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Published online March 10, 2008
Diabetes Care 31:880-881, 2008
DOI: 10.2337/dc07-2215
© 2008 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Research

Effect of Race/Ethnicity and Persistent Recognition of Depression on Mortality in Elderly Men With Type 2 Diabetes and Depression

Lisa K. Richardson, MAPPPSY1,2, Leonard E. Egede, MD, MS3,4 and Martina Mueller, PHD3,5

1 Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
2 School of Psychology, Murdoch University, Perth, Western Australia
3 Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
4 Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
5 Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina

Corresponding author: Leonard E. Egede, MD, MS, Medical University of South Carolina, Center for Health Disparities Research, 135 Rutledge Ave., Room 280H, Charleston, SC 29425. E-mail: egedel{at}musc.edu

OBJECTIVE—To determine whether mortality risk from depression among elderly men with type 2 diabetes differs by ethnicity and persistent recognition of depression.

RESEARCH DESIGN AND METHODS—Data on a cohort of 14,500 male veterans with type 2 diabetes were analyzed. Diagnoses of depression and diabetes were based on ICD-9 codes. Persistent recognition was defined as an ICD-9 code for depression documented in at least the second or third visit after the initial diagnosis of depression. Hazards of death were compared using Cox proportional hazards regression models adjusting for relevant covariates.

RESULTS—Over 10 years, 2,305 deaths were documented. Mortality risk was higher for depressed than nondepressed veterans with diabetes (hazard ratio [HR] 1.6 [95% CI 1.3–1.8]). Among those with depression, mortality risk was lower with persistent recognition (0–2 visits vs. ≥3 visits after initial diagnosis, HR 0.58 [0.40–0.89]) but higher for whites than blacks (1.60 [1.11–2.31]).

CONCLUSIONS—Increased mortality from depression differs by ethnicity and persistent recognition.

Abbreviations: CHD, coronary heart disease


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