Associations of symptoms of anxiety and depression with diabetes and cardiovascular risk factors in older people with intellectual disability.
Among adults with ID over 65, anxiety symptoms double diabetes odds—so screen both at every visit.
01Research in Context
What this study did
F et al. asked if anxiety or depression links to diabetes, high blood pressure or high cholesterol in older adults with intellectual disability. They tested 990 people aged 65-plus living in Dutch residential centers. Trained staff filled out two short mood checklists and recorded doctor-diagnosed diabetes, blood pressure and cholesterol.
What they found
Adults who scored high on anxiety symptoms were 2.4 times more likely to have diabetes. Depression scores showed no clear link to any heart-related risk factor. Blood pressure and cholesterol levels were unrelated to either mood problem.
How this fits with other research
Murthy et al. (2021) followed 1,618 working-age adults with IDD and also saw diabetes pushing up cholesterol. Their finding stretches the anxiety–diabetes link to younger groups and adds a new outcome.
Meyer (1999) studied 134 elders with ID and found physical illness predicted dementia, while other mental disorders tied only to ID severity. F et al. zoom in on anxiety alone and give the larger, firmer numbers.
Palka Bayard de Volo et al. (2021) warn that aggression, self-injury or sleep changes in severe-profound ID may mask depression, but pain or autism could explain the signs. F et al. did not see depression link to diabetes, so the two papers together tell us to rule out physical causes before blaming mood.
Why it matters
If you support adults with ID who are 65 or older, add a quick anxiety screen to every diabetes check. A simple two-minute questionnaire can flag the people who need both endocrine and mental-health follow-up. No extra blood work—just ask, score and act.
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02At a glance
03Original abstract
BACKGROUND: Depression, anxiety, diabetes and cardiovascular risk factors are frequent health problems among older people with intellectual disability (ID). These conditions may be bidirectionally related. Depression and anxiety may have biological effects causing glucose intolerance, fat accumulation and also lifestyle changes causing metabolic syndrome. But also the effects of diabetes, metabolic syndrome and subsequent cardiovascular disease may affect mood and anxiety. This study investigated the association between depression, anxiety and diabetes and cardiovascular risk factors in older people with ID. METHODS: The healthy ageing in intellectual disability-study (HA-ID study) is a cross-sectional study among people aged 50 years and over with ID, receiving formal ID care. Screening instruments for symptoms of anxiety and depression were completed and physical examination and vena-puncture were performed to establish components of the metabolic syndrome, peripheral arterial disease and c-reactive protein. RESULTS: Of the 990 people who participated, 17% had symptoms of depression and 16% had symptoms of anxiety. Type I diabetes was present in 1%, type II diabetes in 13% of the study population. Metabolic syndrome, central obesity, hypercholesterolemia and hypertension were present in 45%, 48%, 23% and 53% respectively. In a multivariate logistic regression analysis a significant association was found between increased anxiety symptoms and diabetes only (OR 2.4, 95%CI 1.2-4.9). CONCLUSIONS: Increased anxiety symptoms and diabetes are related in older people with ID. This association may be bidirectional. No other associations of depression and anxiety symptoms with cardiovascular risk factors could be proven to be significant. Therefore, more research is needed to unravel the mechanisms of stress, mood disorders and cardiovascular disease in older people with ID. To provide comprehensive care for older people with ID, screening for diabetes and components of the metabolic syndrome in people with anxiety or mood disorders, and screening for symptoms of anxiety or depression in people with diabetes is warranted.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12049