Older people with diabetes have higher risk of depression, cognitive and functional impairments: implications for diabetes services

J Nutr Health Aging. 2011 Nov;15(9):751-5. doi: 10.1007/s12603-011-0071-z.


Objectives: To examine the relationship between diabetes and impairments in functional and cognitive status as well as depression in older people.

Design: Cross-sectional study.

Setting: Elderly Health Centres (EHC) in Hong Kong.

Participants: 66,813 older people receiving baseline assessment at EHC in 1998 to 2001.

Measurements: Diabetes status was defined by self-report and blood glucose tests. Functional status was assessed by 5 items of instrumental activities of daily living (IADL) and 7 items of activities of daily living (ADL). Cognitive status was screened by the Abbreviated Mental Test-Hong Kong version (AMT). Depressive symptoms were screened by the Geriatric Depression Scale-Chinese version (GDS).

Results: Among the subjects, 10.4% reported having regular treatment for diabetes, 3.4% had diabetes but were not receiving regular treatment, and 86.2% did not have diabetes. After controlling for age, sex and education level, those having regular treatment for diabetes were 1.7 times more likely (OR=1.65, 95% CI: 1.51-1.80) to have functional impairment, 1.3 times more likely (OR=1.28, 95% CI: 1.11-1.48) to have cognitive impairment and 1.3 times more likely (OR=1.35, 95% CI: 1.25-1.46) to have depression, than older people without diabetes.

Conclusion: Older people with diabetes may be less capable of managing the disease than the younger ones as a result of increased risk of both physical and cognitive impairment. This study provided further evidence for the need of an international consensus statement regarding care of diabetes in older people.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology
  • Aged
  • Aged, 80 and over
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / psychology
  • Cross-Sectional Studies
  • Depression / epidemiology*
  • Depression / psychology
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / psychology
  • Educational Status
  • Female
  • Geriatric Assessment / statistics & numerical data*
  • Hong Kong / epidemiology
  • Humans
  • Logistic Models
  • Male
  • Prevalence
  • Risk Factors