Depressive Symptoms, Subjective Cognitive Decline, and Subjective Sleep Quality Are Associated with Slips and Falls: Data from the Community Health Survey in Korean Adults

Gerontology ◽  
2021 ◽  
pp. 1-11
Author(s):  
Ji Hee Kim ◽  
Joon Ho Song ◽  
Jee Hye Wee ◽  
Jung Woo Lee ◽  
Hyo Geun Choi

<b><i>Background:</i></b> Identifying the risk factors for falls among the elderly population is arguably one of the most imperative public health issues in the current aging society. <b><i>Objectives:</i></b> This study aimed to determine the associations between depressive symptoms, subjective cognitive decline (SCD), and poor subjective sleep quality and the risk of slips/falls in a Korean older population. <b><i>Methods:</i></b> This cross-sectional study involved 228,340 elderly individuals living in Korea. Measurements included self-reported depressive symptoms, SCD, and self-reported sleep quality. The risk of slips/falls was dichotomized depending on whether slips/falls had occurred during the past year, and the associations between different risk factors and slips/falls were explored. Multiple logistic regression was used to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). Complex sampling methods were used to estimate the weighted value of each participant. <b><i>Results:</i></b> The risk of slips/falls was significantly associated with high levels of depressive symptoms (adjusted OR 1.06, 95% CI: 1.05–1.07) and SCD (adjusted OR 1.33, 95% CI: 1.19–1.50). Regarding each sleep quality component, the adjusted ORs for slips/falls were 1.85 for very poor sleep quality, 1.49 for long sleep latency, 1.04 for &#x3c;5 h of sleep duration, 1.32 for low sleep efficiency, 2.78 for high sleep disturbance, 1.52 for the use of sleep medication ≥3 times a week, and 1.82 for high daytime dysfunction due to sleep problems compared to the respective good sleep conditions. <b><i>Conclusions:</i></b> Our results demonstrated that depressive symptoms, SCD, and poor subjective sleep quality are independent factors affecting the occurrence of slips/falls. Thus, efforts to manage depressive symptoms and cognitive decline early and to improve sleep quality can be an alternative strategy to decrease the likelihood of falls.

SLEEP ◽  
2021 ◽  
Author(s):  
Lisa M Christian ◽  
Shannon Webber ◽  
Shannon Gillespie ◽  
Anna M Strahm ◽  
Jonathan Schaffir ◽  
...  

Abstract Study Objectives Delivery prior to full term affects 37% of US births, including ~400,000 preterm births (&lt;37 weeks) and &gt;1,000,000 early term births (37-38 weeks). Approximately 70% of cases of shortened gestation are spontaneous - without medically-indicated cause. Elucidation of modifiable behavioral factors would have considerable clinical impact. Methods This study examined the role of depressive symptoms and sleep quality in predicting the odds of spontaneous shortened gestation among 317 women (135 Black, 182 White) who completed psychosocial assessment in mid-pregnancy. Results Adjusting for key covariates, Black women had 1.89 times higher odds of spontaneous shortened gestation compared to White women (OR (95% CI) = 1.89 (1.01, 3.53), p=0.046). Women who reported only poor subjective sleep quality (PSQI &gt; 6) or only elevated depressive symptoms (CES-D ≥ 16) exhibited no statistically significant differences in odds of spontaneous shortened gestation compared to those with neither risk factor. However, women with comorbid poor sleep and depressive symptoms exhibited markedly higher odds of spontaneous shortened gestation than those with neither risk factor [39.2% versus 15.7%, [OR (95% CI) = 2.69 (1.27, 5.70), p = 0.01]. A higher proportion of Black women met criteria for both risk factors (23% of Black women versus 11% of White women; p=0.004), with a lower proportion experiencing neither risk factor (40.7% of Black versus 64.3% of White women; p &lt; 0.001). Conclusions Additive effects of poor subjective sleep quality and depressive symptoms were observed with markedly higher odds of spontaneous shortened gestation among women with both risk factors. Racial inequities in rates of comorbid exposure corresponded with inequities in shortened gestation. Future empirical studies and intervention efforts should consider the interactive effects of these commonly co-morbid exposures.


