TY - JOUR
T1 - Depression, diabetes, their comorbidity and all-cause and cause-specific mortality
T2 - a prospective cohort study
AU - Prigge, Regina
AU - Wild, Sarah H
AU - Jackson, Caroline A
N1 - Funding Information:
RP is a PhD scholar funded by the University of Edinburgh. Access to the UK Biobank data was funded by a University of Queensland Early Career Researcher grant awarded to CAJ.
Funding Information:
This research was conducted using the UK Biobank resource under application number 13797. Parts of this study were presented at the Annual Meeting of the European Diabetes Epidemiology Group, Mondorf-les-Bains, Luxembourg, 11–15 May 2019. The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. RP, CAJ and SHW conceived the study, RP performed the data analysis and wrote the draft manuscript, and CAJ and SHW reviewed and edited the manuscript. RP, CAJ and SHW gave final approval of the published version of this article. RP is the guarantor of this work and takes responsibility for the content of the article.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/5/27
Y1 - 2022/5/27
N2 - AIMS/HYPOTHESIS: The aim of this study was to investigate the risks of all-cause and cause-specific mortality among participants with neither, one or both of diabetes and depression in a large prospective cohort study in the UK.METHODS: Our study population included 499,830 UK Biobank participants without schizophrenia and bipolar disorder at baseline. Type 1 and type 2 diabetes and depression were identified using self-reported diagnoses, prescribed medication and hospital records. Mortality was identified from death records using the primary cause of death to define cause-specific mortality. We performed Cox proportional hazards models to estimate the risk of all-cause mortality and mortality from cancer, circulatory disease and causes of death other than circulatory disease or cancer among participants with either depression (n=41,791) or diabetes (n=22,677) alone and with comorbid diabetes and depression (n=3597) compared with the group with neither condition (n=431,765), adjusting for sociodemographic and lifestyle factors, comorbidities and history of CVD or cancer. We also investigated the interaction between diabetes and depression.RESULTS: During a median of 6.8 (IQR 6.1-7.5) years of follow-up, there were 13,724 deaths (cancer, n=7976; circulatory disease, n=2827; other causes, n=2921). Adjusted HRs of all-cause mortality and mortality from cancer, circulatory disease and other causes were highest among people with comorbid depression and diabetes (HRs 2.16 [95% CI 1.94, 2.42]; 1.62 [95% CI 1.35, 1.93]; 2.22 [95% CI 1.80, 2.73]; and 3.60 [95% CI 2.93, 4.42], respectively). The risks of all-cause, cancer and other mortality among those with comorbid depression and diabetes exceeded the sum of the risks due to diabetes and depression alone.CONCLUSIONS/INTERPRETATION: We confirmed that depression and diabetes individually are associated with an increased mortality risk and also identified that comorbid depression and diabetes have synergistic effects on the risk of all-cause mortality that are largely driven by deaths from cancer and causes other than circulatory disease and cancer.
AB - AIMS/HYPOTHESIS: The aim of this study was to investigate the risks of all-cause and cause-specific mortality among participants with neither, one or both of diabetes and depression in a large prospective cohort study in the UK.METHODS: Our study population included 499,830 UK Biobank participants without schizophrenia and bipolar disorder at baseline. Type 1 and type 2 diabetes and depression were identified using self-reported diagnoses, prescribed medication and hospital records. Mortality was identified from death records using the primary cause of death to define cause-specific mortality. We performed Cox proportional hazards models to estimate the risk of all-cause mortality and mortality from cancer, circulatory disease and causes of death other than circulatory disease or cancer among participants with either depression (n=41,791) or diabetes (n=22,677) alone and with comorbid diabetes and depression (n=3597) compared with the group with neither condition (n=431,765), adjusting for sociodemographic and lifestyle factors, comorbidities and history of CVD or cancer. We also investigated the interaction between diabetes and depression.RESULTS: During a median of 6.8 (IQR 6.1-7.5) years of follow-up, there were 13,724 deaths (cancer, n=7976; circulatory disease, n=2827; other causes, n=2921). Adjusted HRs of all-cause mortality and mortality from cancer, circulatory disease and other causes were highest among people with comorbid depression and diabetes (HRs 2.16 [95% CI 1.94, 2.42]; 1.62 [95% CI 1.35, 1.93]; 2.22 [95% CI 1.80, 2.73]; and 3.60 [95% CI 2.93, 4.42], respectively). The risks of all-cause, cancer and other mortality among those with comorbid depression and diabetes exceeded the sum of the risks due to diabetes and depression alone.CONCLUSIONS/INTERPRETATION: We confirmed that depression and diabetes individually are associated with an increased mortality risk and also identified that comorbid depression and diabetes have synergistic effects on the risk of all-cause mortality that are largely driven by deaths from cancer and causes other than circulatory disease and cancer.
KW - Cardiovascular Diseases/epidemiology
KW - Cause of Death
KW - Depression/complications
KW - Diabetes Mellitus, Type 2/complications
KW - Humans
KW - Neoplasms/epidemiology
KW - Proportional Hazards Models
KW - Prospective Studies
KW - Risk Factors
U2 - 10.1007/s00125-022-05723-4
DO - 10.1007/s00125-022-05723-4
M3 - Article
C2 - 35622126
SN - 1432-0428
VL - 65
SP - 1450
EP - 1460
JO - Diabetologia
JF - Diabetologia
IS - 9
ER -