Diabetes mellitus (DM) is highly prevalent and increasing in geriatric population. Depression and sleep disorders occur at a higher rate in patients with diabetes compared with controls.
The purpose of this study was to demonstrate whether diabetic complications influence the sleep quality and depression in elderly patients.
154 geriatric diabetic patients (male/female: 69/85) were enrolled in this study. Patients were investigated for microvascular and macrovascular complications. The Pittsburgh Sleep Quality Index (PSQI) and Geriatric Depression Scale (GDS) were performed for assessment of sleep quality and depression, respectively. Linear regression analysis was performed to identify significant independent related factors for GDS and PSQI scores.
Microvascular and macrovascular complications were found in 47.4 % and 29.2 of study population. PSQI and GDS scores of patients with microvascular complications were significantly higher than those of patients without microvascular complications (8.23 ± 3.83 vs 5.76 ± 3.04, p 0.001; 11.07 ± 6.07 vs 6.94 ± 5.35, p 0.001), respectively. There was no difference in GDS scores between the patients with and without macrovascular complications. There was a positive correlation between DM duration and PSQI, GDS scores. Neuropathy was an independent variable for poor sleep quality (OR 1.362, 95 % CI 0.032–2.692, p 0.045) and depression (OR 2.909, 95 % CI 0.610–5.209, p 0.014).
Depression status and sleep quality are strongly influenced by diabetic complications and DM duration in elderly patients.
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International Diabetes Federation (2013) IDF Diabetes Atlas, 6th edn. International Diabetes Federation, Brussels, Belgium. http://www.idf.org/diabetesatlas
Zhang X, Decker FH, Luo H, Geiss LS, Pearson WS, Saaddine JB et al (2010) Trends in the prevalence and comorbidities of diabetes mellitus in nursing home residents in the United States: 1995–2004. J Am Geriatr Soc 58:724–730
Boyle JP, Honeycutt AA, Narayan KM, Hoerger TJ, Geiss LS, Chen H et al (2001) Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S. Diabetes Care 24:1936–1940
Motta M, Bennati E, Cardillo E, Ferlito L, Passamonte M, Vacante M et al (2010) A combination of glycosylated hemoglobin, impaired fasting glucose and waist circumference is effective in screening for individuals at risk for future type 2 diabetes. Arch Gerontol Geriatr 50:105–109
Chiniwala N, Jabbour S (2011) Management of diabetes mellitus in the elderly. Curr Opin Endocrinol Diabetes Obes 18:148–152
Knutson KL (2010) Sleep duration and cardiometabolic risk: a review of the epidemiologic evidence. Best Pract Res Clin Endocrinol Metab 24:731–743
Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG (1995) Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 18:425–432
Cooke JR, Ancoli-Israel S (2006) Sleep and its disorders in older adults. Psychiatr Clin North Am 29:1077–1093
Ancoli-Israel S (2005) Sleep and aging: prevalence of disturbed sleep and treatment considerations in older adults. J Clin Psychiatry 66(Suppl 9):24–30
Poongothai S, Anjana RM, Pradeepa R, Ganesan A, Unnikrishnan R, Rema M et al (2011) Association of depression with complications of type 2 diabetes—the Chennai Urban Rural Epidemiology Study (CURES- 102). J Assoc Physicians India 59:644–648
Kinder LS, Katon WJ, Ludman E, Russo J, Simon G, Lin EH et al (2006) Improving depression care in patients with diabetes and multiple complications. J Gen Intern Med 21:1036–1041
Association AD (2009) Diagnosis and classification of diabetes mellitus. Diabetes Care 32(Suppl 1):S62–S67
Farag YM, Al Wakeel JS (2011) Diabetic nephropathy in the Arab Gulf countries. Nephron Clin Pract 119:c317–c322 (discussion c22-3)
Ko SH, Cha BY (2012) Diabetic peripheral neuropathy in type 2 diabetes mellitus in Korea. Diabetes Metab J 36:6–12
