All Posts tagged relative

Depression – Diabetes Relationship

A baseline questionnaire about medical history and health practices was completed and then repeated every 2 years through 2006. Self-reported symptoms of depression, use of antidepressant medication, and physician-diagnosed depression were used as measures of depression. Depressed mood was assessed using the 5-item Mental Health Index, with a score of 52 or less indicating severe depression.

Those who reported a diagnosis of type 2 diabetes mellitus had the diagnosis confirmed by means of a supplementary questionnaire validated by medical record review.

During the 10-year follow-up, 2844 women were diagnosed as having type 2 diabetes and 7415 developed depression.

The relative risk of developing type 2 diabetes among women who were depressed was 1.17 (95% confidence interval [CI], 1.05 – 1.30). Study participants using antidepressants had a relative risk of 1.25 (95% CI, 1.10 – 1.41).

After controlling for all covariates, the investigators found women with diabetes had a relative risk of 1.29 (95% CI, 1.18 – 1.40) of developing clinical depression.

In addition, the relative risk for depression in diabetic subjects taking no diabetic medication, oral hypoglycemic agents, and insulin was 1.25 (95% CI, 1.09 – 1.42), 1.24 (95% CI, 1.09 – 1.41), and 1.53 (95% CI, 1.26 – 1.85), respectively.

The results also showed that compared with their nondiabetic counterparts, women with diabetes were more likely to have a higher body mass index and less likely to be physically active, a finding that suggests these 2 risk factors could be “major mediating factors.”

Nevertheless, they note the association remained significant after controlling for body mass index and lifestyle factors, which suggests “depression has effects on incident diabetes independent of adiposity and inactivity.”

The finding that women taking antidepressant medications were at higher risk of developing type 2 diabetes compared with those with severe depressive symptoms or physician-diagnosed depression has at least 2 possible explanations — antidepressant medications may be a marker of more severe, chronic, or recurrent depression or the medications themselves may increase diabetes risk.

“Although antidepressant medication use might be a marker of severe depression, its specific association with elevated risk of diabetes warrants further scrutiny,” they write.

In addition, the study authors note that these findings reinforce the hypothesis that diabetes may be related to stress: “Depression may result from the biochemical changes directly caused by diabetes or its treatment, or from the stresses and strains associated with living with diabetes and its often debilitating consequences.”

“This large, well-established cohort study provides evidence that the association between depression and diabetes is bidirectional and this association is partially explained by, but independent of, other known risk factors such as adiposity and lifestyle variables. Future studies are needed to confirm our findings in different populations and to investigate the potential mechanisms underlying this association,” the investigators conclude.

The study was funded by the National Institutes of Health and the National Alliance for Research on Schizophrenia and Depression. The study authors have disclosed no relevant financial relationships.

Arch Intern Med. 2010;170:1884-1891.

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Teenage Physical Activity Reduces Risk of Cognitive Impairment in Later Life

Of the participants, 15.5%, 29.7%, 28.1%, and 21.1% reported being physically inactive at teenage, at 30 years, at 50 years, and in late life respectively; the increase in cognitive impairment for those who were inactive was between 50% and 100% at each time point. When physical activity measures for all four ages were entered into a single model and adjusted for variables such as age, education, marital status, diabetes, hypertension, depressive symptoms, smoking, and BMI, only teenage physical activity status remained significantly associated with cognitive performance in old age.

Middleton added, “As a result, to minimize the risk of dementia, physical activity should be encouraged from early life. Not to be without hope, people who were inactive at teenage can reduce their risk of cognitive impairment by becoming active in later life.”

The researchers concluded that the mechanisms by which physical activity across the life course is related to late life cognition are likely to be multi-factorial. There is evidence to suggest that physical activity has a positive effect on brain plasticity and cognition and in addition, physical activity reduces the rates and severity of vascular risk factors, such as hypertension, obesity, and type II diabetes, which are each associated with increased risk of cognitive impairment.

“Low physical activity levels in today's youth may mean increased dementia rates in the future. Dementia prevention programs and other health promotion programs encouraging physical activity should target people starting at very young ages, not just in mid- and late life,” said Middleton.

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What to expect on your first visit

An Accredited Practising Dietitian is a health professional who is a food and nutrition expert. Dietitians complete a university course in order to be able to understand your medical/surgical condition and nutritional needs and adapt these into practical dietary advice.
Your first appointment is likely to take 45 – 60 minutes and sometimes longer. You need to bring the following to your appointment: 
  • Your referral letter or EPC (Medicare form) from your GP (if you were referred)
  • Your food record / diary if you have been asked to keep one.
  • A list of medications.
  • Dietary advice previously given.
  • Blood sugar records, if applicable.
  • Test results, if applicable.

You can bring a friend, relative or carer to the appointment if you find this helpful.

At the appointment, Nastaran will:

  • Introduce herself and welcome you.
  • Discuss the reason you have been referred.
  • Ask you questions about the types of food you eat, how you cook your foods and when you eat.
  • Ask to measure your height and weight.
  • Agree the changes you may wish to make, to meet your individual needs.
  • Provide you with written information.

Your doctor will be informed of any dietary treatment recommended (if your were referred).

If Nastaran needs to see you again, she will agree this with you and explain how the followup

appointment is made and how long this will take. Generally followup appointments are 20-30 minutes long.

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