Association between depressive symptoms and cognitive function in older adults with type 1 and type 2 diabetes compared to those without diabetes

Background Depression is a major risk factor for cognitive impairment among people with type 2 diabetes (T2D) and the general population. Depression is 3 times more prevalent among people with type 1 diabetes (T1D) than in the general population and interferes with self‐management. Understanding the association between depression and cognitive function in older adults with T1D is crucial. Method Using baseline data from the Study of Longevity in Diabetes (SOLID), we examined the association between depressive symptoms and cognition in older adults with T1D (n=799), T2D (n=240), and without diabetes (n=256 matched on age, sex, race/ethnicity, and education). Based on recommended guidelines, a score of >5 on the 15‐item Geriatric Depression Scale indicated presence of depressive symptoms. Cognitive function was evaluated at baseline. Factor analyses identified the following cognitive domains: executive function (Trail Making A and B, Digit Symbol Substitution, and Stroop Interference Test), language (List sorting, MINT, Phonemic and Category fluency), simple attention (Diamond and TMX cancellation), verbal episodic memory (Word List Learning), and visual episodic memory (Benson). All cognitive scores were standardized (mean=0; SD=1). Linear regression models evaluated the association between depressive symptomatology and cognitive function adjusting for age at interview, sex, race/ethnicity, and education. Result Subjects (mean age of 67.9 years and 50.9% were female) with diabetes had a greater prevalence of depressive symptoms than those without diabetes (T1D: 9.8%; T2D: 9.2%; no diabetes: 2.7%; chi‐square p‐value=0.002). In T1D, depression was associated with poorer performance on the language, executive function, and verbal episodic memory domains (Table 1). In T2D, depression was associated with poorer performance on the executive function domain. There was no observed association between depression and cognitive function among those without diabetes. Conclusion Among older individuals with T1D, depressive symptoms were associated with lower scores on a range of cognitive domains. By contrast, depressive symptoms were only associated with executive function in T2D and were not associated with any cognitive domains in those without diabetes. Our findings underscore the importance of mental health as a key component of healthy aging in older adults with T1D and T2D.