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What types of insomnia relate to anxiety and depressive symptoms in late life?

ABSTRACT: Background:Symptoms of insomnia are associated with symptoms of depression and anxiety in older adults, yet less is known about the relation of specific forms of insomnia (i.e., onset, maintenance, and terminal insomnia) with these symptoms. This study explored how insomnia types related to symptoms of anxiety and depression in older adults. It was hypothesized that onset and maintenance insomnia would have stronger relations to anxiety and depressive symptoms than terminal insomnia. Methods:One-hundred thirty-three older adults (mean age 69, age range 65-89) were recruited using Amazon's Mechanical Turk. Participants completed the Insomnia Severity Index, Geriatric Depression Scale-Short Form, and Geriatric Anxiety Inventory-Short Form. Results:Regression analyses that controlled for the comorbidity between anxiety and depressive symptoms indicated that onset insomnia was the only independent predictor of anxiety symptoms, and maintenance insomnia was the only independent predictor of depressive symptoms, each of which had medium to large effect sizes. Limitations:Our findings are limited by an online, primarily Caucasian, and non-clinical sample as well as the cross-sectional design of the study. Conclusions:Our findings suggest that despite overlap between symptoms of depression and anxiety, insomnia may have different mechanisms of affecting each disorder. Thus, the type of insomnia is clinically relevant and should be assessed when symptoms of anxiety, depression, and/or sleep difficulties are reported.

SUBMITTER: Bolstad CJ

PROVIDER: S-EPMC7609447 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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What types of insomnia relate to anxiety and depressive symptoms in late life?

Bolstad Courtney J CJ Nadorff Michael R MR

Heliyon 20201102 11

<h4>Background</h4>Symptoms of insomnia are associated with symptoms of depression and anxiety in older adults, yet less is known about the relation of specific forms of insomnia (i.e., onset, maintenance, and terminal insomnia) with these symptoms. This study explored how insomnia types related to symptoms of anxiety and depression in older adults. It was hypothesized that onset and maintenance insomnia would have stronger relations to anxiety and depressive symptoms than terminal insomnia.<h4> ...[more]

PMID: 33163672

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Project description:ImportanceThe neurobiologic basis of late-life depressive symptoms is not well understood.ObjectiveTo test the hypothesis that neurodegeneration and neuronal density in brainstem aminergic nuclei are related to late-life depressive symptoms. DESIGN, SETTING, PARTICIPANTS, AND EXPOSURE: Longitudinal clinicopathological cohort study at residences of participants in the Chicago, Illinois, metropolitan area. Participants included 124 older persons without dementia in the Rush Memory and Aging Project who had annual evaluations for a mean (SD) of 5.7 (2.8) years, died, and underwent a postmortem neuropathological examination that provided estimates of the densities of Lewy bodies, neurofibrillary tangles, and aminergic neurons in the locus ceruleus, dorsal raphe nucleus, substantia nigra, and ventral tegmental area.Main outcomes and measuresThe number of depressive symptoms (mean [SD], 1.61 [1.48]; range, 0-6; skewness, 0.94) on the Center for Epidemiological Studies Depression Scale averaged across annual evaluations.ResultsBrainstem Lewy bodies were associated with depressive symptoms, and the association was attenuated in those taking antidepressant medication. Brainstem tangles were associated with more depressive symptoms in those without cognitive impairment but with fewer symptoms in those with mild cognitive impairment. Lower density of tyrosine hydroxylase-immunoreactive neurons in the ventral tegmental area was robustly associated with a higher level of depressive symptoms (mean [SE] estimate, -0.014 [0.003]; P < .001; 16.3% increase in adjusted R2). The association was not modified by medication use or cognitive impairment. Neither tyrosine hydroxlyase-immunoreactive neurons in the locus ceruleus nor tryptophan hydroxlyase-immunoreactive neurons in the dorsal raphe nucleus were related to depressive symptoms.Conclusions and relevanceThe results suggest that the mesolimbic dopamine system, especially the ventral tegmental area, has an important role in late-life depressive symptoms.

Project description:Background: Depression and anxiety are the most common comorbid psychiatric disorders in the elderly. Psychiatrists have been reporting worsened depression symptoms and prognosis by comorbid anxiety symptoms. However, it is still unclear how anxiety affects the course of depression in the elderly. The aims of this study are (1) to identify the symptom network in late-life depression (LLD), and (2) to examine the role of anxiety in LLD with a network perspective. Methods: The study analyzed 776 community-based participants who were clinically diagnosed with depression and enrolled in Suwon Geriatric Mental Health Center. Network analysis was used to investigate the relationships between the symptoms of the Montgomery-Åsberg Depression Rating Scale (MADRS). The depression sample was divided into groups of low and high anxiety according to the Beck Anxiety Index. Propensity score matching (PSM) was used to minimize the effects of depression severity on the network. Network comparison test (NCT) were carried out to compare the global connectivity, global strength, and specific edge strength between the two subgroups. Results: Reported sadness, pessimistic thinking, and suicidal ideation are the core symptoms of LLD in terms of node strength. The MADRS sum score [mean (SD) 28.10 (9.19) vs 20.08 (7.11); P < .01] was much higher in the high anxiety group. The NCT before PSM showed the high anxiety group had significantly higher global strength (P < .01). However, the NCT after PSM did not reveal any statistical significance both in global structure (P = .46) and global strength (P = .26). A comparison between centrality indices showed a higher node strength of vegetative symptoms in the high anxiety group and this also remained after PSM. Conclusion: Based on the statistical analysis, anxiety worsens the severity of depression in the elderly. However, NCT after PSM revealed comorbid anxiety does not change the global structure and strength of the depression symptom network. Therefore, anxiety may affect LLD in a way of worsening the severity, rather than changing psychopathology. Additionally, the study revealed the centrality of vegetative symptoms was low in LLD but increased substantially in patients with comorbid anxiety.

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What types of insomnia relate to anxiety and depressive symptoms in late life?

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What types of insomnia relate to anxiety and depressive symptoms in late life?

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