Journal Article

Diabetes, anxiety, and mortality risk among middle and older-aged Americans

Gonzales-Lagos, Rafael, Banerjee, Srikanta, Khubchandani, Jagdish

2025

Overview

Type 2 Diabetes (T2D) continues to be a major cause of morbidity and a leading cause of mortality in the United States. Also, anxiety ranks among the topmost common mental health problems in the U.S. While the burden of anxiety among individuals with T2D is well known, the long-term impact of anxiety among adults with T2D has not been well explored. Thus, the purpose of this national study was to ascertain the impact of anxiety on mortality among Americans with T2D. Data from the U.S. National Health and Nutrition Examination Survey (years 2007–2012) were linked with mortality data from the National Death Index up to December 31st, 2019. A total of 14,137 adults (aged 50 years and older) were included in the study sample, with more than a tenth (12.8 %) having T2D and more than a fifth (22.6 %) having anxiety. The unadjusted hazard ratio (HR) for all-cause mortality risk among those with T2D was 2.08 (95 % confidence interval [CI], 1.83–2.35, p < 0.01) compared to those without T2D. In the adjusted analysis, the risk of all-cause mortality was highest among individuals with both anxiety and T2D [AHR = 1.81 (95 % CI 1.37–2.40, p < 0.01)] compared to those with anxiety or T2D alone. Our analysis provides vital information on factors that could be helpful for interventions to reduce mortality risk among those with T2D and anxiety. Also, given the higher risk of mortality with co-occurring T2D and anxiety, collaborative healthcare practices should help with widespread screening for and treatment of anxiety among middle and older-age adults with Type 2 Diabetes. •People with Type 2 Diabetes have frequently co-occurring and higher rates of anxiety.•The role of anxiety in predicting mortality among people with Type 2 diabetes is not well explored.•Using national data from the U.S, we found that more than a tenth had Type 2 Diabetes and more than a fifth had anxiety.•The risk of mortality was significantly higher among people with both Type 2 Diabetes and anxiety (81% higher).

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Aged / Aged, 80 and over / Anxiety / Anxiety - complications / Anxiety - epidemiology / Anxiety - mortality / Anxiety disorders / Cause of Death / Chronic diseases / Comorbidity / Confidence intervals / Diabetes / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - epidemiology / Diabetes Mellitus, Type 2 - mortality / Diabetes Mellitus, Type 2 - psychology / Education / Ethnicity / Female / Humans / Hypertension / Kidney diseases / Male / Medical personnel / Medical prognosis / Mental disorders / Mental health / Metabolism / Middle Aged / Mortality / Nutrition Surveys / Population / Quality of life / Risk Factors / Sociodemographics / United States - epidemiology / Variables