Depressive symptoms are not longitudinally associated with joint glycemic, blood pressure and cholesterol control among middle-aged and older adults with diabetes in USA

Depression co-occurs with diabetes at twice the rate, relative to the general population without diabetes but it is unknown whether depression is longitudinally associated with diabetes control in the general population. To characterize the longitudinal association between depressive symptoms and joint achievement of glycemic, blood pressure (BP), and cholesterol control (ABC control) among middle-aged and older adults (≥50 years) with diabetes in United States. Data of the nationally representative Health and Retirement Study 2006-2017 were pooled across study waves conducted every 2 years. Center for Epidemiological Studies Depression (CES-D8) scale was used to assess baseline depressive symptoms (≥3 points). Joint ABC control 4 years later was ascertained using HbA1c (<7.0% [53 mmol/mol] if <65 years, <7.5% [58 mmol/mol] if ≥65 years or <8.0% [64 mmol/mol] with comorbidities), BP (systolic < 140 and diastolic < 90 mm Hg), and non-HDL cholesterol (<130 mg/dL). Survey-weighted modified Poisson regressions were used to study the association (risk ratios [RR]) of depressive symptoms with ABC control. The study sample consisted of 3 332 observations from 2 531 individuals (mean age: 64.4 years [SD: 8.8], 55.4% women). Depressive symptoms were neither associated with the achievement of joint ABC control (RR: 0.91 [95% CI, 0.76-1.09]) nor achievement of glycemic, BP or cholesterol control after adjusting for covariates. Findings were consistent across various subgroups defined by age, gender, baseline ABC control, medication use, and duration of diabetes. Baseline depressive symptoms do not compromise future diabetes management. Care models should focus on both conditions independently to potentially improve overall health.