We aim to examine the relationship between diabetes and depression risk in longitudinal cohort studies and by how much the incidence of depression in a population would be reduced if diabetes was reduced. Medline/PubMed, EMBASE, PsycINFO, and Cochrane Library databases were searched for English-language published literature from January 1990 to December 2017. Longitudinal studies with criteria for depression and self-report doctors' diagnoses or diagnostic blood test measurement of diabetes were assessed. Systematic review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. Pooled odds ratios were calculated using random effects models. Population attributable fractions (PAFs) were used to estimate potential preventive impact. Twenty high-quality articles met inclusion criteria and were analyzed. The pooled odds ratio (OR) between diabetes and depression was 1.33 (95% CI, 1.18–1.51). For the various study types the ORs were as follows: prospective studies (OR 1.34, 95% CI 1.14–1.57); retrospective studies (OR 1.30, 95% CI 1.05–1.62); self-reported diagnosis of diabetes (OR 1.37, 95% CI 1.17–1.60); and diagnostic diabetes blood test (OR 1.25, 95% CI 1.04–1.52). PAFs suggest that over 9.5 million of global depression cases are potentially attributable to diabetes. A 10–25% reduction in diabetes could potentially prevent 930,000 to 2.34 million depression cases worldwide. Our systematic review provides fairly robust evidence to support the hypothesis that diabetes is an independent risk factor for depression while also acknowledging the impact of risk factor reduction, study design and diagnostic measurement of exposure which may inform preventive interventions.

BackgroundPain is an important health problem adversely affecting functionality and quality of life. Though self- rated health (SRH) is a major predictor of mortality, its relationship with pain is not well understood. We explore 1) how pain and age interact to influence SRH, and 2) provincial variations in SRH across Canada.MethodsWe analyzed cross-sectional data from Statistics Canada’s Canadian Community Health Survey-Healthy Aging (n = 30,685), which targeted those 45 years and older and was conducted from 2008 to 12-01 to 2009–11-30. The response rate was 74.4%.The topics covered included socio-demographics, well-being and chronic diseases. We performed both bivariate and multivariate analyses between each predictor and SRH; unadjusted and adjusted odds ratios and 95% confidence intervals are reported. Two-level logistic regression mixed model was used to account for provincial differences. An intraclass correlation coefficient was also computed.ResultsSlightly more than half of respondents (56.40%) were female. In bivariate analyses, those experiencing pain had an odds ratio of 0.20. Which means that the odds of reporting good self-rated health are 4 to 5 times lower for those with pain, compare to the odds of reporting good self-rated health among those without pain (p < 0.001). In multivariate analyses the highly educated, female gender, the never married or single and households with high yearly income were predictors of good health (p < 0.001). Those who reported depressive symptoms, the lonely, the obese, daily smokers and/or the stressed were less likely to rate their health as good (p < 0.001). The influence of pain on SRH was stronger among younger age groups (45–54 years) compared to older age groups (75-84 years, with an odds ratio of 3.53 [p < 0.001] versus 3.14 [p < 0.001]).ConclusionsPain, among other determinants, is associated with SRH. Individuals in rating their health may consider a variety of factors, some of which may not be apparent to health providers. We found that those who reported depressive symptoms, were daily smokers, the obese, the lonely, and/or having a stressful life were less likely to rate their health as good. No significant provincial variations in SRH in Canada was observed in this study.

Background During health disaster events such as the current devastating havoc being inflicted on countries globally by the SARS-CoV-19 pandemic, mental health problems among survivors and frontline workers are likely concerns. However, during such health disaster events, stakeholders tend to give more precedence to the socio-economic and biomedical health consequences at the expense of mental health. Meanwhile, studies show that regardless of the kind of disaster/antecedent, all traumatic events trigger similar post-traumatic stress symptoms among survivors, families, and frontline workers. Thus, our study investigated the prevalence of anxiety, depression and insomnia symptoms among survivors of the 2014–2016 Ebola virus disease that plagued the West African sub-region. Methods We systematically retrieved peer-reviewed articles published between 1970 and 2019 from seven electronic databases, including Google Scholar, MEDLINE, PsychInfo, PubMed, Scopus, Springer Link, Web of Science on Ebola and post-traumatic stress disorder symptoms. A comprehensive hand search complemented this literature search. Of the 87 articles retrieved, only 13 met the inclusion criteria for this meta-analysis. Results After heterogeneity, influence, and publication bias analysis, our meta-analysis pooled proportion effects estimates showed a moderate to a high prevalence of anxiety (14%; 99% CI: 0.05–0.30), depression (15%; 99% CI: 0.11–0.21), and insomnia (22%; 99% CI: 0.13–0.36). Effect estimates ranging from (0.13; 99% CI: 0.05, 0.28) through to (0.11; 99% CI: 0.05–0.22), (0.15; 99% CI: 0.09–0.25) through to (0.13; 99% CI: 0.08–0.21) and (0.23; 99% CI: 0.11–0.41) to (0.23; 99% CI: 0.11–0.41) were respectively reported for anxiety, depression and insomnia symptoms. These findings suggest a significant amount of EVD survivors are struggling with anxiety, depression and insomnia symptoms. Conclusion Our study provided the first-ever meta-analysis evidence of anxiety, depression, and insomnia symptoms among EVD survivors, and suggest that the predominant biomedical health response to regional and global health disasters should be complemented with trauma-related mental health services.