Fong DS, Aiello L, Gardner TW, King GL, Blankenship G, Cavallerano JD, American Diabetes Association et al (2003) Diabetic retinopathy. Diabetes Care 26:226–229
Carpenter JS, Andrykowski MA (1998) Psychometric evaluation of the Pittsburgh Sleep Quality Index. J Psychosom Res 45:5–13
Agargun MY, Kara H, Anlar O (1996) The validity and reliability of the Pittsburgh Sleep Quality Index. Turk Psikiyatri Derg 7:107–115
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213
Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M et al (1982) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17:37–49
Ertan T, Eker E (2000) Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: are there different factor structures for different cultures? Int Psychogeriatr 12:163–172
Knutson KL, Van Cauter E (2008) Associations between sleep loss and increased risk of obesity and diabetes. Ann NY Acad Sci 1129:287–304
Knutson KL, Ryden AM, Mander BA, Van Cauter E (2006) Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med 166:1768–1774
Cuellar NG, Ratcliffe SJ (2008) A comparison of glycemic control, sleep, fatigue, and depression in type 2 diabetes with and without restless legs syndrome. J Clin Sleep Med 4:50–56
Luyster FS, Dunbar-Jacob J (2011) Sleep quality and quality of life in adults with type 2 diabetes. Diabetes Educ 37:347–355
Zelman DC, Brandenburg NA, Gore M (2006) Sleep impairment in patients with painful diabetic peripheral neuropathy. Clin J Pain 22:681–685
Raymann RJ, Swaab DF, Van Someren EJ (2008) Skin deep: enhanced sleep depth by cutaneous temperature manipulation. Brain 131:500–513
Sharma S, Oliver-Fernandez A, Liu W, Buchholz P, Walt J (2005) The impact of diabetic retinopathy on health-related quality of life. Curr Opin Ophthalmol 16:155–159
Devenney R, O’Neill S (2010) The experience of diabetic retinopathy: a qualitative study. Br J Health Psychol. doi:10.1348/2044-8287.002008
Coyne KS, Margolis MK, Kennedy-Martin T, Baker TM, Klein R, Paul MD et al (2004) The impact of diabetic retinopathy: perspectives from patient focus groups. Fam Pract 21:447–453
Scanlon PH, Martin ML, Bailey C, Johnson E, Hykin P, Keightley S (2006) Reported symptoms and quality-of-life impacts in patients having laser treatment for sight- threatening diabetic retinopathy. Diabet Med 23:60–66
Fenwick EK, Pesudovs K, Khadka J, Dirani M, Rees G, Wong TY et al (2012) The impact of diabetic retinopathy on quality of life: qualitative findings from an item bank development project. Qual Life Res 21:1771–1782
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Diabetes Prevention Program Research Group et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403
de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ (2001) Association of depression and diabetes complications: a meta-analysis. Psychosom Med 63:619–630
Lustman PJ, Griffith LS, Gavard JA, Clouse RE (1992) Depression in adults with diabetes. Diabetes Care 15:1631–1639
Lin EH, Rutter CM, Katon W, Heckbert SR, Ciechanowski P, Oliver MM et al (2010) Depression and advanced complications of diabetes: a prospective cohort study. Diabetes Care 33:264–269
Golden SH, Lee HB, Schreiner PJ, Diez Roux A, Fitzpatrick AL, Szklo M et al (2007) Depression and type 2 diabetes mellitus: the multiethnic study of atherosclerosis. Psychosom Med 69:529–536
Kathol RG, Jaeckle RS, Lopez JF, Meller WH (1989) Pathophysiology of HPA axis abnormalities in patients with major depression: an update. Am J Psychiatry 146:311–317
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Öztürk, Z.A., Yesil, Y., Kuyumcu, M.E. et al. Association of depression and sleep quality with complications of type 2 diabetes in geriatric patients. Aging Clin Exp Res 27, 533–538 (2015). https://doi.org/10.1007/s40520-014-0293-0