Association of Depression With Accelerated Cognitive Decline Among Patients With Type 2 Diabetes in the ACCORD-MIND Trial

Sullivan, Mark D.; Katon, Wayne; Lovato, Laura; Miller, Michael E.; Murray, Anne M.; Horowitz, Karen R.; Bryan, R. Nick; Gerstein, Hertzel C.; Marcovina, Santica M.; Akpunonu, Basil E.; Johnson, Janice; Yale, Jean-François; Williamson, Jeff D.; Launer, Lenore J.

doi:10.1001/jamapsychiatry.2013.1965

Cited by 114 publications

(86 citation statements)

References 45 publications

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“…Our observation that depressive symptoms were elevated in people with type 2 diabetes replicates previous research (6) and is important in light of the evidence that depression in diabetic populations is associated with accelerated cognitive decline (22) and increased mortality risk (23). It is interesting that all of the psychosocial measures except for caregiving indicated greater stress among people with diabetes than controls.…”

Section: Discussionsupporting

confidence: 84%

Disruption of multisystem responses to stress in type 2 diabetes: Investigating the dynamics of allostatic load

Steptoe

Hackett

Lazzarino

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

137

121

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Psychological stress-related processes are thought to contribute to the development and progression of type 2 diabetes, but the biological mechanisms involved are poorly understood. Here, we tested the notion that people with type 2 diabetes experience chronic allostatic load, manifest as dynamic disturbances in reactivity to and recovery from stress across multiple (cardiovascular, neuroendocrine, inflammatory, metabolic) biological systems, coupled with heightened experience of chronic life stress. We carried out an experimental comparison of 140 men and women aged 50-75 y with type 2 diabetes and 280 nondiabetic individuals matched on age, sex, and income. We monitored blood pressure (BP) and heart rate, salivary cortisol, plasma interleukin (IL)-6, and total cholesterol in response to standardized mental stress, and assessed salivary cortisol over the day. People with type 2 diabetes showed impaired poststress recovery in systolic and diastolic BP, heart rate and cholesterol, and blunted stress reactivity in systolic BP, cortisol, cholesterol, and IL-6. Cortisol and IL-6 concentrations were elevated, and cortisol measured over the day was higher in the type 2 diabetes group. Diabetic persons reported greater depressive and hostile symptoms and greater stress experience than did healthy controls. Type 2 diabetes is characterized by disruption of stress-related processes across multiple biological systems and increased exposure to life stress. Chronic allostatic load provides a unifying perspective with implications for etiology and patient management.ype 2 diabetes has a heterogeneous pathophysiology in which β-cell dysfunction and insulin resistance play pivotal roles (1). Stress-related factors may contribute to risk of type 2 diabetes through their impact on inflammatory, metabolic, cardiovascular, and neuroendocrine regulation (2). Socioeconomic adversity over the life course predicts type 2 diabetes in later life (3), whereas stress at work and more general indicators of perceived stress are associated with future diabetes (4, 5). There appears to be a bidirectional relationship between type 2 diabetes and depressive symptoms (6), and people with type 2 diabetes may report greater social isolation and more limited social support (7).These diverse associations between stress-related processes and diabetes are only partly accounted for by lifestyle factors such as physical inactivity, alcohol consumption, or adiposity, suggesting that direct psychobiological pathways may be involved. A helpful concept in this regard is allostatic load. Allostasis refers to the dynamic process of adaptation to environmental challenges through adjustments in multiple biological systems, including the hypothalamic-pituitary-adrenocortical (HPA) axis, autonomic nervous system, and metabolic and immune systems (8). Allostasis is essential for maintaining homeostasis, but repeated or sustained stimulation leads to allostatic load, the wear-and-tear that results from dysregulation of mediating processes. Allostatic load is freque...

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Section: Discussionsupporting

confidence: 84%

Disruption of multisystem responses to stress in type 2 diabetes: Investigating the dynamics of allostatic load

Steptoe

Hackett

Lazzarino

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

137

121

View full text Add to dashboard Cite

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“…Untreated psychosocial disorders in DM, may lead to more physical symptoms [9] , cardiovascular complications [10] and depression [11,12] . Depression may lead to cognitive decline and further aggravate the vicious cycles of self-care ability [13] . Many previous studies have largely been on the relationship between depression and diabetes [14,15] , with the focus on major depressive disorder.…”

Section: Introductionmentioning

confidence: 99%

Psychological aspects of diabetes care: Effecting behavioral change in patients

Chew

Sazlina

Fernandez

2014

WJD

107

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Patients with diabetes mellitus (DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient's adherence to the effective therapies, there would be persistent sub-optimal control of diseases, increase diabetes-related complications, causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patient's psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psychological domains such as cognition, self-regulation, self-efficacy and behavior. Some descriptions are also provided on willpower, resilience, illness perception and proactive coping in relating execution of new behaviors, coping with future-oriented thinking and influences of illness perception on health-related behaviors. These psychological aspects are further discussed in relation to DM and interventions for patients with DM. Equipped with the understanding of the pertinent nature of psychology in patients with DM; and knowing the links between the psychological disorders, inflammation and cardiovascular outcomes would hopefully encourages healthcare professionals in giving due attention to the psychological needs of patients with DM. Key words: Psychology; Psychosocial aspects; Emotions; Cognition; Distress; Depression; Psychological resilience; Self-care; Coping behaviors; Quality of life; Diabetes mellitus Core tip: Positive psychological health may sustain long-term coping efforts and protect patients from the negative consequences of prolonged emotional disorders, illness perception and thus facilitating diabetes self-management behaviors and better physical health. Having patients acquire valued personal beliefs and achievable standards of performance could strengthen self-regulation and self-efficacy leading to more positive experience and healthy behaviors. Furthermore, improved personal resources such as resilience would lead to better functioning of cognition and stronger will power, quality of life and disease control in patients with diabetes mellitus.Chew BH, Shariff-Ghazali S, Fernandez A. Psychological aspects of diabetes care: Effecting behavioral change in patients. World J Diabetes 2014; 5(6): 796-808 Available from:

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“…Cognitive impairment in type 2 diabetes might lead to impaired self-management and an increased incidence of diabetes-related complications, such as hypoglycaemia (Bruce et al, 2009;Punthakee et al, 2012). Although we know that in patients with type 2 diabetes there is a relation between depression and risk of cognitive impairment, (Katon et al, 2010;Katon et al, 2012;Sullivan et al, 2013) the relation of cognitive impairment with health status is unclear. Although the terms health status and health-related quality of life are often used interchangeably they have different meanings.…”

Section: Introductionmentioning

confidence: 99%

Undiagnosed cognitive impairment, health status and depressive symptoms in patients with type 2 diabetes

Koekkoek

Biessels

Kooistra

et al. 2015

Journal of Diabetes and its Complications

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Association of Depression With Accelerated Cognitive Decline Among Patients With Type 2 Diabetes in the ACCORD-MIND Trial

Cited by 114 publications

References 45 publications

Disruption of multisystem responses to stress in type 2 diabetes: Investigating the dynamics of allostatic load

Disruption of multisystem responses to stress in type 2 diabetes: Investigating the dynamics of allostatic load

Psychological aspects of diabetes care: Effecting behavioral change in patients

Undiagnosed cognitive impairment, health status and depressive symptoms in patients with type 2 diabetes

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