A multi-state analysis of disease trajectories and mental health transitions in patients with type 2 diabetes: A population-based retrospective cohort study utilizing health administrative data.
Diabetes Res Clin Pract
; 209: 111561, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-38325659
ABSTRACT
AIMS:
To investigate the risk of major depression and dementia in patients with type 2 diabetes, including dementia resulting from depression, and their impact on diabetes-related complications and mortality.METHODS:
We conducted a population-based retrospective cohort study including 11,441 incident cases of diabetes in 2015-2017, with follow-up until 2022. A multi-state survival analysis was performed on a seven-state model with 15 transitions to capture disease progression and onset of mental disorders.RESULTS:
Eight-year probabilities of depression, dementia, diabetes-related complications, and death were 9.7% (95%âCI 8.7-10.7), 0.9% (95%âCI 0.5-1.3), 10.4% (95%âCI 9.5-11.4), and 14.8% (95%âCI 13.9-15.7), respectively. Depression increased the risk of dementia up to 3.7% (95%âCI 2.0-5.4), and up to 10.3% (95%âCI 0.3-20.4) if coupled with diabetes complications. Eight-year mortality was 37.5% (95%âCI 33.1-42.0) after depression, 74.1% (95%âCI 63.7-84.5) after depression plus complications, 76.4% (95%âCI 68.8-83.9) after dementia, and 98.6% (95%âCI 96.1-100.0) after dementia plus complications.CONCLUSIONS:
The interconnections observed across depression, dementia, complications, and mortality underscore the necessity for comprehensive and integrated approaches in managing diabetes. Early screening for depression, followed by timely and targeted interventions, may mitigate the risk of dementia and improve diabetes prognosis.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Demência
/
Complicações do Diabetes
/
Diabetes Mellitus Tipo 2
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Itália