A multi-state analysis of disease trajectories and mental health transitions in patients with type 2 diabetes: A population-based retrospective cohort study utilizing health administrative data
Authors' conclusion
The interconnections observed across depression, dementia, complications, and mortality underscore the necessity for comprehensive and integrated approaches in managing diabetes. Early screening for depression, followed by timely and targeted interventions, may mitigate the risk of dementia and improve diabetes prognosis.
Study context
- Population
- Incident cases of T2D in 2015–2017, follow-up until 2022
- Participants
- 11,441 incident cases
- Outcome
- Risk of major depression and dementia, including dementia resulting from depression, and their impact on diabetes-related complications and mortality
- Follow-up
- 8 years
Methodological detailsmulti-state survival analysis, seven-state model with 15 transitions
- Multi-state survival analysis
- Seven-state model with 15 transitions
Main finding
As reported in the abstract
Eight-year probabilities
- Depression
- 9.7% (95% CI 8.7-10.7)
- Dementia
- 0.9% (95% CI 0.5-1.3)
- Diabetes-related complications
- 10.4% (95% CI 9.5-11.4)
- Death
- 14.8% (95% CI 13.9-15.7)
- Dementia risk after depression
- up to 3.7% (95% CI 2.0-5.4)
- Dementia risk after depression plus diabetes complications
- up to 10.3% (95% CI 0.3-20.4)
Observational data: associations, not effects.
Further findings
Eight-year mortality by preceding state · 8 years
- After depression
- 37.5% (95% CI 33.1-42.0)
- After depression plus complications
- 74.1% (95% CI 63.7-84.5)
- After dementia
- 76.4% (95% CI 68.8-83.9)
- After dementia plus complications
- 98.6% (95% CI 96.1-100.0)
Original publication
A multi-state analysis of disease trajectories and mental health transitions in patients with type 2 diabetes: A population-based retrospective cohort study utilizing health administrative data. Diabetes Res Clin Pract. Published 5 February 2024. doi:10.
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