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Shafiee A, Teymouri Athar MM, Seighali N, Amini MJ, Hajishah H, Arabazadeh Bahri R, Akhoundi A, Beiky M, Sarvipour N, Maleki S, Zandifar A, Bakhtiyari M. The prevalence of depression, anxiety, and sleep disturbances among medical students and resident physicians in Iran: A systematic review and meta-analysis. PLoS One 2024; 19:e0307117. [PMID: 39178292 PMCID: PMC11343466 DOI: 10.1371/journal.pone.0307117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 06/29/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND We sought to conduct this comprehensive systematic review and meta-analysis to assess the prevalence of depression, anxiety, and sleep disturbance in Iranian medical students and resident physicians. METHODS A systematic search was conducted on 23 December 2023 in PubMed/MEDLINE, Web of Science, Scopus, and Iranian national databases. We pooled the prevalence of individual studies using the random effect model. RESULTS Our systematic search showed 36 articles that meet the eligibility criteria. Most included studies were cross-sectional. The most used questionnaire to assess depression, anxiety, and sleep disturbance were Beck Depression Inventory (BDI), The Depression, Anxiety and Stress Scale-21 Items (DASS-21), and The Pittsburgh Sleep Quality Index (PSQI), respectively. The overall prevalence of depression, anxiety, and sleep disturbance among Iranian medical students were 43% (95%CI: 33%-53%%, I2 = 98%), 44% (95%CI: 31%-58%%, I2 = 99%), 48% (95%CI: 39%-56%%, I2 = 97%), respectively. The results of subgroup and meta-regression analyses showed questionnaires used and the place of the medical school were significantly associated with the prevalence of aforementioned outcomes. Funnel plot and Begg's regression test did not show a significant source of funnel plot asymmetry for depression, anxiety, and sleep disturbance. CONCLUSION In conclusion, our study showed that nearly half of the medical students had some type of depression, anxiety, and sleep disturbance problems. To address this serious national public health issue, efficient preventive measures, routine screenings, and prompt interventions are required.
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Affiliation(s)
- Arman Shafiee
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Niloofar Seighali
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Javad Amini
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamed Hajishah
- Student Research Committee, School of Medicine, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | - Amirhossein Akhoundi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Maryam Beiky
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Nastaran Sarvipour
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Saba Maleki
- School of Medicine, Guilan University of Medical Sciences (GUMS), Rasht, Guilan Province, Iran
| | - Atefeh Zandifar
- Department of Psychiatry, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahmood Bakhtiyari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Sakai T, Jadczak AD, Khalid A, Piovezan RD, Leemaqz S, Visvanathan R. The prevalence of, and factors associated with, a risk of depression in residential aged care services residents: Findings from the FIRST study. Australas J Ageing 2024. [PMID: 39073245 DOI: 10.1111/ajag.13358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 06/01/2024] [Accepted: 06/18/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES Depression is common amongst Australian residential aged care services (RACS) residents. This study aimed to estimate the risk of depression amongst residents and identify factors associated with this risk. In care settings such as RACS, time-efficient screening tools to identify depression risk may be a preferred tool. METHODS The two-item Patient Health Questionnaire (PHQ-2), derived from the nine-item PHQ-9 used commonly in the United States (US), was employed in this study. A resident was identified as being at risk of depression where the score was ≥3. Multivariable logistic regression analysis was used to identify independent factors associated with being at risk of depression. RESULTS Residents' mean age was 87.7 (standard deviation: 7.3) years and 73% were female. One-fifth of residents (n = 108 or 20%) were at risk of depression. Age (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93-0.99); Pain Assessment in Advanced Dementia (PAINAD) score (OR 1.55, 95% CI 1.11-2.16); Epworth Sleepiness Scale (ESS) score (OR 1.08, 95% CI 1.03-1.13); and 38-item Frailty Index (FI) score (OR 1.07, 95% CI 1.03-1.10) were significantly associated with being at risk of depression, whilst sex, urinary incontinence, polypharmacy, Dementia Severity Rating Scale (DSRS) and Nursing Home Life Space Diameter (NHLSD) score were not. CONCLUSIONS One in five residents were at risk of depression. Younger age, higher pain, higher daytime sleepiness and higher frailty status were associated with depressive risk. Future studies focusing on interventions targeting these factors may contribute to improved health outcomes.
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Affiliation(s)
- Tomomichi Sakai
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Agathe Daria Jadczak
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Ashna Khalid
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Ronaldo D Piovezan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Shalem Leemaqz
- South Australian Health and Medical Research Institute (SAHMRI) Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
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Wang Q, Huang X, Liu M, Wang C, Sun Z, Huang C, Tang S. Prevalence and risk factors of depression among elderly people in nursing homes from 2012 to 2022: a systematic review and meta-analysis. Aging Ment Health 2024:1-12. [PMID: 38952191 DOI: 10.1080/13607863.2024.2367044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 02/20/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES To determine a pooled prevalence of depression and its influencing factors among nursing home residents. METHOD PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors. RESULTS This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65). CONCLUSION The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.
