Learning Objective #1: Explain the relationship between type-2 diabetes, depression, and psychosocial factors in community-dwelling elders

Learning Objective #2: Describe the odd-ratios for depression in older adults with type-2 diabetes

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The purpose of this study was to analyze the rate of depression and determine correlates and predictors of depression in community-dwelling older adults with type-2 diabetes. The study was a retrospective correlational design in which participants were interviewed in their homes. The sample consisted of 170 community-dwelling older adults with type-2 diabetes, the majority of whom were Medicaid recipients. The sample was predominately female (81 percent), and 35 percent were African-American. Ages ranged from 60-96, with a mean of 76. Data collection instruments were used to measure depression (GDS), loneliness, social support, co-morbidities, medications and activities of daily living (ADLs). The prevalence rate of depression was 45 percent (GDS score greater than 5). Eighty percent reported loneliness, and only nine percent reported that they were fully independent on activities of daily living; yet, 54 percent lived alone, and 42 per cent reported a lack of satisfaction with family support. Participants with co-morbidities were more likely to be depressed, although race and gender were not significant. Loneliness, functional limitations and low levels of social support contributed to depression in the multiple regression model and accounted for 29 percent of the variance. Covariate adjusted odds ratios suggest that older adults with type-2 diabetes and limitations in functional status, feelings of loneliness and lower satisfaction with family support are more likely to be depressed. Older adults with type-2 diabetes have high rates of functional limitations and are at much higher risk for depression, which compromises health outcomes. Therefore, performance on ADLs, satisfaction with family support, perceptions of loneliness and depression are all important areas of screening to include when managing type-2 diabetics within a community setting.