Association between type 2 diabetes mellitus and psychosocial burdens in older adults in Germany: findings from the longitudinal Gesundheit 65+ study

INTRODUCTION: This study investigates the association between type 2 diabetes mellitus and six psychosocial burdens (depressive symptoms, loneliness, and low levels of energy, life satisfaction, satisfaction with one's activity level, and perceived social support) among older adults, using data from the population-based longitudinal study Gesundheit 65+ in Germany. RESEARCH DESIGN AND METHODS: Data were collected from June 2021 to April 2023 via a baseline survey and three follow-up waves, primarily using paper questionnaires. The present study included 12,514 observations across 3,547 participants aged 65 and older. The presence of type 2 diabetes in the last 12 months was self-reported. Psychosocial burdens were assessed using validated scales. Binomial and multinomial logistic regressions were conducted, adjusting for sex, age, education, physical activity, obesity, cardiovascular comorbidities and cancer. RESULTS: Type 2 diabetes was significantly associated with all examined psychosocial burdens in the unadjusted analysis. In the fully adjusted model, having type 2 diabetes increased the odds of experiencing depressive symptoms (OR 1.60, 95% CI 1.18 to 2.17), low energy (1.37, 95% CI 1.06 to 1.77), low/middle life satisfaction (1.41, 95% CI 1.15 to 1.73), loneliness (1.31, 95% CI 1.03 to 1.66) and neither satisfaction nor dissatisfaction with one's activity level (1.38, 95% CI 1.11 to 1.72), whereas the association with perceived social support lost statistical significance. Sensitivity analysis confirmed the results. No significant interactions were found for sex, age group, or study wave. CONCLUSIONS: Type 2 diabetes is associated with higher odds of different psychosocial challenges in older adults. These findings emphasize the need for integrated care models that routinely screen for and manage these conditions in persons with diabetes.