Background and aims: Depressive symptoms and diabetes are both increasing and worse in the elderly population. Diabetes complicates depressive symptoms which are conversely harmful to diabetic outcomes. The aim of the study was to evaluate the presence of depressive symptoms and the clinical variables associated with depressive symptoms in elderly diabetic patients.
Materials and methods: A cross-sectional study was conducted among diabetic patients aged ≥60 years old admitted to a National Geriatric Hospital from October 2015 to October 2016. Depressive symptoms were assessed by using the Geriatric Depression Scale (GDS).We obtained information on socio-demographic, medical history, glycaemic control (fasting plasma glucose and HbA1c), daily activities (Activities of Daily Living - ADL and Instruments Activities of Daily Living - IADL scale) and fall risks (the Time Up and Go test). Chi-square (χ2) statistics and logistic regression were used to analyse the collected data.
Results: 412 diabetic patients were recruited with ages ranging between 60 and 91 years (average age 71.9 ± 7.63 years). 327 (79.4%) patients were categorized according to having depressive symptoms and the group aged 70 - 80 years old had the highest rate of depressive symptoms (141 patients, 43.1%). The proportion of participants with mild, moderate and severe depression symptoms were 62.9%, 14.6% and 1.9%, respectively. The average age, rates of secondary completion or lower, history of hypertension, and using insulin were higher in the depressive symptom group than those in the non-depressive symptom group (p < 0.05). The presence of depressive symptoms in the group with duration of diabetes ≥ 5 years was double in comparision with the group with duration of diabetes < 5 years (OR 2.4, 95% CI 1.27-4.66, p<0.01). The level of HbA1c was significantly different between the depressive symptom group and the non-depressive symptom group (7.74 ± 1.57 % and 6.61±1.21 %, p < 0.05, respectively). Depressive symptoms increased risk of falls (OR: 2.93; 95% CI: 1.28-6.72, p = 0.01), uncontrolled fasting blood glucose (OR: 4.09, 95% CI: 2.1-7.9, p < 0.001) and impairment of IADL (OR: 7.12, 95% CI: 3.4-14.9, p < 0.001). Rate of decreased ADL in the depressive symptom group (56.6 %) were higher than that in the non-depressive symptom group (10.6%) (p< 0.05).
Conclusion: The prevalence of depressive symptoms was high and the presence of depressive symptoms was associated with increased poor glycemic control, fall risk and impairments of ADL, IADL among elderly diabetic patients.

Depressive symptoms and related factors in elderly diabetic patients at a national geriatric hospital