Ethnicity predicts long-term depressive symptom patterns in older adults with type 2 diabetes

Objectives: Depression is a chronic disorder that significantly affects functional decline in older adults, especially those with type 2 diabetes (T2D). Ethnic groups may experience different depression risks and severities, yet the effect of ethnicity on depression trajectories and specific dimensions in older adults with T2D remains largely unexamined. We examined the longitudinal associations of ethnicity with depression and its specific dimensions over time in older Ashkenazi and non-Ashkenazi Jews with T2D. Design: Generalized estimating equations (GEE) models were employed to analyze the longitudinal associations of ethnicity with numbers of depressive symptoms and specific depression dimension, adjusting for sociodemographics, cognition, T2D characteristics, and cardiovascular risk factors. Setting: Community-dwelling older adults from the longitudinal Israel Diabetes and Cognitive Decline (IDCD) study. Participants: 902 Ashkenazi and non-Ashkenazi Jews, mean age= 72.3 years. Measurements: The Geriatric Depression Scale-15 (GDS-15) and its five dimensions: Dysphoric Mood, Withdrawal Apathy-Lack of Vigor, Anxiety, Hopelessness, and Memory Complaint. Results: At baseline, Ashkenazi Jews reported significantly lower GDS-15 scores compared to non-Ashkenazi Jews. They exhibited lower scores in Dysphoric Mood and Hopelessness dimensions. GEE models confirmed these findings, showing Ashkenazi Jews had significantly lower total GDS-15 scores (β = 0.86, 95 % CI 0.75–0.99; p = 0.03), Dysphoric Mood (β = 0.76 (0.52–0.90], p = 0.006), Hopelessness (β = 0.74 [0.58–0.95], p = 0.017) and lower rates of clinical depression (OR= 0.68 [0.52–0.90], p = 0.006). These data offered no evidence of a difference in trends between the Ashkenazi and non-Ashkenazi groups on depression trajectories. Conclusions: Ethnicity is associated with the longitudinal trajectories of depression and its specific dimensions in older adults with T2D. Further investigation of contributing factors, including social determinants of health, is essential.