The proposed research is a study of the relationship between diabetes, functional disability, and depression in the elderly. Examining the correlates and consequences of a specific disease (diabetes) that is strongly associated with both functional impairment ad high levels of depressive symptomatology, in a specific population (older Mexican- Americans) will provide a unique contribution to our understanding of these relationships. This approach will help to eliminate much of the confounding effects introduced by examining these relationships concomitantly in several chronic diseases and in heterogenous populations. It will also add to our understanding of the more general relationship between compromised health and depression in the Mexican-American elderly. In particular, the study is significant in that it will (1) conduct an extensive examination of the epidemiology of diabetes and its functional and emotional consequences in older Mexican-Americans; (2) compare different profiles of comorbidity of diabetes and other chronic conditions in terms of their association with functional disability, pain, and depression; (3) examine differences in the utilization of health care services associated with depression in this group; and (4) make use of a longitudinal design to identify probable causal paths between diabetes and depressive status, while controlling for the possible moderating effects of personal factors such as sociodemographic characteristics, health-related factors, and cultural factors.
These aims will be accomplished by examining data from a population-based longitudinal panel study of Mexican -American elderly, in which a sample of 3050 older adults are administered extensive interviews. Cross-sectional analyses will examine associations between diabetes and other chronic physical health conditions, activity limitations, functional capacity, pain, medication use, depression and moderating factors. Longitudinal analyses will identify the influences of change in disease status, functional disability, and pain on depression, and characterize the mechanisms by which chronic conditions influence the development, chronicity, and exacerbation of depression in the elderly. Findings from this study will provide a unique contribution to our understanding of the functional and emotional consequences of compromised physical health, not only in older diabetic Mexican-Americans, but among older adults in general. These findings will also help to improve the health care of all older adults by enhancing our understanding of the risk factors for depression in the elderly.
| Tolea, M I; Black, S A; Carter-Pokras, O D et al. (2007) Depressive symptoms as a risk factor for osteoporosis and fractures in older Mexican American women. Osteoporos Int 18:315-22 |
