased mortality hazard in individuals with DM and depression was independent of sex.Keywords: diabetes mellitus, depression, mortality, cohort |
