臺大公衛學院-流行病學與預防醫學研究所;Pan, Hsueh-HsingHsueh-HsingPanLi, Chung-YiChung-YiLiChen, Pei-ChunPei-ChunChenLee, Ming-DerMing-DerLeeLiang, Chun-YuChun-YuLiangHou, Wen-HsuanWen-HsuanHouWang, Kwua-YunKwua-YunWang2014-02-172018-06-292014-02-172018-06-292012http://ntur.lib.ntu.edu.tw//handle/246246/259987Objective: To prospectively examine the roles of diabetic macro-vascular complications and hip fracture in association with depression onset in Taiwan's elderly diabetic population. Methods: A representative sample of elderly diabetic patients (n=144,216) identified in 2000 were linked to National Health Insurance claims (2000-2007) to ascertain the diagnoses of depression in both outpatient and inpatient settings. The person-year approach with Poisson assumption was used to estimate the hazard rates. Using Cox proportional hazard regression model, we evaluated the relative risk of depression in relation to diabetic macro-vascular complications and hip fracture. The additive effects from the above medical conditions were also assessed. Results: The 8-year cumulative risk of depression was 5.08%, representing an incidence density of 8.40 per 1000 patient-years. Hazard ratio (HR) with 95% confidence interval (Cl) for the elderly diabetes associated with cardiovascular disease (CVD), hip fracture, and lower extremity amputation was 1.13 (1.04-1.23), 1.10(0.91-1.34), and 1.25 (0.95-1.65), respectively. Additionally, we found that the more the complications or hip fracture, the higher the risk of depression onset in elderly diabetes. Conclusion: The increased number of diabetic macro-vascular complications and hip fracture is significantly associated with a higher risk of depression onset in elderly diabetes. Future studies should be conducted to assess the feasibility and cost-effectiveness of intensive depression screening program in elderly diabetes suffering from macro-vascular complications and hip fracture. (C) 2012 Elsevier Inc. All rights reserved.114 bytestext/htmlDepressionDiabetic complicationsElderlyPopulation-based[SDGs]SDG3aged; article; cohort analysis; depression; diabetic angiopathy; disease association; female; follow up; hazard ratio; hip fracture; human; incidence; major clinical study; male; non insulin dependent diabetes mellitus; population research; prospective study; risk assessment; risk factor; Age Factors; Aged; Cardiovascular Diseases; Depressive Disorder; Diabetic Angiopathies; Female; Follow-Up Studies; Hip Fractures; Humans; Male; Poisson Distribution; Proportional Hazards Models; Prospective Studies; Risk; Sex Factors; Taiwan10.1016/j.jpsychores.2012.06.003http://ntur.lib.ntu.edu.tw/bitstream/246246/259987/1/index.html