Depression and glycemic intake in the homebound elderly

J Affect Disord. 2011 Jul;132(1-2):94-8. doi: 10.1016/j.jad.2011.02.002. Epub 2011 Mar 11.

Abstract

Background: Depression is associated with an increase in the incidence of type 2 diabetes, but the mechanism is unclear. We aimed to study the relationship between depression and glycemic intake in the elderly, and examine whether antidepressant use modified this relationship.

Design, setting and participants: We evaluated 976 homebound elders in a cross-sectional study. Depression was defined by having a Center for Epidemiological Studies Depression (CES-D) score ≥16. Antidepressant use was documented. Glycemic index (GI), Glycemic load (GL), and fasting blood insulin levels were measured.

Results: Depressed elders had slightly higher GI (Mean±SD: 55.8±3.8 vs. 55.1±3.7, P=0.003) and higher insulin levels (Median: 84.0 vs. 74.4pmol/ml, P=0.05) than non-depressed elders. Depressed elders receiving antidepressants, primarily selective serotonin reuptake inhibitors (SSRI), had lower GI (Mean±SD: 55.1±4.7 vs. 56.2±3.4, P=0.002) and GL (Median: 170.3 vs. 6826.3, P=0.03) than those not taking antidepressants. After adjusting for potential confounding variables, GI remained positively associated with depression (β=+0.65, SE=0.28, P=0.02); the logarithm of GL was positively associated with depression (β=+0.33, SE=0.17, P=0.05) and negatively associated with antidepressant use (β=-0.54, SE=0.18, P=0.003).

Conclusions: Prospective studies are needed to examine whether high glycemic intake is a mediating factor between late life depression and the risk of type 2 diabetes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use
  • Blood Glucose / metabolism
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder / blood*
  • Depressive Disorder / drug therapy
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology*
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / psychology*
  • Dietary Carbohydrates / administration & dosage*
  • Dietary Carbohydrates / metabolism
  • Feeding Behavior*
  • Female
  • Glycemic Index*
  • Homebound Persons / psychology*
  • Humans
  • Insulin / blood*
  • Male
  • Multivariate Analysis
  • Reference Values
  • Risk Factors
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Statistics as Topic

Substances

  • Antidepressive Agents
  • Blood Glucose
  • Dietary Carbohydrates
  • Insulin
  • Serotonin Uptake Inhibitors