Type 2 diabetes, depressive symptoms and disability over a 15-year follow-up period in older Mexican Americans living in the southwestern United States

Abstract

AIMS To evaluate how depression and diabetes severity impacts disability progression among Mexican Americans over a 15-year period. METHODS We used seven waves of the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE). Primary disability outcomes included the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales. Explanatory variables included time since diagnosis with diabetes (no type 2 diabetes, 1-10, 11-20, 21+), an indicator of disease severity, and depression. Longitudinal generalized estimating equation models were used to estimate the relationship between time since diabetes diagnosis, depressive symptoms and ADL and IADL disability progression over a 15-year time period. RESULTS Years since diabetes diagnosis was associated with more rapid ADL and IADL disability progression compared to those without type 2 diabetes. Depression accelerated the disabling process in participants who were diagnosed with diabetes 11 years or more years ago. CONCLUSIONS Longer duration of diabetes and greater symptoms of depression increases vulnerability for disability among older Mexican American adults.

Demographics, A1C Testing, and Medication Use of Mexican Americans and Mexicans With Diabetes

“…Some diabetes studies have examined Hispanics as a homogeneous group, 11,12 while other studies like the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) have focused on specific Hispanic subgroups of the US population. For those diabetes studies of Hispanic subgroups, the focus has been solely on Mexican Americans 13,14 residing in the United States. [13][14][15] Studies (ie, the HCHS/SOL and San Antonio Heart) on Hispanic subgroups have found Mexicans to have the highest diabetes prevalence rate [16][17][18] and to have a significant secular trend in the 7-to 8-year incidence of diabetes.…”

“…For those diabetes studies of Hispanic subgroups, the focus has been solely on Mexican Americans 13,14 residing in the United States. [13][14][15] Studies (ie, the HCHS/SOL and San Antonio Heart) on Hispanic subgroups have found Mexicans to have the highest diabetes prevalence rate [16][17][18] and to have a significant secular trend in the 7-to 8-year incidence of diabetes. 15 These findings show the growing diabetes rates among Mexicans in the United States.…”

The Impact of Living Alone and Intergenerational Support on Depressive Symptoms Among Older Mexican Americans: Does Gender Matter?

“…The number of Mexican American older adults aged 65 years and older is growing rapidly because of the high immigration volume from Mexico, persistent high fertility rates, low mortality rates, and the natural aging process (Angel & Angel, 1998; Federal Interagency Forum on Aging-Related Statistics, 2012; Pew Hispanic Center, 2016). Many older Mexican immigrants face mental health challenges, of which, depressive symptoms are the most common one (Black & Markides, 1999; Salinas, Gonzalez, & Al Snih, 2018). The Hispanic Established Population for the Epidemiologic Study of the Elderly reported that the prevalence of depression (16 or more Center for Epidemiologic Studies-Depression score) was 21.2% among older Mexican Americans (Salinas et al., 2018).…”

“…Many older Mexican immigrants face mental health challenges, of which, depressive symptoms are the most common one (Black & Markides, 1999; Salinas, Gonzalez, & Al Snih, 2018). The Hispanic Established Population for the Epidemiologic Study of the Elderly reported that the prevalence of depression (16 or more Center for Epidemiologic Studies-Depression score) was 21.2% among older Mexican Americans (Salinas et al., 2018). Elevated levels of depressive symptoms concomitant with chronic conditions such as diabetes, heart disease, hypertension, cancer, and stroke increase the risk of mortality and disability among Mexican American older adults (Black & Markides, 1999; Salinas et al., 2018).…”

“…The Hispanic Established Population for the Epidemiologic Study of the Elderly reported that the prevalence of depression (16 or more Center for Epidemiologic Studies-Depression score) was 21.2% among older Mexican Americans (Salinas et al., 2018). Elevated levels of depressive symptoms concomitant with chronic conditions such as diabetes, heart disease, hypertension, cancer, and stroke increase the risk of mortality and disability among Mexican American older adults (Black & Markides, 1999; Salinas et al., 2018). However, the impact of living alone and intergenerational support on the depressive symptoms in older Mexican Americans has not been sufficiently studied.…”