2018 ◽  
Author(s):  
Charlotte Mary Horne ◽  
Ray Norbury

Increasing evidence suggests that eveningness is associated with increased risk for depression. Eveningness, however, is also associated with poor sleep quality and the unique role of eveningness in depressive symptomatology remains to be elucidated. The goal of the current study, therefore, was to examine the inter-relationships between eveningness, subjective sleep quality and depressive symptoms in healthy participants free of current or previous depression and sleep disorder. Here, 167 healthy participants (mean age 24.16, 129/38 females/males) completed the reduced Morningness-Eveningness Questionnaire (rMEQ), the Pittsburgh Sleep Quality Index (PSQI) and the Centre for Epidemiological Studies Depression Scale (CES-D). Bootstrap mediation analysis for a simple mediation model including rMEQ, PSQI and CES-D was applied. Eveningness was associated with increased depressive symptoms and mediation analysis showed that this relationship was partly mediated by sleep quality. Our results suggest that indicators of depression observed in evening-type individuals cannot be attributed exclusively to disturbed sleep. We suggest that interventions that target both sleep quality and dysfunctionl cognitive styles would be optimal to promote well-being in evening-type individuals.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ciqing Bao ◽  
Ling Xu ◽  
Weina Tang ◽  
Shiyu Sun ◽  
Wenmiao Zhang ◽  
...  

Although many risk factors for suicidal ideation have been identified, few studies have focused on suicidal ideation and pre-natal depression. The purpose was to investigate the relationship between decision-making (DM) dysfunction and sleep disturbance on suicidal ideation in pre-natal depression. Participants included 100 women in the third trimester of pregnancy, including pregnant women with pre-natal depression who had recent suicidal ideation (n = 30), pre-natal depression without SI (n = 35) and healthy controls (n = 35). The Iowa Gambling Task (IGT) was used to evaluate the DM function and the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep index. The Edinburgh Post-natal Depression Scale (EPDS) was used to assess suicidal ideation and the seriousness of depression. Overall, the two groups with pre-natal depression showed worse sleep quality and decreased DM function compared with healthy controls. The pre-natal depression with suicidal ideation group showed a significantly higher score in subjective sleep quality and a lower score in block 5 of IGT than the pre-natal depression without suicidal ideation group. Further correlation analysis showed that suicidal ideation positively correlated with subjective sleep quality, sleep duration, and daytime function, and negatively correlated with IGT scores. Sleep disturbance and impaired DM function may be risk factors for suicidal ideation in pre-natal depression.


2020 ◽  
Author(s):  
Min-Fang Hsu ◽  
Kang-Yun Lee ◽  
Tsung-Ching Lin ◽  
Wen-Te Liu ◽  
Shu-Chuan Ho

Abstract Background: As a complex phenomenon, sleep quality is difficult to objectively define and measure, and multiple factors related to sleep quality, such as age, lifestyle, physical activity, and physical fitness, feature prominently in older adult populations. The aim of the present study was to evaluate subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and to associate sleep quality with health-related physical fitness factors, depressive symptoms, and the number of chronic diseases in the middle-aged and elderly.Methods: We enrolled a total of 283 middle-aged and elderly participants from a rehabilitation clinic or health examination department. The PSQI was used to evaluate sleep quality. The health-related fitness assessment included anthropometric and physical fitness parameters. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Data were analyzed with SPSS 18.0, and descriptive statistics and logistic regression analysis were used for the analyses.Results: Overall, 27.9% of participants in this study demonstrated poor sleep quality (with a PSQI score of >5), 10.2% of study participants frequently used sleep medication to help them fall asleep, and 6.0% reported having significant depressive symptoms (with a CES-D score of ≥10). There are two major findings: (1) depression symptoms, the number of chronic diseases, self-rated health, and arthritis were significantly associated with a poor sleep quality, and (2) the 2-min step test was associated with longer sleep latency. These results confirmed that the 2-min step was associated with a longer sleep latency among the health-related physical fitness items.Conclusions: Our study found that depressive syndrome, chronic disease numbers, a poor self-rated health status, and arthritis were the main risk factors that influenced subjective sleep quality.


