Depression in older diabetic patients is not at all unusual and accounts for poor diet, not taking prescribed pills, and poor quality of life, according to Dr. Hilary Bogner, MD, at the University of Pennsylvania. Dr. Bogner, along with her colleagues, published a study in the December issue of Diabetes Care which indicates that the five-year death rate in depressed, older, diabetic patients is lessened by half when receiving treatment for depression. According to the study, the risk for death was 0.49 among patients receiving intense treatment for depression and 95% CI (0.24 to 0.98) among those in the same demographic that were not receiving treatment for depression. Data for the study was taken from the Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT). The sample group consisted of 584 patients between the ages of 60 to 94, among whom 123 had diabetes. The five-year death ratio varied by 17% in non-diabetic patients and 27% in diabetic patients. The following is an article from the RX Times that reviews the study:
Depressed, older adults with diabetes live longer when they are treated for depression,
according to a study in the December issue of Diabetes Care, which
publishes on November 27, 2007.
Also being published this month is an editorial by U.S. Food and Drug
Administration (FDA) Medical Officer Dr. Robert Misbin, highlighting
lessons learned from the recent Avandia controversy and suggesting a
re-evaluation of the approval process for diabetes drugs.
The depression study, which followed primary care patients in the New
York City, Philadelphia and Pittsburgh areas for five years, also showed
that treating depression reduced mortality more for those who had diabetes
than for those who did not.
“Depression is not only common in persons with diabetes but contributes
to not taking medicines, not following prescribed diets, and overall
reduced quality of life,” said lead researcher Dr. Hillary R. Bogner,
Assistant Professor at the Department of Family Practice and Community
Medicine at the University of Pennsylvania.
I think this study brings out a very simple and practical point; depression “is” an issue with older diabetic patients and treatment “does” help immensely. Surely, many other end-of-life health issues could cause depression as well. In my opinion, and unfortunately, there is a pessimism that excludes the hope of a bountiful and enjoyable life for elderly with severe or terminal health issues. As such, and in accordance with a pessimistic outlook, depression would be a natural end-of-life behavior. It is unfortunate that this opinion is held because, as this study clearly points out, quality of life can be greatly improved for older patients struggling with depression associated with health problems, in this case diabetes.