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The Association of Psychological Factors, Physical Activity, Neuropathy, and Quality of Life in Type 2 Diabetes

Yale University School of Nursing, New Haven, CT, deborah.chyun{at}yale.edu

Gail D. Melkus, EdD

Yale University School of Nursing, New Haven, CT

Deborah M. Katten, MS

Hartford Hospital, Hartford, CT

Wendie J. Price, RN

University of Virginia Medical Center, Charlottesville, VA

Janice A. Davey, MSN

Yale University School of Medicine, New Haven, CT

Neil Grey, MD

Diabetes Life Care

Gary Heller, MD

Nuclear Cardiology Laboratory, at Hartford Hospital, Hartford, CT

Frans J. Th. Wackers, MD

Diagnostic Radiology and Internal Medicine, at Yale University School of Medicine, New Haven, CT

The objective of this study was to determine the relationship of sociodemographics; diabetes-related factors, including diabetes-related microvascular complications; cardiac risk factors; and psychological factors with quality of life (QOL). Participants enrolled at three sites in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study were invited to participate in this ancillary study. Questionnaires assessing psychological factors were completed by participants, and the remainder of the data was obtained as part of the DIAD study. Many participants had elevated levels of anxiety (n = 91; 82%), depressive symptoms (n = 16; 14%), anger (n = 38; 34%), and hostility (n = 17; 17%). Results of multivariate analyses conducted for each of the eight domains on the Medical Outcomes Study Short Form-36 and two Diabetes Quality of Life domains demonstrated that in the majority of models (42% to 68% of the variance explained), female sex, peripheral or autonomic neuropathy, physical inactivity, higher body mass index, and the presence of depressive symptoms and anxiety were associated with poorer QOL (p = .0001). These findings demonstrate that anxiety, depressive symptoms, and neuropathy are prevalent in older adults with type 2 diabetes. In addition, potentially important correlations were demonstrated between psychological factors, neuropathy, body mass index, and physical inactivity.

Key Words: type 2 diabetes • quality of life • neuropathy • physical activity • psychological factors

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