Dataset Information

Persistent sleep disturbance: a risk factor for recurrent depression in community-dwelling older adults.

ABSTRACT:

Study objectives

The objective of this study was to examine the associations between the temporal and severity characteristics of sleep disturbance and subsequent depression in community-dwelling older adults.

Design

A prospective cohort study with assessment of sleep disturbance and depression at baseline and across 2 years of follow-up.

Setting

Three urban communities in the United States.

Participants

Community-dwelling older adults in whom prior depression (n = 145), current depression (n = 68), or never mentally ill (n = 206) were diagnosed at the baseline assessment.

Measurements and results

Major depression at year 2, defined by the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. Among patients with either a depression history or current depression at baseline, persistent sleep disturbance throughout year 1 was associated with persistent or recurrent depression at year 2, after adjustment for group status, antidepressant and hypnotic sedative use, severity of depressive symptoms, chronic medical burden, and sociodemographic variables (adjusted odds ratio = 5.20, 95% confidence interval [CI] = 1.16 to 23.29). Among those who were not depressed at year 1, persistent sleep disturbance throughout year 1 predicted depression recurrence during year 2 (adjusted hazards ratio = 16.05, CI = 1.21 to 213.06), independent of the severity of sleep disturbance. None of the older adults who were never mentally ill developed a depression.

Conclusions

Persistent sleep disturbance during a year-long period is associated with depression the following year. Among older adults with prior depression, identification of those with persistent sleep disturbance may optimize the efficacy of sleep related interventions to improve depression remission and/or prevent late-life depression.

SUBMITTER: Lee E

PROVIDER: S-EPMC3792386 | biostudies-literature | 2013 Nov

REPOSITORIES: biostudies-literature

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Publications

Persistent sleep disturbance: a risk factor for recurrent depression in community-dwelling older adults.

Lee Eun E Cho Hyong Jin HJ Olmstead Richard R Levin Myron J MJ Oxman Michael N MN Irwin Michael R MR

Sleep 20131101 11

<h4>Study objectives</h4>The objective of this study was to examine the associations between the temporal and severity characteristics of sleep disturbance and subsequent depression in community-dwelling older adults.<h4>Design</h4>A prospective cohort study with assessment of sleep disturbance and depression at baseline and across 2 years of follow-up.<h4>Setting</h4>Three urban communities in the United States.<h4>Participants</h4>Community-dwelling older adults in whom prior depression (n = 1 ...[more]

PMID: 24179302

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Project description:ObjectivesThis review aims to: (1) explore the social support measures in studies examining the association between social support and depression among community-dwelling older adults in Asia and (2) the evidence of association.DesignA systematic review was conducted using electronic databases of CINAHL, PubMed, PsychINFO, Psychology and Behavioural Sciences Collection, SocINDEX and Web of Science for articles published until the 11th of January 2018.Eligibility criteriaAll observational studies investigating the association between social support and depression among community-dwelling older adults in Asia were included.ParticipantsOlder adults aged 60 years and more who are living in the community.Exposure measuresSocial support.Outcome measuresDepression.ResultsWe retrieved16 356 records and screened 66 full-text articles. Twenty-four observational studies were included in the review. They consisted of five cohort studies and 19 cross-sectional studies. Social support was found to be measured by multiple components, most commonly through a combination of structural and functional constructs. Perceived social support is more commonly measured compared with received social support. Good overall social support, having a spouse or partner, living with family, having a large social network, having more contact with family and friends, having emotional and instrumental support, good support from family and satisfaction with social support are associated with less depressive symptoms among community-dwelling older adults in Asia.ConclusionsThere were 20 different social support measures and we applied a framework to allow for better comparability. Our findings emphasised the association between good social support and decrease depression among older adults. Compared with western populations, family support has a greater influence on depression among community-dwelling older adults in Asia. This indicates that the family institution needs to be incorporated into designed programmes and interventions when addressing depression in the Asian context. TRIAL : registration number : CRD42017074897.

Project description:ImportanceDepressive symptoms are prevalent among older adults and may be early manifestations of Alzheimer disease (AD) before onset of mild cognitive impairment. However, it remains unclear whether worsening depressive symptoms in the presence of AD pathology are associated with cognitive decline in older adults.ObjectiveTo determine the longitudinal association between depressive symptoms, cognition, and cortical amyloid in community-dwelling older adults.Design, setting, and participantsParticipants from the Harvard Aging Brain Study, a cohort study, underwent annual assessments of depression and cognition and baseline cortical amyloid measurement (mean, 4.42 years; range, 2-7 years). Data collection was from September 2010 to August 2017 in a convenience sample of community-dwelling adults (276 participants, all cognitively unimpaired) with at most mild depression at entry.Main outcomes and measuresDepression (Geriatric Depression Scale [GDS]), cognition (Preclinical Alzheimer Cognitive Composite [PACC]), and a continuous measure of cortical amyloid (Pittsburgh Compound-B positron emission tomography imaging). Change in GDS and baseline amyloid were examined as interactive predictors of PACC decline in a linear mixed model with backward elimination, adjusting for age, sex, and education.ResultsParticipants were 164 women and 112 men (mean [SD] age, 73.5 [6.0] years). At baseline, the mean (SD) GDS score was 3.0 (2.8) (range, 0-12), the mean (SD) PACC score was -0.004 (0.67) (range, -2.32 to 1.88), and the mean (SD) amyloid positron emission tomography distribution volume ratio was 1.16 (0.20) (range, 0.92-1.94). At last follow-up, the mean (SD) GDS score was 3.9 (2.9) (range, 0-12), and the mean (SD) PACC score was -0.09 (1.27) (range, -5.66 to 1.67). The interaction between cortical amyloid and increasing GDS was associated with declining cognition (β = -0.19; 95% CI, -0.27 to -0.12; P < .001).Conclusions and relevanceIn this study, cortical amyloid moderated the association between worsening depressive symptoms and declining cognition in older adults. While future work is needed to better understand causal associations, these findings may enhance early detection and prevention of AD clinical symptoms.

Dataset Information

Persistent sleep disturbance: a risk factor for recurrent depression in community-dwelling older adults.

Study objectives

Design

Setting

Participants

Measurements and results

Conclusions

Publications

Persistent sleep disturbance: a risk factor for recurrent depression in community-dwelling older adults.

Similar Datasets

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