Education as a moderator in the effect of diabetes on depressive symptoms in Chinese middle-aged and older adults: A population-based longitudinal study.

BACKGROUND

Co-morbid diabetes and depression is common; however, little evidence was regarding the effect of education on this association. This study aimed to investigate the role of education in the effect of diabetes on depressive symptoms in China.

METHODS

We used data from the China Health and Retirement Longitudinal Study, including 6,921 participants free from depressive symptoms in three waves of cohort study from 2011. We assessed the depressive symptoms based on Center for Epidemiological Studies-Depression scale. We fitted Cox proportional hazards regression models to examine the effect of baseline diabetes on the subsequent depressive symptoms.

RESULTS

Participants with diagnosed diabetes were more likely than their nondiabetic peers to develop depressive symptoms only in 45-64 years group, with a hazard ratio of 1.30 (95% CI: 1.05, 1.61). In addition, the effect of diagnosed diabetes on depressive symptoms only occurred in participants with a diploma of primary school or below.

LIMITATIONS

Information was unavailable may offer additional explanatory power.

CONCLUSION

Our findings suggested that diagnosed diabetes was a chronic stressor in developing depressive symptoms, and that response to this stressor varied by individuals' educational attainment. Action to prevent and treat diabetes may contribute to the fight against depressive symptoms, especially in the lower-education population.