{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T02:28:27Z","timestamp":1783132107389,"version":"3.54.6"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"publisher","award":["SDAP-2023-001"],"award-info":[{"award-number":["SDAP-2023-001"]}],"id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This article investigates predictive associations between diabetes and depressive symptoms across Ireland, the United Kingdom, and four European regions. The data were obtained by merging datasets from three large prospective cohort studies\u2014the English Longitudinal Study on Ageing, The Irish Longitudinal study on Ageing, and the Survey on Health, Ageing and Retirement in Europe. We first applied a survival analysis design to two samples of 43\u2009061 and 35\u2009993 participants, investigating elevated depressive symptoms as a risk factor for diabetes, and diabetes as a risk factor for elevated depressive symptoms, respectively. We next applied a multilevel modeling approach to examine depressive symptoms before, during, and after diabetes onset across 101\u2009799 participants. We found a bidirectional association between diabetes and depressive symptoms; however, the strength of these associations did not significantly differ between the regions (P &amp;gt; .01). The results also showed that individuals with newly diagnosed diabetes consistently reported higher depressive symptoms than those without diabetes, even before diagnosis. However, we observed no country-specific differences in the gradual changes in depressive symptoms regardless of participants\u2019 diabetes status. Diabetes at baseline was associated with higher risk of developing depression; and vice versa. These associations were not moderated by geographical location. Therefore, the risks of diabetes and depressive symptoms comorbidity seem to be equal across all observed geographic regions.<\/jats:p>","DOI":"10.1093\/eurpub\/ckaf132","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T11:33:38Z","timestamp":1753184018000},"page":"1264-1270","source":"Crossref","is-referenced-by-count":2,"title":["Prospective associations between diabetes and depressive symptoms across European regions: a secondary analysis of ELSA, TILDA, and SHARE datasets"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6076-1632","authenticated-orcid":false,"given":"Jaroslav","family":"Gottfried","sequence":"first","affiliation":[{"name":"School of Psychology, University College Dublin , Dublin,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-0591","authenticated-orcid":false,"given":"Katarzyna","family":"Gajewska","sequence":"additional","affiliation":[{"name":"Diabetes Ireland , Dublin,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5034-1282","authenticated-orcid":false,"given":"Belinda","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"National Centre for Pharmacoeconomics , Dublin,","place":["Ireland"]},{"name":"Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, Trinity College Dublin , Dublin,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9336-8124","authenticated-orcid":false,"given":"Rose Anne","family":"Kenny","sequence":"additional","affiliation":[{"name":"The Irish Longitudinal Study on Ageing, Trinity College Dublin , Dublin,","place":["Ireland"]},{"name":"Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin , Dublin,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8863-3069","authenticated-orcid":false,"given":"Cathy","family":"Lloyd","sequence":"additional","affiliation":[{"name":"Faculty of Wellbeing, Education & Language Studies, The Open University , Milton Keynes,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0609-4082","authenticated-orcid":false,"given":"Arie","family":"Nouwen","sequence":"additional","affiliation":[{"name":"Department of Psychology, Middlesex University , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3778-705X","authenticated-orcid":false,"given":"Shane","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"School of Business, University College Dublin , Dublin,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8438-4184","authenticated-orcid":false,"given":"Ricardo","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"SOCIUS\/CSG, ISEG (Lisbon School of Economics & Management), University of Lisbon , Lisbon,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7777-6323","authenticated-orcid":false,"given":"Norbert","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Population-Based Medicine, University of T\u00fcbingen , T\u00fcbingen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9258-0895","authenticated-orcid":false,"given":"Sonya","family":"Desch\u00eanes","sequence":"additional","affiliation":[{"name":"School