Diabetes: A risk factor for poor mental health in aging population

Background: Data on diabetes as a risk factor for mental health disorders in older population is limited. The health systems need to assess the burden on mental health disorders secondary to chronic diseases for better care provision. This study aims to assess the burden of depression, generalized anxiety disorder (GAD), and cognitive impairment among older patients with diabetes compared to age- and sex-matched nondiabetes and study the impact of diabetes on quality of life (QOL). Subjects and Methods: Cross-sectional comparative study was performed in Geriatric Medicine Outpatient Department (OPD) from November 2014 to June 2016. Ambulatory patients from OPD who provided informed consent were the participants of the study. They included 180 diabetic cases and 180 age- and sex-matched nondiabetic controls. The cases and controls were subjected to assessment for the presence of depression, GAD, and cognitive impairment using Geriatric Depression Scale, Mini International Neuropsychiatric Interview, and Montreal Cognitive Assessment, respectively. Health-related QOL was assessed with WHOQOL-BREF scale. They were also subjected to routine comprehensive geriatric assessment. McNemar's Chi-square test and Paired t-test was used for statistical analysis. Results: Older diabetics have significantly higher frequency of depression (35.6% vs. 16.7%), GAD (12.8% vs. 4.4%), and cognitive impairment (53.9% vs. 27.2%) compared to nondiabetics. In addition, they also report poorer health-related QOL. Conclusions: Diabetes in old age is associated with increased risk of mental health disorders and an accompanying poor health-related QOL in all domains. Thus, patients with diabetes require access to mental health support in addition to management of metabolic abnormalities. Future research to assess the impact of screening of mental health disorders on outcomes such as glycemic control, morbidity, and mortality is required.