title: Insulin resistance and depressive symptoms in older men: the health in men study.
abstract: OBJECTIVE
  A positive association between depression and diabetes has been reported, but the direction and nature of this association is unclear. Insulin resistance is a state of reduced responsiveness of target tissues to normal circulating levels of insulin and predisposes to diabetes in the presence of beta cell dysfunction.
  
  
  METHODS
  We conducted this cross-sectional and prospective study in a community representative sample of 3,140 older men free of diabetes to determine if insulin resistance was associated with prevalent and incident depressive symptoms.
  
  
  RESULTS
  Men with insulin resistance had increased odds of depression cross-sectionally (odds ratio [OR]: 1.61; 95% confidence interval [CI]: 1.08-2.40), although this was not significant after adjustment for possible confounding (OR: 1.32; 95% CI: 0.85-2.03). In the longitudinal analysis, men with insulin resistance were more likely to develop clinically significant depressive symptoms (adjusted risk ratio [RR]: 2.33; 95% CI: 1.17-4.62), and this risk was greatest for men in the highest quartile of insulin resistance compared with those in the lowest quartile (adjusted RR: 2.54; 95% CI: 1.04-6.18).
  
  
  CONCLUSIONS
  Older men with clinically significant depressive symptoms were more likely to have higher markers of insulin resistance. Additionally, the odds of depression increased with increasing levels of insulin resistance, and insulin resistance increased the risk of developing depression over 5 years later. Because depression is now a leading cause of disability worldwide, addressing the rising challenge of insulin resistance may prove important in improving the future health of our communities.
authors.affiliation: WA Centre for Health & Ageing, Centre for Medical Research & School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia. Electronic address: andrew.ford@uwa.edu.au.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Ford
authors.affiliation: WA Centre for Health & Ageing, Centre for Medical Research & School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Fremantle and Royal Perth Hospitals, Perth, WA, Australia.
authors.forename: Bu B
authors.initials: BB
authors.lastname: Yeap
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia; Path West Laboratory Medicine, Fremantle and Royal Perth Hospitals, Perth, WA, Australia.
authors.forename: S A Paul
authors.initials: SA
authors.lastname: Chubb
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University and Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Queensland, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Golledge
authors.affiliation: WA Centre for Health & Ageing, Centre for Medical Research & School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia.
authors.forename: Osvaldo P
authors.initials: OP
authors.lastname: Almeida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D001794:Blood Pressure; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D054526:Men's Health; D016017:Odds Ratio; D011446:Prospective Studies
keywords: Diabetes; depression; insulin resistance; older adults