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ORIGINAL RESEARCH article
Front. Public Health
Sec. Injury Prevention and Control
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1488923
This article is part of the Research Topic Gender Differences in Falls and Mobility Patterns of Older Adults View all 7 articles
The Impact of Depression and Cardiovascular Disease on Fall Risk in Type 2 Diabetes Mellitus: A Gender and Sleep Status Analysis
Provisionally accepted- 1 Guangxi Medical University, Nanning, China
- 2 People's Hospital of Luchuan, Yulin, China
- 3 School of Medicine, Guangxi University of Science and Technology, Liuzhou, Guangxi Zhuang Region, China
Background: This study aims to examine the combined effects of depressive symptoms (DS) and cardiovascular disease (CVD) on fall risk in patients with type 2 diabetes mellitus (T2DM), as well as evaluating the potential moderating effects of sleep status and gender.Methods: This study analyzed 941 participants from the China Health and Retirement Longitudinal Study (CHARLS). Participants were divided into four groups: those with both depressive symptoms and CVD (DS+/CVD+), those with only depressive symptoms (DS+/CVD-), those with only CVD (DS-/CVD+), and those with neither depressive symptoms nor CVD (DS-/CVD-). Additionally, stratified analyses were conducted to differentiate participants based on sleep statuses and gender.In the absence of potential confounding variables, the phenotypes DS+/CVD+, DS+/CVD-, and DS-/CVD+ were each independently linked to a higher fall risk relative to the reference category DS-/CVD-(RR = 1.96, 95% CI: 1.25-3.07; RR = 1.92, 95% CI: 1.29-2.87; RR = 1.58, 95% CI: 1.03-2.42, respectively). Specifically, within the sleep sufficiency group, the DS+/CVD+, DS+/CVD-, and DS-/CVD+ phenotypes exhibited a significantly elevated risk of falls relative to the DS-/CVD-phenotype (RR = 2.23, 95% CI: 1.22-4.05; RR = 2.02, 95% CI: 1.19-3.43; RR = 1.73, 95% CI: 1.02-2.93, respectively). After adjusting for confounding variables, Males with DS-/CVD+ phenotypes are significantly more likely to fall (RR = 2.04, 95% CI: 1.04-3.98). In contrast, the DS+/CVD+ and DS+/CVD-phenotypes are linked to a heightened risk of falls in females, with odds ratios of 1.79 (95% CI: 1.04-3.09) and 1.82 (95% CI: 1.11-2.98), respectively. Furthermore, there was no evidence of an additive interaction between depression and CVD in relation to fall risk among patients with T2DM (P > 0.05).The co-occurrence of depression and CVD significantly elevates the risk of falls in diabetic patients. It is recommended that female patients prioritize the prevention and management of depression, whereas male patients should focus on the prevention and management of cardiovascular diseases. Additionally, ensuring adequate sleep is essential for all patients.
Keywords: Depression, cardiovascular disease, type 2 diabetes, falls, Additive interaction
Received: 30 Aug 2024; Accepted: 26 Feb 2025.
Copyright: © 2025 Li, Chen, Chen and Liang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Dianyin Liang, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545026, Guangxi Zhuang Region, China
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