2020 ◽  
Author(s):  
Min-Fang Hsu ◽  
Kang-Yun Lee ◽  
Tsung-Ching Lin ◽  
Wen-Te Liu ◽  
Shu-Chuan Ho

Abstract Background: As a complex phenomenon, sleep quality is difficult to objectively define and measure, and multiple factors related to sleep quality, such as age, lifestyle, physical activity, and physical fitness, feature prominently in older adult populations. The aim of the present study was to evaluate subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and to associate sleep quality with health-related physical fitness factors, depressive symptoms, and the number of chronic diseases in the middle-aged and elderly.Methods: We enrolled a total of 283 middle-aged and elderly participants from a rehabilitation clinic or health examination department. The PSQI was used to evaluate sleep quality. The health-related fitness assessment included anthropometric and physical fitness parameters. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Data were analyzed with SPSS 18.0, and descriptive statistics and logistic regression analysis were used for the analyses.Results: Overall, 27.9% of participants in this study demonstrated poor sleep quality (with a PSQI score of >5), 10.2% of study participants frequently used sleep medication to help them fall asleep, and 6.0% reported having significant depressive symptoms (with a CES-D score of ≥10). There are two major findings: (1) depression symptoms, the number of chronic diseases, self-rated health, and arthritis were significantly associated with a poor sleep quality, and (2) the 2-min step test was associated with longer sleep latency. These results confirmed that the 2-min step was associated with a longer sleep latency among the health-related physical fitness items.Conclusions: Our study found that depressive syndrome, chronic disease numbers, a poor self-rated health status, and arthritis were the main risk factors that influenced subjective sleep quality.


2012 ◽  
Vol 24 (11) ◽  
pp. 1827-1835 ◽  
Author(s):  
Chiara Cupidi ◽  
Sabrina Realmuto ◽  
Gianluca Lo Coco ◽  
Antonio Cinturino ◽  
Simona Talamanca ◽  
...  

ABSTRACTBackground: Knowledge about sleep complaints of caregivers of patients with Alzheimer's disease (AD) and Parkinson's disease (PD) is limited, and we lack information about the relationship between caregivers’ sleep problems and their quality of life (QoL).Methods: We evaluated subjective sleep quality and its relationship to QoL in a group of 80 caregivers of patients with AD (ADCG, n = 40) and PD (PDCG, n = 40), and in 150 controls. Information about night-time complaints was collected using the Pittsburgh Sleep Quality Index (PSQI). QoL was measured using the McGill QoL Questionnaire.Results: Eighteen ADCG (45%), 22 PDCG (55%), and 45 (30%) controls reported poor sleep quality. Mean global PSQI score of PDCG (6.25 ± 3.9) was not significantly different from that of ADCG (5.8 ± 3.5; p = 0.67). However, both PDCG and ADCG scored significantly higher than control group (4.3 ± 3.1; p < 0.01). ADCG frequently reported difficulties falling asleep (72.5%) and disturbed sleep (100%). PDCG reported reduced subjective sleep quality (80%) and increased sleep disturbances (100%). Poor sleep quality was associated with depressive symptoms and correlated with QoL in caregivers of both groups, particularly the psychological symptoms domain.Conclusions: Among caregivers of patients with AD and PD, poor sleep quality is frequent and significantly linked to QoL and depressive symptoms. Identifying the nature of sleep disturbances not only in patients but also in their caregivers is important as appropriate treatment may lead to a better management of the needs of families coping with these patients.


Author(s):  
Malgorzata W Kozusznik ◽  
Sara Puig-Perez ◽  
Barbara Kożusznik ◽  
Matias M Pulopulos

Abstract Background Several studies have proposed that coping strategies are a key predictor of sleep problems. Furthermore, some authors have suggested that depressive symptoms, a factor that is related to both coping strategies and sleep, may play a critical role in this relationship. However, this preliminary research has shown mixed results. Purpose The aim of this research was to study the relationship between coping strategies (i.e., emotion-focused and problem-focused coping) and sleep, and investigate whether this relationship is direct or mediated by depressive symptoms. Methods Using a cross-sectional design, we tested this idea in a sample of 723 participants from the Midlife in the United States 2 study (mean age = 54.22 years, age range = 25–74 years, 54.40% females, 95.1% had at least a high school education). We applied mediation analyses with bootstrapped bias-corrected 95% confidence intervals to test total, direct, and indirect effects. Coping and depression were assessed using questionnaires. Objective and subjective sleep quantity and quality were measured using the Pittsburgh Sleep Quality Index, sleep diaries, and actigraphy. Results The results show that low emotion-focused coping and high problem-focused coping are associated with lower depressive symptoms, which, in turn, are associated with better objective and subjective sleep quality. Moreover, greater use of emotion-focused coping is related to more perceived sleep time. Conclusions This study sheds light on the process of the development of sleep problems in people who use different coping strategies. It offers explanations for the association between emotion-focused and problem-focused coping and sleep problems, via depressive symptoms.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A387-A387
Author(s):  
S N Price ◽  
J I Trejo ◽  
L M Halaby ◽  
D Guzman ◽  
Y Liu ◽  
...  

