The Influences of Loneliness and Depression on A1C among Middle-Aged and Older Adults with Diabetes

Huang, Ya Ching Garcia Alexandra A.; Cho, Emma S.; Kuo, Hsuanju

Purpose: Loneliness and depression are significant challenges for middle-aged and older adults, and are associated with worse overall health. Even before the COVID-19 pandemic, about 43% of adults aged 60 and above reported experiencing loneliness. People with diabetes (DM) are 2 to 3 times more likely to have depression than those without DM. Loneliness and depression often co-exist and each is likely to worsen DM outcomes. The aim of this study was to examine how loneliness and depression affect A1C levels among middle-aged and older adults with DM. Methods: This study is a secondary analysis of data from the Midlife in the United States Refresher (MIDUS-R) survey that included a national sample of U.S. adults aged 25 to 74 years. We conducted correlation analyses and estimated a hierarchical logistic regression to predict people with A1C levels ≤ 7 or > 7 using the following sets of predictors: 1) demographics and physical health (ethnicity, gender, education, age, and comorbidities), 2) family and friends support, and 3) psychological factors (loneliness and depression). Results: The sample was composed of 92 participants with DM and A1C data in the MIDUS-R. Mean age was 57.37±11.83, 51% were male, and 68 % were non-Hispanic Whites;39.1 % had A1C >7. The average level of depression was low (CES-D mean 9.42) and loneliness was moderate (mean 12.43, range 1-28). Loneliness was correlated with A1C (r= .26, p< .05);depressive symptoms (r= .71, p< .001), family and friends support (r=.36, r=.38, respectively, both p<.001). Only loneliness significantly predicted higher A1C levels in this analysis. People with higher levels of loneliness had increased odds of having an A1C >7 (OR = 1.18, p < .05) after controlling for depression and all other variables. Conclusion: Loneliness is more prevalent and had a greater impact than depression on A1C level. Healthcare providers should assess patients for loneliness and reduce adverse health impacts by referring them for psychosocial interventions as needed.