Objective: The objective of this study was to examine shared and unique risk factors for incident depression and diabetes mellitus in a national longitudinal population-based survey. Methods: Canadian National Population Health Survey (NPHS) longitudinal study was used. A subsample of the initial NPHS sample ( n = 4845), free of depression or diabetes mellitus at baseline was tracked over a 10-year period. Univariate and multivariate modified Poisson regression models were used to estimate the relative risk (RR). Stratified analyses by sex were conducted to measure its moderating role. The goodness-of-fit of the various models was tested. Results: The cumulative incidence rate of major depressive disorder and incident diabetes mellitus at 10-year follow-up were 4.1% and 10.1% respectively. Hypertension, daily smoking, physical inactivity and being overweight or obese were shared risk factors for major depressive episode and diabetes mellitus. Being female, family stress, traumatic events, having any chronic disease or heart disease were uniquely associated with depression while increasing age and ethnicity (non-white) were unique risk factors for diabetes mellitus. Also, underweight, family stress, chronic disease, and heart disease were risk factors for major depressive disorder in both sexes. Six risk factors, age, ethnicity (non-white), high blood pressure, daily smoking, physical inactivity, and body mass index were associated with incident diabetes mellitus in both sexes. Conclusion: We found common risk behaviors/conditions not specific to either diabetes mellitus or depression. These risks have also been implicated in the development of a variety of chronic diseases. These findings underline the importance of public health prevention programs targeting generic risk behaviors.

Background The prevalence of cognitive impairment or dementia is of public health concern globally. Accurate estimates of this debilitating condition are needed for future public health policy planning. In this study, we estimate prevalence and modifiable risk factors for cognitive impairment by sex over approximately 16 years. Methods Canadian Study of Health and Aging (CSHA) baseline data conducted between 1991–1992 were used to measure the prevalence of cognitive impairment and dementia among adults aged 65+ years. The standard Modified Mini-Mental State Examination (3MS) was used for the screening test for cognitive impairment. We compared the CSHA data with Canadian Community Health Survey–Healthy Aging (CCHS-HA) conducted between 2008–2009. The CCHS-HA used a four-dimension cognitive module to screen for cognitive impairment. Only survey community-dwelling respondents were included in the final sample. After applying exclusion criteria, final samples of (N = 8504) respondents in the CSHA sample and (N = 7764) respondents for CCHS–HA sample were analyzed. To account for changes in the age structure of the Canadian population, prevalence estimates were calculated using age-sex standardization to the 2001 population census of Canada. Logistic regression analyses were used to examine predictors of cognitive impairment. A sex stratified analysis was used to examine risk factors for cognitive impairment in the survey samples. Results We found that prevalence of cognitive impairment among respondents in CSHA sample was 15.5% in 1991 while a prevalence of 10.8% was reported in the CCHS–HA sample in 2009, a 4.7% reduction [15.5% (CI = 14.8–16.3), CSHA vs 10.8% (CI = 10.1–11.5), CCHS–HA]. Men reported higher prevalence of cognitive impairment in CSHA study (16.0%) while women reported higher prevalence of cognitive impairment in CCHS–HA (11.6%). In the multivariable analyses, risk factors such as age, poor self-rated health, stroke, Parkinson’s disease, and hearing problems were common to both cohorts. Sex differences in risk factors were also noted. Conclusions This study provides suggestive evidence of a potential reduction in the occurrence of cognitive impairment among community-dwelling Canadian seniors despite the aging of the Canadian population. The moderating roles of improved prevention and treatment of vascular morbidity and improvements in the levels of education of the Canadian population are possible explanations for this decrease in the cognitive impairment.