Abstract Introduction Diagnoses of cancer and depression are independent predictors of poor sleep, but less is known about subjective sleep quality among patients with both of these potential risk factors or about recommendations made by physicians for improving sleep among this population. This study examines correlates of poor subjective sleep quality and sleep recommendations received by patients with cancer enrolled in the Collaborative Oncology Project to Enhance Depression Care (COPE-D), a collaborative care intervention to treat depression among patients with cancer. Methods Participants were 74 adult cancer survivors. Demographic and clinical characteristics, subjective sleep quality, and provider sleep recommendations were obtained by patient self-report prior to intervention. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), general health status was measured using the PROMIS Global-10, and depressive symptoms were measured using the PHQ-9. Results 81% of patients reported significantly poor sleep quality (PSQI global scores &gt;8) and 75.3% reported poor sleep efficiency (&lt;85%). The strongest correlates of poor sleep quality were worse global mental (r=-.431, p&lt;.01) and physical health (r=-.40, p=&lt;.01). 63% reported pain interference with sleep at least once per week. Cancer type and stage, current cancer treatment, and depressive symptoms were not significantly associated with poor sleep quality (p’s&gt;.05). 12% of those reporting sleep disturbances since their cancer diagnosis had not discussed these problems with a medical provider. Among those who talked to their provider, 41.8% reported receiving sleep hygiene recommendations, 40.5% anti-depressants, 14.9% sedative-hypnotic medication (e.g. zolpidem, benzodiazepines), 10.8% cognitive behavioral therapy, 9.6% antihistamines, 6.8% melatonin, and 4.1% were recommended meditation or hypnosis. Conclusion Cancer patients seeking treatment for depression report very high rates of poor subjective sleep quality, which was most strongly associated with global mental and physical health. Improved screening and patient-provider communication about sleep may be especially beneficial for this at-risk population. Support Merck Foundation Alliance to Advance Patient-Centered Cancer Care


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyan Wang ◽  
Xiaoling Dai ◽  
Zichuan Yao ◽  
Xianqing Zhu ◽  
Yunzhong Jiang ◽  
...  

Abstract Introduction To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic. Methods This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression. Results Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384–1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805–0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286–0.920). Conclusions This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.


Author(s):  
Yanlin Wang ◽  
Ping Jiang ◽  
Shi Tang ◽  
Lu Lu ◽  
Xuan Bu ◽  
...  

Abstract Anxiety and depressive symptoms may predispose individuals to sleep disturbance. Understanding how these emotional symptoms affect sleep quality, especially the underlying neural basis, could support the development of effective treatment. The aims of the present study were therefore to investigate potential changes in brain morphometry associated with poor sleep quality and whether this structure played a mediating role between the emotional symptoms and sleep quality. One hundred and forty-one healthy adults (69 women, mean age = 26.06 years, SD = 6.36 years) were recruited. A structural magnetic resonance imaging investigation was performed, and self-reported measures of anxiety, depressive symptoms and sleep quality were obtained for each participant. Whole-brain regression analysis revealed that worse sleep quality was associated with thinner cortex in left superior temporal sulcus (STS). Furthermore, the thickness of left STS mediated the association between the emotional symptoms and sleep quality. A subsequent commonality analysis showed that physiological component of the depressive symptoms had the greatest influence on sleep quality. In conclusion, thinner cortex in left STS may represent a neural substrate for the association between anxiety and depressive symptoms and poor sleep quality and may thus serve as a potential target for neuromodulatory treatment of sleep problems.


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