Association between Depressive Symptoms and Cognitive Function in Persons with Diabetes Mellitus: A Systematic Review

Abstract

Depression and diabetes are independent risk factors for one another, and both are associated with increased risk of cognitive decline. Diabetes patients with lower cognitive function are more likely to suffer poorer health outcomes. However, the role of depression in cognitive decline among people with diabetes is not well understood. This systematic review assessed whether adults with comorbid diabetes and depression or depressive symptoms exhibit greater cognitive decline relative to individuals with diabetes alone. Searches were run in CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and PubMed (MEDLINE) with no time or language restrictions. Studies were eligible for inclusion if they were of any quantitative study design, included participants aged 18 years or older with diabetes mellitus of which some must have presented with current depression, and measured cognition as an outcome. The Cochrane Collaboration’s Risk Of Bias In Non-randomized Studies–of Interventions tool was used for quality assessment of each study and its collected outcome. Fifteen articles were included in the final analysis. The high degree of heterogeneity in exposures, outcomes, and participant characteristics precluded a meta-analysis of any of the studies, and the risk of bias observed in these studies limits the strength of the evidence. Nonetheless, this review found the presence of comorbid depression was associated with poorer cognitive outcomes than for persons with diabetes alone. While large-scale preventive efforts must address epidemic levels of diabetes and its comorbidities, on the patient level healthcare professionals must be cognizant of the added difficulties that depression poses to patients and the extra support required to management diabetes in these cases. This systematic review is registered with the University of York Centre for Reviews and Dissemination under registration number 2015:CRD42015025122.

Relationship between Illness Perception and Depressive Symptoms among Type 2 Diabetes Mellitus Patients in China: A Mediating Role of Coping Style

“…Diabetes is a chronic and progressive metabolic disease characterized by high blood sugar [ 1 ]. The global prevalence of diabetes is rising annually, reaching 467 million in 2019 [ 2 ].…”

The associations between self-reported depression, self-reported chronic inflammatory conditions and cognitive abilities in UK Biobank

“…Studies of combined effects of depression and chronic inflammatory conditions on cognitive ability are however rare [ 9 ]. In the context of functioning and wellbeing, although effects have been small and inconsistent [ 10 ], some studies have reported interactions between depression and chronic disease status on various health-related outcomes.…”

“…Studies of combined effects of depression and chronic inflammatory conditions on cognitive ability are however rare. One study found that multiple sclerosis (MS) patients with and without depression did not differ on tests of verbal fluency, attention or verbal memory [ 13 ], while a recent systematic review found that depression in addition to diabetes was associated with reduced cognitive performance relative to diabetes without depression [ 9 ]. Aside from these studies, the potential for worse cognitive outcomes in comorbid depression and inflammatory disease, and the possibility that these types of disorders interact to have multiplicative effects on cognition has remained understudied, despite evidence of associations of cognitive decline in depression and inflammatory conditions with reduced quality of life and increased functional impairment [ 14 ].…”

BDNF‐TrkB pathway mediates antidepressant‐like roles of H2S in diabetic rats via promoting hippocampal autophagy

“…The prevalence of depression in diabetic patients is higher than that in the average population . Although some antidepressants are used in the treatment of depressive patients caused by diabetes mellitus, there are still many depressive patients with poor therapeutic efficacy.…”