American Diabetes Association
LACovid_Supplement_2021_10_11.pdf (333.04 kB)

Changes in the Prevalence of Symptoms of Depression, Loneliness, and Insomnia in U.S. Older Adults With Type 2 Diabetes During the COVID-19 Pandemic: The Look AHEAD Study

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posted on 2021-11-09, 19:30 authored by Ariana M. Chao, Thomas A. Wadden, Jeanne M. Clark, Kathleen M. Hayden, Marjorie J. Howard, Karen C. Johnson, Blandine Laferrère, Jeanne M. McCaffery, Rena R. Wing, Susan Z. Yanovski, Lynne E. Wagenknecht, the Look AHEAD Research Group
Objective: To evaluate changes in the prevalence of depressive symptoms, loneliness, and insomnia among older adults with type 2 diabetes from 2016 to 2020, and to assess risk factors for these conditions including demographics, multimorbidity, body mass index, treatment group, and pre-COVID-19 measure scores.

Research Design and Methods: This was a prospective, observational study of participants from the Look AHEAD cohort study. Data were from two assessments before COVID-19 (Visit 1 (V1): April 2016-June 2018 and Visit 2 (V2): February 2018-February 2020), and one assessment during COVID-19 (Visit 3 (V3): July-December 2020). Surveys were administered to assess depressive symptoms, loneliness, and insomnia.

Results: The study included 2829 adults (63.2% female, 60.6% white, mean [SD] age 75.6 [6.0] years). The prevalence of mild or greater depressive symptoms did not change significantly between the two pre-pandemic visits (p=0.88) but increased significantly from pre- to during COVID-19 (19.3% at V2 to 30.4% at V3 (p<0.001)). Higher odds of mild or greater depressive symptoms at V3 were associated with being female (adjusted odds ratio [OR]=1.4; 95% CI, 1.1-1.7), identifying as non-Hispanic White (OR=1.4; 95% CI, 1.1-1.7), having obesity (OR=1.3; 95% CI, 1.0-1.5), and reporting mild or greater depressive symptoms at Visit 1 (OR=4.0; 95% CI, 2.9-5.4), V2 (OR=4.4; 95% CI, 3.2-5.9), or both visits (OR=13.4; 95% CI, 9.7-18.4). The prevalence of loneliness increased from 12.3% at V1 to 22.1% at V3 (p<0.001), while the prevalence of insomnia remained stable across visits at 31.5-33.3%.

Conclusions: The prevalence of mild or greater depressive symptoms in older adults with diabetes was more than 1.6 times higher during COVID-19 than before the pandemic.


This study was funded by the National Institutes of Health through cooperative agreements with the National Institute on Aging: AG058571 and National Institute of Diabetes and Digestive and Kidney Diseases: DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135, and DK56992. Additional funding was provided by the National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Center on Minority Health and Health Disparities; NIH Office of Research on Women’s Health; and the Centers for Disease Control and Prevention. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. The Indian Health Service (I.H.S.) provided personnel, medical oversight, and use of facilities. The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the I.H.S. or other funding sources.


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