of Psychology, University College Dublin , Dublin,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"2025121614271899000_ckaf132-B1","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1017\/S1092852913000667","article-title":"Metabolic syndrome and major depression","volume":"19","author":"Marazziti","year":"2014","journal-title":"CNS Spectr"},{"key":"2025121614271899000_ckaf132-B2","doi-asserted-by":"crossref","first-page":"e15061","DOI":"10.1111\/dme.15061","article-title":"Prediabetes and the risk of type 2 diabetes: investigating the roles of depressive and anxiety symptoms in the lifelines cohort study","volume":"40","author":"Desch\u00eanes","year":"2023","journal-title":"Diabet Med"},{"key":"2025121614271899000_ckaf132-B3","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1111\/dme.13611","article-title":"Prevalence and correlates of depressive disorders in people with type 2 diabetes: results from the international prevalence and treatment of diabetes and depression (INTERPRET-DD) study, a collaborative study carried out in 14 regions","volume":"35","author":"Lloyd","year":"2018","journal-title":"Diabet Med"},{"key":"2025121614271899000_ckaf132-B4","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1016\/S0165-0327(12)70004-6","article-title":"Epidemiology of depression and diabetes: a systematic review","volume":"142(Suppl)","author":"Roy","year":"2012","journal-title":"Journal of Affective Disorders"},{"key":"2025121614271899000_ckaf132-B5","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1038\/mp.2016.7","article-title":"Depression and risk of type 2 diabetes: the potential role of metabolic factors","volume":"21","author":"Schmitz","year":"2016","journal-title":"Mol Psychiatry"},{"key":"2025121614271899000_ckaf132-B6","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s00592-019-01295-9","article-title":"The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies","volume":"56","author":"Khaledi","year":"2019","journal-title":"Acta Diabetol"},{"key":"2025121614271899000_ckaf132-B7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pcd.2021.11.001","article-title":"A systematic review and meta-analysis to compare the prevalence of depression between people with and without type 1 and type 2 diabetes","volume":"16","author":"Farooqi","year":"2022","journal-title":"Prim Care Diabetes"},{"key":"2025121614271899000_ckaf132-B8","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1093\/eurpub\/cky050","article-title":"The association between diabetes and depressive symptoms varies by quality of diabetes care across Europe","volume":"28","author":"Graham","year":"2018","journal-title":"Eur J Public Health"},{"key":"2025121614271899000_ckaf132-B9","author":"Cebolla Garrof\u00e9","year":"2014"},{"key":"2025121614271899000_ckaf132-B10","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1093\/ije\/dys168","article-title":"Cohort profile: the English longitudinal study of ageing","volume":"42","author":"Steptoe","year":"2013","journal-title":"Int J Epidemiol"},{"key":"2025121614271899000_ckaf132-B11","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1093\/ije\/dyy163","article-title":"Cohort profile update: the Irish longitudinal study on ageing (TILDA)","volume":"47","author":"Donoghue","year":"2018","journal-title":"Int J Epidemiol"},{"key":"2025121614271899000_ckaf132-B12","first-page":"S265","article-title":"Design and methodology of the Irish Longitudinal Study on Ageing","volume":"61(Suppl 2)","author":"Whelan","year":"2013","journal-title":"J Am Geriatr Soc"},{"key":"2025121614271899000_ckaf132-B13","volume-title":"Survey Participation in the Survey of Health, Ageing and Retirement in Europe (SHARE), Wave 1-7. Based on Release 7.0.0. SHARE Working Paper Series 41-2019","author":"Bergmann","year":"2019"},{"key":"2025121614271899000_ckaf132-B14","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1093\/ije\/dyt088","article-title":"Data resource profile: the survey of health, ageing and retirement in Europe (SHARE)","volume":"42","author":"B\u00f6rsch-Supan","year":"2013","journal-title":"Int J Epidemiol"},{"key":"2025121614271899000_ckaf132-B15","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.5255\/UKDA-SN-5050-27","article-title":"English longitudinal study of