title: Depressive symptoms and risk of type 2 diabetes in a national sample of middle-aged and older adults: the English longitudinal study of aging.
abstract: OBJECTIVE
  To examine the association between baseline elevated depressive symptoms and incident type 2 diabetes in a national sample of people aged > or =50 years.
  
  
  METHODS
  The sample consisted of 6,111 individuals free from self-reported doctor-diagnosed diabetes at baseline in 2002-2003. The eight-item Center for Epidemiological Studies-Depression (CES-D) scale was the measurement of depressive symptoms. Cox proportional hazards regression models were used to assess whether baseline elevated (> or =4) depressive symptoms were associated with a higher risk of type 2 diabetes over 45.8 months of follow-up.
  
  
  RESULTS
  The hazard ratio (HR) for diabetes was 1.62 (95% CI 1.15-2.29) in a model adjusted for age, sex, marital status, education, total net household wealth, cardiovascular and psychiatric and other noncardiovascular comorbidities, BMI, and health behaviors for participants with elevated CES-D symptoms compared with those without. Complementary analysis performed for a subsample (n = 5,090) showed that additional adjustment of this model for use of antidepressants did not explain the association (HR 1.58, 95% CI 1.09-2.29).
  
  
  CONCLUSIONS
  Elevated depressive symptoms were associated with a higher risk of developing type 2 diabetes after accounting for sociodemographic, lifestyle, and clinical factors in a national sample of people aged > or =50 years.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK. p.demakakos@ucl.ac.uk
authors.forename: Panayotes
authors.initials: P
authors.lastname: Demakakos
authors.forename: Mary B
authors.initials: MB
authors.lastname: Pierce
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
mesh_terms: D000368:Aged; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis