Type 2 diabetes, change in depressive symptoms over time, and cerebral small vessel disease: Longitudinal data of the ages-reykjavik study

Sytze P. Rensma, Thomas T. van Sloten, Jennifer Ding, Sigurdur Sigurdsson, Coen D.A. Stehouwer, Vilmundur G Guðnason, Lenore J. Launer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

OBJECTIVE Type 2 diabetes has been associated with depression. However, the underlying pathophysiological mechanisms remain unknown. Cerebral small vessel disease, a consequence of diabetes, may lead to depression. Therefore, we evaluated whether cerebral small vessel disease mediates the association between type 2 diabetes and higher depressive symptoms. RESEARCH DESIGN AND METHODS We used longitudinal data from the population-based Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, with examinations from 2002 to 2006 and 5 years later. Type 2 diabetes was defined as self-reported history of type 2 diabetes, use of blood glucose–lowering drugs, or fasting blood glucose level ≥7.0 mmol/L. Cerebral small vessel disease load was quantified in a composite score based on MRI-defined presence of high white matter hyperintensity volume, low total brain parenchyma volume, and subcortical infarcts, cerebral microbleeds, and large perivascular spaces. The 5-year change in the 15-item Geriatric Depression Scale score (GDS-15) was measured between baseline and follow-up. RESULTS Included were 2,135 individuals without dementia and baseline depression (baseline age 74.5 [SD 4.6] years, 1,245 women [58.3%], and 197 [9.2%] with diabetes). The GDS-15 score increased 0.4 (SD 1.6) points over time. Baseline diabetes was associated with a greater increase in the GDS-15 score (β = 0.337; 95% CI 0.094; 0.579), adjusted for age, sex, education, and cardiovascular risk factors. Baseline cerebral small vessel disease and change of cerebral small vessel disease statistically significantly mediated a part of this association. CONCLUSIONS Type 2 diabetes is associated with a greater increase in depressive symptoms score over 5 years, and cerebral small vessel disease partly explains this association.

Original languageEnglish
Pages (from-to)1781-1787
Number of pages7
JournalDiabetes Care
Volume43
Issue number8
DOIs
Publication statusPublished - Aug 2020

Bibliographical note

Funding. The AGES-Reykjavik Study was supported by the Icelandic Heart Association, Intramural Research Program at the National Institute on Aging (grants N01-AG-12100 and HHSN271201200022C), the Althingi (the Icelandic Parliament), and the Icelandic Centre for Research (RANNIS) (grant 141101-051). T.T.v.S. is supported by a Veni research grant (916.19.074) from the Netherlands Organisation for Scientific Research (NWO) and the Netherlands Organisation for Health Research and Development (ZonMw) and by a Dutch Heart Foundation research grant (2018T025).

The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.

Publisher Copyright:
© 2020 by the American Diabetes Association.

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