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Haemoglobin A1c, fasting glucose and future risk of elevated depressive symptoms over 2 years of follow-up in the English Longitudinal Study of Ageing

Published online by Cambridge University Press:  02 February 2011

M. Hamer ,
G. D. Batty  and
M. Kivimaki
M. Hamer*
Affiliation:
Department of Epidemiology and Public Health, University College London, London, UK
G. D. Batty
Affiliation:
Department of Epidemiology and Public Health, University College London, London, UK Medical Research Council Social and Public Health Sciences Unit, Glasgow, UK Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
M. Kivimaki
Affiliation:
Department of Epidemiology and Public Health, University College London, London, UK
*
*Address for correspondence: M. Hamer, Ph.D., Department of Epidemiology and Public Health, 1–19 Torrington Place, University College London, London WC1E 6BT, UK. (Email: m.hamer@ucl.ac.uk)
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Abstract

Background

The cross-sectional association between impaired glucose/diabetes and depression is inconsistent. We examined the longitudinal associations between diabetes, indicators of glucose metabolism and depressive symptoms over 2 years of follow-up.

Method

Participants were 4338 men and women from the English Longitudinal Study of Ageing, a prospective study of community-dwelling older adults [aged 62.9 (s.d.=9.0) years, 45.2% men]. Depressive symptoms were assessed at baseline and after 2 years of follow-up using the eight-item Centre of Epidemiological Studies – Depression (CES-D) scale. Glycated haemoglobin (HbA1c) levels, fasting glucose and other biological and behavioural risk factors were also assessed at baseline.

Results

Approximately 11.5% of the sample were categorized with elevated depressive symptoms at follow-up (a score ⩾4 on the CES-D). There was an association between HbA1c and depressive symptoms at follow-up [per unit increase, odds ratio (OR) 1.17, 95% confidence interval (CI) 1.03–1.33] after adjustment for age and baseline CES-D. Cross-sectionally, the probability of depressive symptoms increased with increasing HbA1c levels until the value of 8.0% after which there was a plateau [p(curve)=0.03]. Compared with those with normal fasting glucose, participants with diabetes (confirmed through self-report or elevated fasting blood glucose) at baseline had an elevated risk of depressive symptoms at follow-up (OR 1.52, 95% CI 1.01–2.30) after adjusting for depressive symptoms at baseline, behavioural and sociodemographic variables, adiposity and inflammation.

Conclusions

These data suggest that poor glucose metabolism and diabetes are risk factors for future depression in older adults. There was no evidence of a U-shaped association.

Keywords

Ageingdepressive symptomsdiabeteshaemoglobin A1cpsychobiology
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 9 , September 2011 , pp. 1889 - 1896
Copyright
Copyright © Cambridge University Press 2011

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