Effect of Race/Ethnicity and Persistent Recognition of Depression on Mortality in Elderly Men With Type 2 Diabetes and Depression

Abstract

OBJECTIVE—To determine whether mortality risk from depression among elderly men with type 2 diabetes differs by ethnicity and persistent recognition of depression. RESEARCH DESIGN AND METHODS—Data on a cohort of 14,500 male veterans with type 2 diabetes were analyzed. Diagnoses of depression and diabetes were based on ICD-9 codes. Persistent recognition was defined as an ICD-9 code for depression documented in at least the second or third visit after the initial diagnosis of depression. Hazards of death were compared using Cox proportional hazards regression models adjusting for relevant covariates. RESULTS—Over 10 years, 2,305 deaths were documented. Mortality risk was higher for depressed than nondepressed veterans with diabetes (hazard ratio [HR] 1.6 [95% CI 1.3–1.8]). Among those with depression, mortality risk was lower with persistent recognition (0–2 visits vs. ≥3 visits after initial diagnosis, HR 0.58 [0.40–0.89]) but higher for whites than blacks (1.60 [1.11–2.31]). CONCLUSIONS—Increased mortality from depression differs by ethnicity and persistent recognition.