To evaluate changes in the prevalence of depressive symptoms, loneliness, and insomnia among older adults with type 2 diabetes from 2016 to 2020 and to assess risk factors for these conditions including demographics, multimorbidity, BMI, treatment group, and pre-coronavirus 2019 (COVID-19) measure scores.

This was a prospective, observational study of participants from the Look AHEAD (Action for Health in Diabetes) cohort study. Data were from two assessments before COVID-19 (visit 1: April 2016–June 2018 and visit 2: February 2018–February 2020) and one assessment during COVID-19 (visit 3: July–December 2020). Surveys were administered to assess depressive symptoms, loneliness, and insomnia.

The study included 2829 adults (63.2% female, 60.6% White, mean [SD] age 75.6 [6.0] years). The prevalence of mild or greater depressive symptoms did not change significantly between the two prepandemic visits (P = 0.88) but increased significantly from pre- to during COVID-19 (19.3% at V2 to 30.4% at V3; P < 0.001). Higher odds of mild or greater depressive symptoms at V3 were associated with being female (adjusted odds ratio [OR] 1.4 [95% CI 1.1–1.7]), identifying as non-Hispanic White (OR 1.4 [95% CI 1.1–1.7]), having obesity (OR 1.3 [95% CI 1.0–1.5]), and reporting mild or greater depressive symptoms at V1 (OR 4.0 [95% CI 2.9–5.4]), V2 (OR 4.4 [95% CI 3.2–5.9]), or both visits (OR 13.4 [95% CI 9.7–18.4]). The prevalence of loneliness increased from 12.3% at V1 to 22.1% at V3 (P < 0.001), while the prevalence of insomnia remained stable across visits at 31.5–33.3%.

The prevalence of mild or greater depressive symptoms in older adults with diabetes was more than 1.6 times higher during COVID-19 than before the pandemic.

评估 2016 年至 2020 年老年 2 型糖尿病患者抑郁症状、孤独感和失眠患病率的变化，并评估这些情况的风险因素，包括人口统计学、多发病、BMI、治疗组和 2019 年冠状病毒感染前（COVID -19) 测量分数。

这是一项针对 Look AHEAD（糖尿病健康行动）队列研究参与者的前瞻性观察性研究。数据来自 COVID-19 之前的两项评估（访问 1：2016 年 4 月至 2018 年 6 月和访问 2：2018 年 2 月至 2020 年 2 月）和 COVID-19 期间的一项评估（访问 3：2020 年 7 月至 12 月）。进行了调查以评估抑郁症状、孤独感和失眠。

该研究包括 2829 名成年人（63.2% 为女性，60.6% 为白人，平均 [SD] 年龄 75.6 [6.0] 岁）。在两次大流行前就诊之间，轻度或更严重抑郁症状的患病率没有显着变化（P = 0.88），但从 COVID-19 之前到期间显着增加（V2 时为 19.3%，V3 时为 30.4%；P < 0.001）。V3 时出现轻度或重度抑郁症状的几率较高与女性相关（调整后的优势比 [OR] 1.4 [95% CI 1.1–1.7]），确定为非西班牙裔白人（OR 1.4 [95% CI 1.1–1.7] ), 肥胖 (OR 1.3 [95% CI 1.0–1.5]), 并在 V1 (OR 4.0 [95% CI 2.9–5.4]), V2 (OR 4.4 [95% CI 3.2–5.9] 时报告轻度或更严重的抑郁症状])，或两次就诊 (OR 13.4 [95% CI 9.7–18.4])。孤独的患病率从 V1 的 12.3% 增加到 V3 的 22.1%（P < 0.001），而失眠的患病率在就诊期间保持稳定在 31.5-33.3%。

在 COVID-19 期间，患有糖尿病的老年人中轻度或更严重抑郁症状的患病率是大流行之前的 1.6 倍以上。