ageing","volume":"0\u201310","author":"Banks","year":"2024","journal-title":"Waves"},{"key":"2025121614271899000_ckaf132-B16","author":"TILDA","year":"2024"},{"key":"2025121614271899000_ckaf132-B17","author":"TILDA","year":"2024"},{"key":"2025121614271899000_ckaf132-B18","author":"TILDA","year":"2024"},{"key":"2025121614271899000_ckaf132-B19","author":"TILDA","year":"2024"},{"key":"2025121614271899000_ckaf132-B20","author":"TILDA","year":"2024"},{"key":"2025121614271899000_ckaf132-B21","doi-asserted-by":"publisher","author":"B\u00f6rsch-Supan","year":"2022","DOI":"10.6103\/SHARE.easy.800"},{"key":"2025121614271899000_ckaf132-B22","doi-asserted-by":"publisher","author":"SHARE-ERIC","year":"2024","DOI":"10.6103\/SHARE.w4.900"},{"key":"2025121614271899000_ckaf132-B23","doi-asserted-by":"publisher","author":"SHARE-ERIC","year":"2024","DOI":"10.6103\/SHARE.w5.900"},{"key":"2025121614271899000_ckaf132-B24","doi-asserted-by":"publisher","author":"SHARE-ERIC","year":"2024","DOI":"10.6103\/SHARE.w6.900"},{"key":"2025121614271899000_ckaf132-B25","doi-asserted-by":"publisher","author":"SHARE-ERIC","year":"2024","DOI":"10.6103\/SHARE.w7.900"},{"key":"2025121614271899000_ckaf132-B26","doi-asserted-by":"publisher","author":"SHARE-ERIC","year":"2024","DOI":"10.6103\/SHARE.w8.900"},{"key":"2025121614271899000_ckaf132-B27","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D scale: a Self-Report depression scale for research in the general population","volume":"1","author":"Radloff","year":"1977","journal-title":"Appl Psychol Meas"},{"key":"2025121614271899000_ckaf132-B28","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1192\/bjp.174.4.330","article-title":"Development of the EURO-D scale\u2014a European, union initiative to compare symptoms of depression in 14 european centres","volume":"174","author":"Prince","year":"1999","journal-title":"Br J Psychiatry"},{"key":"2025121614271899000_ckaf132-B29","author":"Publications Office of the European Union","year":"2024"},{"key":"2025121614271899000_ckaf132-B30","author":"World Health Organization","year":"2010"},{"key":"2025121614271899000_ckaf132-B31","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2024"},{"key":"2025121614271899000_ckaf132-B32","doi-asserted-by":"crossref","first-page":"137","DOI":"10.4082\/kjfm.2018.39.3.137","article-title":"The bidirectional relationship between diabetes and depression: a literature review","volume":"39","author":"Alzoubi","year":"2018","journal-title":"Korean J Fam Med"},{"key":"2025121614271899000_ckaf132-B33","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.2337\/dc22-2373","article-title":"Bidirectional mendelian randomization and multiphenotype GWAS show causality and shared pathophysiology between depression and type 2 diabetes","volume":"46","author":"Maina","year":"2023","journal-title":"Diabetes Care"},{"key":"2025121614271899000_ckaf132-B34","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.2337\/dc21-2297","article-title":"Diabetes distress, depressive symptoms, and anxiety symptoms in people with type 2 diabetes: a network analysis approach to understanding comorbidity","volume":"45","author":"McInerney","year":"2022","journal-title":"Diabetes Care"},{"key":"2025121614271899000_ckaf132-B35","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jcjd.2014.11.006","article-title":"Depression and risk for diabetes: a meta-analysis","volume":"39","author":"Yu","year":"2015","journal-title":"Can J Diabetes"},{"key":"2025121614271899000_ckaf132-B36","doi-asserted-by":"crossref","first-page":"e729\u201338","DOI":"10.1016\/S2468-2667(21)00047-5","article-title":"Prevalence and variability of current depressive disorder in 27 european regions: a population-based study","volume":"6","author":"Arias-de la Torre","year":"2021","journal-title":"The Lancet Public Health"},{"key":"2025121614271899000_ckaf132-B37","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1002\/mpr.1489","article-title":"Are different measures of depressive symptoms in old age comparable? An analysis of the CES-D and Euro-D scales in 13 regions","volume":"24","author":"Courtin","year":"2015","journal-title":"Int J Methods Psychiatric Res"},{"key":"2025121614271899000_ckaf132-B38","volume-title":"Generating easySHARE: Guidelines, Structure, Content and Programming. SHARE Working Paper Series 17-2014","author":"Gruber","year":"2014"}],"container-title":["European Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/35\/6\/1264\/64428075\/ckaf132.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/35\/6\/1264\/64428075\/ckaf132.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T19:27:32Z","timestamp":1765913252000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurpub\/article\/35\/6\/1264\/8267964"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,29]]},"references-count":38,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,9,29]]},"published-print":{"date-parts":[[2025,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurpub\/ckaf132","relation":{},"ISSN":["1101-1262","1464-360X"],"issn-type":[{"value":"1101-1262","type":"print"},{"value":"1464-360X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,9,29]]}}}