Predictors of Depressive Symptoms Among Mid-Aged and Older Men With Diabetes in China

Background and Purpose: Although mounting evidence has consistently shown that depressive symptoms are more common among diabetic women than among diabetic men, diabetic men are frequently overlooked in diabetes-related mental health studies, and research on predicators of depressive symptoms among diabetic men remains scarce. Therefore, the purpose of this study was to examine the gender-specific characteristics that predict depressive symptoms among midaged and elderly men with diabetes. Methods: A secondary data analysis was performed using the baseline data from the China and Health Retirement Longitudinal Study. A total of 824 men aged 45 years or older with diabetes were included in the analysis. Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale short form. Age, education level, marital status, nighttime sleep duration, smoking status, duration of diabetes, treatment with insulin, and pain were based on self-reports. Information on hemoglobin A1c (HbA1c), functional impairment, weight, height, and blood lipids was also collected. Results: The prevalence of depressive symptoms was 22.7%. Male-specific significant predictors of depressive symptoms included nighttime sleep duration (short sleepers [p = .019], normal sleepers [p = .001], and long sleepers [p = .000]), instrumental activities of daily living (p = .001), and pain (mild pain [p = .003], moderate pain [p = .024], and severe pain [p = .017]). Implications for Practice: This study provides important findings about nighttime sleep duration, pain, and functional impairment and their relationships with presence of depressive symptoms in mid-aged and older men with diabetes. Screening tools should include these items to enable early detection and depression treatment for vulnerable men who may be otherwise missed.