Courses of depressive symptoms and diabetes incidence among middle-aged and older adults: A prospective study

Elevated depressive symptoms are a risk factor for diabetes. Although depressive symptoms can remit or emerge over time, little work has considered if courses of depressive symptoms are associated with incident diabetes. The purpose of this study was to explore associations between courses of depressive symptoms and incident diabetes. Data came from the English Longitudinal Study of Ageing (n = 4,978), which is an ongoing, cohort study of adults aged 50 years and older residing in private households in England. Depressive symptoms were measured biennially from 2002 to 2008. Participants were categorized into one of six groups: no depressive symptoms, remitted depressive symptoms, incident depressive symptoms with remission, incident depressive symptoms without remission, chronic depressive symptoms, and variable course. Diabetes status was self-reported biennially from 2010 to 2018. After adjusting for covariates, remitted depressive symptoms (HR = 1.52, 95% CI [1.06, 2.22]) and variable course depressive symptoms (HR = 1.83, 95% CI [1.19, 2.81]) remained associated with incident diabetes. In sensitivity analyses, which lowered the cut-off score for depressive symptoms, variable course depressive symptoms (HR = 1.61, 95% CI [1.11, 2.33]) remained associated with incident diabetes. Specific courses of depressive symptoms, including variable course depressive symptoms, were associated with diabetes incidence. Continuing to examine the link between patterns of depressive symptoms over time and incident diabetes may lead to the development of more targeted interventions.