Individuals with diabetes are at increased risk of developing depression. The prevalence of depression in non-Hispanic Blacks (NHB) with diabetes is about 25%, higher than the prevalence among non-Hispanic Whites (NHWs) . Frailty, a measure of biological age and one’s increased susceptibility to negative health outcomes and has been found to be associated with disability and dependency. The aim of this study was to examine the association between depression and frailty and to understand whether this association differs by race/ethnicity among adults with diabetes. Data on 3792 adults with diabetes from NHANES (2003-2005) were analyzed. Depression was assessed using scores from the 9-item Patient Health Questionnaire (PHQ-9) . Frailty index composed of 46 variables (comorbidities, disability, symptoms, labs, general health) was created ranging from 0 - 1 (frail>=0.21; not frail<0.21) . Unadjusted and adjusted linear regression models were used to assess the association between depression and frailty. Covariates included age, sex, education, income-to-poverty ratio, marry, insurance, employment, smoke, physical activity, and body mass index. All models were stratified by race/ethnicity. Unadjusted models showed an association depression and frailty across all racial/ethnic groups with those who were frail having significantly higher PHQ9 scores (NHW: b 2.63; 95%CI:1.36, 3.89; NHB: b 3.26; 95%CI:2.23, 4.23; Hispanic/Other (H/O) : b 1.33; 95%CI:0.52, 2.14) . The association remained significant across all groups in adjusted models (NHW: b 4.5; 95%CI:1.9, 7.1; NHB: b 6.3; 95%CI:4.2, 8.4; H/O: b 2.1; 95%CI:0.5, 3.7) .While depression was associated with frailty across all racial/ethnic groups, NHBs who were frail had the highest mean PHQ9 score. Additional research is needed to identify the key drivers of this relationship and potential targets for home-based lifestyle intervention to improve care provided to and outcomes for frail patients with diabetes.
L.E.Egede: None. A.Z.Dawson: None. J.A.Campbell: None. R.J.Walker: None.
American Diabetes Association (1-19-JDF-075) ; National Institute of Diabetes and Digestive and Kidney Diseases (grant K24DK093699, R01DK118038, R01DK120861, Principal Investigator (PI) : Leonard Egede, MD) National Institute on Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker)