Palta Priya, Golden Sherita Hill, Teresi Jeanne A, Palmas Walter, Trief Paula, Weinstock Ruth S, Shea Steven, Manly Jennifer J, Luchsinger Jose A
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Diabetes Complications. 2014 Nov-Dec;28(6):798-804. doi: 10.1016/j.jdiacomp.2014.06.014. Epub 2014 Jul 1.
We investigated the longitudinal association of depression, with and without cognitive dysfunction, with hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein (LDL) in a predominantly minority cohort.
There were 613 participants. Presence of depression was defined by a score ≥7 on the Short-CARE depression scale. We tested participants for executive dysfunction using the Color Trails Test (CTT), part 2, and for memory dysfunction using the total recall task of the Selective Reminding Test (TR-SRT). We classified performance in these tests as abnormal based on standardized score cutoffs (<16th percentile and one standard deviation below the sample mean). Random effects models were used to compare repeated measures of the diabetes control measures between those with depression versus those without depression and ever versus never cognitively impaired.
Baseline depression was present in 36% of participants. Over a median follow-up of 2 years, depression was not related to worse HbA1c, SBP, or LDL. The presence of (1) abnormal performance on a test of executive function and depression (n=57) or (2) abnormal performance on a test of verbal recall and depression (n=43) was also not associated with clinically significant worse change in diabetes control.
Depression, with or without low performance in tests of executive function and memory, may not affect clinically significant measures of diabetes control in the elderly.
在一个以少数族裔为主的队列中,我们研究了伴有或不伴有认知功能障碍的抑郁症与糖化血红蛋白(HbA1c)、收缩压(SBP)和低密度脂蛋白(LDL)之间的纵向关联。
共有613名参与者。抑郁症的存在由简短综合老年抑郁量表(Short-CARE)得分≥7来定义。我们使用色词试验(CTT)第2部分测试参与者的执行功能障碍,使用选择性提醒试验(TR-SRT)的总回忆任务测试记忆功能障碍。根据标准化分数临界值(<第16百分位数和低于样本均值一个标准差)将这些测试中的表现分类为异常。使用随机效应模型比较抑郁症患者与非抑郁症患者以及认知功能受损者与未受损者之间糖尿病控制指标的重复测量值。
36%的参与者存在基线抑郁症。在中位随访2年期间,抑郁症与较差的HbA1c、SBP或LDL无关。(1)执行功能测试表现异常且伴有抑郁症(n = 57)或(2)言语回忆测试表现异常且伴有抑郁症(n = 43)也与糖尿病控制的临床显著恶化变化无关。
伴有或不伴有执行功能和记忆测试表现不佳的抑郁症可能不会影响老年人糖尿病控制的临床显著指标。