title: Geriatric syndromes and depressed mood in lower-income Singaporeans with diabetes: implications for diabetes management and health promotion.
abstract: BACKGROUND
  This study aims to determine the association of geriatric syndromes and depressed mood among respondents with diabetes in a lower income community; and their association with self-management, lifestyle behaviour, and healthcare utilisation. This paper focuses primarily on the 114 respondents with diabetes aged 50+ to inform policy formulation at the community level.
  
  
  METHODS
  A pilot community health assessment was conducted in 4 blocks of 1- and 2-room apartments in Toa Payoh district from July to November 2009. Using a standard questionnaire, interviewers conducted face-to-face interviews with household members on chronic diseases, geriatric syndromes and health-related behaviour. Data were analysed using SPSSv15.
  
  
  RESULTS
  A total of 795 respondents were assessed with a response rate of 61.8%. Of 515 (64.8%) aged 50+ analysed in this study, 22.1% reported having diabetes, of whom 31.6% reported being depressed. Respondents with diabetes who reported being depressed had a higher prevalence of geriatric syndromes compared with those non-depressed; i.e. functional decline (30.6% vs 5.1%, P <0.001); falls (33.3% vs 10.3%, P = 0.003); stumbling (30.6% vs 10.3%, P = 0.007); urinary incontinence (33.3% vs 5.1%, P <0.001), progressive forgetfulness (27.8% vs 6.4%, P = 0.002) and poor eyesight (22.2% vs 6.4%, P = 0.014). They were less likely to comply with medications (86.1% vs 97.3%, P = 0.026) and performed exercise (13.9% vs 53.8%, P <0.001). More had hospital admissions (13.9% vs 7.7%); and they had more outpatient visits per person (2.4 visits vs 0.9 visits, P = 0.03) at Specialist Outpatient Clinics.
  
  
  CONCLUSIONS
  Geriatric syndromes were associated with the presence of depressed mood among persons with diabetes in the lower income group. As those with depressed mood had more unfavourable self-management and lifestyle behaviour, and utilise higher healthcare services, diabetes management must take these findings into consideration.
authors.affiliation: Health Services and Outcomes Research, National Healthcare Group, Singapore. lai_yin_wong@nhg.com.sg
authors.forename: Lai Yin
authors.initials: LY
authors.lastname: Wong
authors.forename: Bee Hoon
authors.initials: BH
authors.lastname: Heng
authors.forename: Charis W L
authors.initials: CW
authors.lastname: Ng
authors.forename: Joseph A D
authors.initials: JA
authors.lastname: Molina
authors.forename: Pradeep P
authors.initials: PP
authors.lastname: George
authors.forename: Jason T S
authors.initials: JT
authors.lastname: Cheah
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000523:psychology*; D019468:Disease Management; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011203:Poverty; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires