Depressed Women with Diabetes at High Risk for Heart Disease, Death
Women with diabetes and depression are at higher risk of dying from all causes suggests new research.
In a study of 78,282 women, aged 54 to 79 participating in the Nurses' Health Study in 2000, An Pan, Ph.D., Harvard School of Public Health, Boston, and colleagues found that depression and diabetes significantly increased the chances that a woman will die from heart disease or other causes over a 6-year period.
Women in the study were confirmed to be diabetic via questionnaires. Among those studied, depression was determined by diagnosis, found on a depression index-scoring tool or identified from use of antidepressants.
During the six-year follow up, the researchers found a 44 percent increased chance of dying from cardiovascular among women with depression and a 35 percent increased death risk among women with diabetes, compared to those who had neither.
For cardiovascular disease alone, women with diabetes had a 67 percent higher risk of death. Depression boosted the chances of dying 37 percent, but for women with diabetes and depression the increased chance of dying was 2.7 times higher.
The authors say the reasons are not clear, but perhaps depression leads to poor eating habits and failure to control diabetes that leads to complications. Other unhealthy behaviors such as poor eating, smoking and lack of exercise could also be contributing factors that are manifestations of depression.
"Considering the size of the population that could be affected by these two prevalent disorders, further consideration is required to design strategies aimed to provide adequate psychological management and support among those with longstanding chronic conditions, such as diabetes," the authors conclude.
The findings are significant given the prevalence of diabetes globally and depression that affects 15 million U.S. adults each year, according to background information from the study. The prevalence of depression among diabetics is double that of people without the disease.
The authors also speculate diabetes and depression might be linked to higher death rates in women because of changes in the nervous system that affect the heart.
Arch Gen Psychiatry. 2011;68(1):42-50. doi:10.1001/archgenpsychiatry.2010.176