Contributions of diabetic macro-vascular complications and hip fracture to depression onset in elderly patients with diabetes: An 8-year population-based follow-up study

Hsueh Hsing Pan, Chung Yi Li, Pei Chun Chen, Ming Der Lee, Chun Yu Liang, Wen Hsuan Hou, Kwua Yun Wang

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: To prospectively examine the roles of diabetic macro-vascular complications and hip fracture in association with depression onset in Taiwan's elderly diabetic population. Methods: A representative sample of elderly diabetic patients (. n=. 144,216) identified in 2000 were linked to National Health Insurance claims (2000-2007) to ascertain the diagnoses of depression in both outpatient and inpatient settings. The person-year approach with Poisson assumption was used to estimate the hazard rates. Using Cox proportional hazard regression model, we evaluated the relative risk of depression in relation to diabetic macro-vascular complications and hip fracture. The additive effects from the above medical conditions were also assessed. Results: The 8-year cumulative risk of depression was 5.08%, representing an incidence density of 8.40 per 1000 patient-years. Hazard ratio (HR) with 95% confidence interval (CI) for the elderly diabetes associated with cardiovascular disease (CVD), hip fracture, and lower extremity amputation was 1.13 (1.04-1.23), 1.10 (0.91-1.34), and 1.25 (0.95-1.65), respectively. Additionally, we found that the more the complications or hip fracture, the higher the risk of depression onset in elderly diabetes. Conclusion: The increased number of diabetic macro-vascular complications and hip fracture is significantly associated with a higher risk of depression onset in elderly diabetes. Future studies should be conducted to assess the feasibility and cost-effectiveness of intensive depression screening program in elderly diabetes suffering from macro-vascular complications and hip fracture.

Original languageEnglish
Pages (from-to)180-184
Number of pages5
JournalJournal of Psychosomatic Research
Volume73
Issue number3
DOIs
Publication statusPublished - Sep 2012

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Diabetic Angiopathies
Hip Fractures
Population
National Health Programs
Taiwan
Amputation
Proportional Hazards Models
Cost-Benefit Analysis
Blood Vessels
Inpatients
Lower Extremity
Outpatients
Cardiovascular Diseases
Confidence Intervals
Incidence

Keywords

  • Depression
  • Diabetic complications
  • Elderly
  • Population-based

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Contributions of diabetic macro-vascular complications and hip fracture to depression onset in elderly patients with diabetes : An 8-year population-based follow-up study. / Pan, Hsueh Hsing; Li, Chung Yi; Chen, Pei Chun; Lee, Ming Der; Liang, Chun Yu; Hou, Wen Hsuan; Wang, Kwua Yun.

In: Journal of Psychosomatic Research, Vol. 73, No. 3, 09.2012, p. 180-184.

Research output: Contribution to journalArticle

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abstract = "Objective: To prospectively examine the roles of diabetic macro-vascular complications and hip fracture in association with depression onset in Taiwan's elderly diabetic population. Methods: A representative sample of elderly diabetic patients (. n=. 144,216) identified in 2000 were linked to National Health Insurance claims (2000-2007) to ascertain the diagnoses of depression in both outpatient and inpatient settings. The person-year approach with Poisson assumption was used to estimate the hazard rates. Using Cox proportional hazard regression model, we evaluated the relative risk of depression in relation to diabetic macro-vascular complications and hip fracture. The additive effects from the above medical conditions were also assessed. Results: The 8-year cumulative risk of depression was 5.08{\%}, representing an incidence density of 8.40 per 1000 patient-years. Hazard ratio (HR) with 95{\%} confidence interval (CI) for the elderly diabetes associated with cardiovascular disease (CVD), hip fracture, and lower extremity amputation was 1.13 (1.04-1.23), 1.10 (0.91-1.34), and 1.25 (0.95-1.65), respectively. Additionally, we found that the more the complications or hip fracture, the higher the risk of depression onset in elderly diabetes. Conclusion: The increased number of diabetic macro-vascular complications and hip fracture is significantly associated with a higher risk of depression onset in elderly diabetes. Future studies should be conducted to assess the feasibility and cost-effectiveness of intensive depression screening program in elderly diabetes suffering from macro-vascular complications and hip fracture.",
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AB - Objective: To prospectively examine the roles of diabetic macro-vascular complications and hip fracture in association with depression onset in Taiwan's elderly diabetic population. Methods: A representative sample of elderly diabetic patients (. n=. 144,216) identified in 2000 were linked to National Health Insurance claims (2000-2007) to ascertain the diagnoses of depression in both outpatient and inpatient settings. The person-year approach with Poisson assumption was used to estimate the hazard rates. Using Cox proportional hazard regression model, we evaluated the relative risk of depression in relation to diabetic macro-vascular complications and hip fracture. The additive effects from the above medical conditions were also assessed. Results: The 8-year cumulative risk of depression was 5.08%, representing an incidence density of 8.40 per 1000 patient-years. Hazard ratio (HR) with 95% confidence interval (CI) for the elderly diabetes associated with cardiovascular disease (CVD), hip fracture, and lower extremity amputation was 1.13 (1.04-1.23), 1.10 (0.91-1.34), and 1.25 (0.95-1.65), respectively. Additionally, we found that the more the complications or hip fracture, the higher the risk of depression onset in elderly diabetes. Conclusion: The increased number of diabetic macro-vascular complications and hip fracture is significantly associated with a higher risk of depression onset in elderly diabetes. Future studies should be conducted to assess the feasibility and cost-effectiveness of intensive depression screening program in elderly diabetes suffering from macro-vascular complications and hip fracture.

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