223 Prevalence of Depression Among People with Diabetes; Comparative Analysis of Older Adults Across Three Health Systems Using Nationally Representative Data (Age and Ageing)

AbstractBackgroundThe co-occurrence of depression and diabetes is an emerging global challenge but any association is influenced by variations in prevalence, study design and measure used. We compared depression prevalence in older adults with and without diabetes across three health systems using a validated measure to examine the causal association between diabetes and depression.MethodsWe used data of adults aged over 49 years, from three nationally representative ageing datasets; The Irish Longitudinal Study on Ageing (TILDA), the English Longitudinal Study on Ageing (ELSA) and the Health and Retirement Study (HRS). Data were collected during 2009-2011 (TILDA), and 2010 (ELSA, HRS). The 8-item CESD scale categorised depression using recommended cut-off scores of < 3 for ELSA and HRS and < 8 for TILDA. Self-reported individual, environmental, behavioural risk, and health system exposure variables were selected a-priori using literature and a directed acyclic graph. Prevalence was presented as a percentage with corresponding 95% confidence intervals. Binomial logistic regression examined the odds of depression by diabetes status. Data were analysed in Stata v15 using the `svy` function.ResultsDiabetes prevalence (Ireland;8%[(95%CI:7.5-8.6), England;11%(95%CI:10.6-12.0) and USA;19%[(95%CI:18.8-20.1);p<0.001]) and depression prevalence (Ireland;10%(95%CI:9.0-10.6), England;16%(95%CI:15.3-16.9), USA;14%[(95%CI:13.5-14.7);p<0.001] varied across countries. Depression was consistently higher among people with versus without diabetes (Ireland;14%(95%CI:10.9-16.6)vs.9%(95%CI:8.7-10.3),p=0.001], England;25%(95%CI:21.7-27.7)vs.15%[(95%CI:14.2-15.9),p