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Johar, H. ; Schaefer, A.* ; Su, T.T.*

Depressive symptoms mediate the longitudinal association between diabetes and subjective cognitive decline. Findings from a semirural multi-ethnic older population in Malaysia.

Prev. Med. 167:107390 (2023)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
The potential role of psychological distress as the pathway linking diabetes and subjective cognitive decline (SCD) is still unclear. This study aims to investigate whether depressive symptoms mediate the relationship between diabetes and SCD in older adults. Baseline data from 3428 adults (55-94 years) of the South East Asia Community Observatory (SEACO), Malaysia were utilized. Subjective cognitive complaints (SCC) were recorded at baseline and five years later. Mediation analyses with non-parametric bootstrapping methods were employed. A proportion of 20% of participants without SCC at baseline reported a decline in SCC after 5 years of follow-up. Known diabetes (β = -0.13, SE = 0.05, p = 0.02) and depressive symptoms (ß = -0.18, SE = 0.05, p = 0.001) were independently associated with SCD. Previously diagnosed diabetes was associated with depressive symptoms at baseline (ß = 0.04, SE = 0.02, p = 0.01), and greater SCD at follow-up (β = -0.19, SE = 0.06, p = 0.001). Mediation analyses revealed that 9% of the association between diabetes and SCD was attributable to an indirect effect through depressive symptoms (ß = -0.01, 95% CI 0.02-0.001, p < 0.0001). This study provides further evidence of the detrimental effects of diabetes and depression on subjective cognitive decline. Our findings also suggest that depression is an important pathway linking previously diagnosed diabetes with subjective cognitive decline in older adulthood.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Ageing ; Depressive Symptoms ; Diabetes ; Malaysia ; Mediation Analysis ; Subjective Cognitive Decline; World-health-organization; Memory Complaints; Risk-factors; Alzheimers-disease; Primary-care; Impairment; Dementia; People; Dysregulation; Performance
ISSN (print) / ISBN 0091-7435
e-ISSN 0091-7435
Quellenangaben Volume: 167, Issue: , Pages: , Article Number: 107390 Supplement: ,
Publisher Elsevier
Publishing Place 525 B St, Ste 1900, San Diego, Ca 92101-4495 Usa
Non-patent literature Publications
Reviewing status Peer reviewed
Grants Monash University
Monash University funds South East Asia Community Observatory (SEACO) health and demographic surveillance system
Long-Term Research Grant Scheme of the Malaysian government