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Diabetes Care Publish Ahead of Print published online ahead of print March 10, 2008
DOI: 10.2337/dc07-2215
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Original Research

EFFECT OF RACE/ETHNICITY AND PERSISTENT RECOGNITION OF DEPRESSION ON MORTALITY IN ELDERLY MEN WITH TYPE 2 DIABETES AND DEPRESSION

Lisa K. Richardson, MAppPsy1,,2, Leonard E. Egede, MD, MS3,,4 and Martina Mueller, PhD3,,5

Department of Psychiatry, Medical University of South Carolina, Charleston, SC1
School of Psychology, Murdoch University, Perth, Western Australia2
Ralph H. Johnson VAMC, Charleston, SC3
Department of Medicine, Medical University of South Carolina, Charleston, South Carolina4
Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina5

egedel{at}musc.edu

ABSTRACT

Objective: To determine whether mortality risk from depression among elderly men with type 2 diabetes differs by persistent recognition of depression and ethnicity.

Research Design and Methods: Data on a cohort of 14, 500 male veterans with type 2 were analyzed. Diagnoses of depression and diabetes were based on ICD-9 codes. Persistent recognition was defined as individuals with ICD-9 code for depression documented at ≥2 and ≥3 visits after initial diagnosis of depression. Hazards of death were compared using Cox proportional hazards regression models adjusting for relevant covariates.

Results: Over 10 years, 2, 305 deaths were documented. Mortality risk was higher for depressed compared to non-depressed veterans with diabetes (HR 1.6 [1.3-1.8]). Among those with depression, mortality risk was lower with persistent recognition (0-2 vs. ≥3, HR 0.58 [0.40-0.89]), but higher for whites compared to blacks (1.60, 95% CI 1.11-2.31).

Conclusion: Increased mortality from depression differs by ethnicity and persistent recognition.


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