The co-occurrence of depressive symptoms and cognitive impairment and its relationship with self-care behaviors among community dwelling older adults with diabetes

Aims The aims of the present study were to investigate the co-occurrence of depressive symptoms and cognitive impairment in community dwelling older adults with diabetes and its relationship with specific diabetes self-care behaviors. Methods We analyzed data from two national samples of older adults (65 years or older) with self-reported physician-diagnosed diabetes (N = 1034), who participated in the 2005 or 2009 National Health Interview Survey in Taiwan. The Mini-Mental State Examination was used to assess cognitive function. The Center for Epidemiologic Studies Depression Scale was used to assess depressive symptoms. The study assessed self-care behaviors including medication adherence, exercise, healthy diet, and self-monitoring of blood glucose. Results In this study, 8.8% of participants with diabetes had both depressive symptoms and cognitive impairment. After adjusting for other factors, participants with both cognitive impairment and depressive symptoms were less likely to exercise (Prevalence Ratios (PR) = 0.66; 95% Confidence Intervals (CI) = [0.47–0.91]; P-value = 0.011), and have a healthy diet (PR = 0.82; 95%CI = [0.70–0.96]; P-value = 0.012). Conclusions Our results illustrate the high prevalence of combined depressive symptoms and cognitive impairment and that this combination is associated with worse self-care behaviors in older adults with diabetes. These findings highlight the difficulty that some older adults with diabetes may have in maintaining self-care behaviors in the presence of depressed mood and cognitive impairment, particularly in the areas of diet and exercise. The results emphasize the importance of providing more support for these aspects of self-care to such older adults.