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Affiliation(s)
- Qing Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoting Huang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Chunyu Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Zaiqing Sun
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Chongmei Huang
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
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Zhang W, Zhou B, Jiang C, Jin Y, Zhu T, Zhu F, Cheng KK, Lam TH, Xu L. Associations of daytime napping and nighttime sleep quality with depressive symptoms in older Chinese: the Guangzhou biobank cohort study. BMC Geriatr 2023; 23:875. [PMID: 38114908 PMCID: PMC10731710 DOI: 10.1186/s12877-023-04579-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/07/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Poor sleep quality has been linked to depression in older adults, but results of the association between daytime napping and depression remains limited and conflicting. Moreover, whether the association of daytime napping with depression varies by nighttime sleep quality is unclear. Hence, we examined the associations of daytime napping and nighttime sleep quality with depressive symptoms in older Chinese. METHODS A total of 16,786 participants aged ≥50 from the Guangzhou Biobank Cohort Study second-round examination (2008-2012) were included in this cross-sectional study. Geriatric Depression Scale (GDS-15), Pittsburgh Sleep Quality Index (PSQI), napping and demographic data were collected by face-to-face interview using a computerized questionnaire. Logistic regression was used to calculate odds ratio (OR) of depressive symptoms for napping and sleep quality. RESULTS The prevalence of depressive symptoms (GDS score > 5) and poor global sleep quality (PSQI score ≥ 6) was 5.3 and 31.9%, respectively. Compared to non-nappers, nappers showed significantly higher odds of depressive symptoms, with OR (95% confidence interval (CI)) being 1.28 (1.11-1.49). The odds of depressive symptoms for daytime napping varied by nighttime sleep quality (P for interaction = 0.04). In good-quality sleepers, compared to non-nappers, nappers had significantly higher odds of depressive symptoms, with OR (95% CI) being 1.57 (1.23-2.01), whereas no association was found in poor-quality sleepers (OR = 1.13, 0.94-1.36). CONCLUSION Napping was associated with higher odds of depressive symptoms in older people, and the association was stronger in good-quality sleepers.
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Affiliation(s)
- Weisen Zhang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Baijing Zhou
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chaoqiang Jiang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Yali Jin
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Tong Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Feng Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, Guangdong, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Bhar S, Davison TE, Schofield P, Quinn S, Ratcliffe J, Waloszek JM, Dunkerley S, Silver M, Linossier J, Koder D, Collins R, Milte R. Study protocol for ELders AT Ease (ELATE): a cluster randomised controlled trial of cognitive behaviour therapy to reduce depressive symptoms in aged care residents. BMC Geriatr 2023; 23:555. [PMID: 37700236 PMCID: PMC10498637 DOI: 10.1186/s12877-023-04257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND This protocol describes a study of the effectiveness of cognitive behaviour therapy (CBT) for reducing depressive symptoms in older adults living in residential aged care (RAC) facilities in Australia. Depressive symptoms are highly prevalent in this population, yet the benefits of CBT for reducing such symptoms in RAC facilities have not been widely investigated. Elders at Ease (ELATE) is a 16-session CBT intervention designed for implementation in RAC facilities. The intervention includes cognitive, behavioural and reminiscence strategies and is delivered by mental health trainees (MHTs) in collaboration with RAC facility staff and residents' family. METHODS AND ANALYSIS ELATE will be evaluated using a cluster randomised trial comparing outcomes for residents who participate in the intervention with those living in usual care control facilities. The participants are RAC residents aged 65 years or above, with depressive symptoms (Patient Health Questionnaire-2 ≥ 3) and normal cognition or mild cognitive impairment (Standardised Mini Mental Status Examination ≥ 21). They are assessed at four time points: baseline prior to randomisation (T1), mid-treatment (T2; 2.5 months post randomisation), post-treatment (T3; 5 months post-randomisation) and 3-month follow-up (T4; 8 months post randomisation). The primary outcome is change in depressive symptoms between T1 and T3. Secondary outcomes are depressive symptoms at T4, anxiety, suicide ideation, sleep problems, quality of life, staff and family knowledge of late-life depression, stress levels and efficacy in caring for residents, and MHT levels of geropsychology competencies. Residents receiving the intervention are hypothesised to report a greater decrease in depressive symptoms between T1 and T3 compared to residents receiving usual care. The primary analysis is a regression, clustered over site to account for correlated readings, and independent variables are condition and depressive symptoms at T1. A cost-utility analysis is also undertaken. DISCUSSION ELATE is a comprehensive CBT intervention for reducing depressive symptoms in RAC residents. It is designed to be implemented in collaboration with facility staff and residents' families, individually tailored to residents with normal cognition to mild cognitive impairment and delivered by trainee therapists. ELATE offers a model that may be widely applicable across the RAC sector. TRIAL REGISTRATION Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number ACTRN12619001037190, prospectively registered on 22 July 2019.
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Affiliation(s)
- Sunil Bhar
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia.
| | - Tanya E Davison
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
- Silverchain, Osborne Park, WA, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC, Australia
- Health Services Research and Implementation Sciences, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Stephen Quinn
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Joanna M Waloszek
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Sofie Dunkerley
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Mark Silver
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Jennifer Linossier
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Deborah Koder
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Rebecca Collins
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Rachel Milte
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
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Haldar P, Prasad K, Kant S, Dwivedi SN, Vibha D, Pandit AK, Srivastava AK, Kumar A, Ikram MA, Henning T. Metabolic risk factors and psychosocial problems independently explain poor sleep quality and obstructive sleep apnea symptoms among adults in urban India. Sleep Breath 2023; 27:1541-1555. [PMID: 36280653 DOI: 10.1007/s11325-022-02725-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
STUDY OBJECTIVES To determine if metabolic risk factors are associated with poor sleep quality and obstructive sleep apnea-like symptoms (OSA symptoms) independent of psychosocial problems and demographic and lifestyle factors in older Indian adults. METHODOLOGY We analyzed baseline data from adults (≥ 50 years) from a population-based cohort, the LoCARPoN study, in India. Variables were grouped as (a) demographic and lifestyle factors such as smoking, alcohol use, and physical activity; (b) psychosocial problems including symptoms of depression, anxiety, and perceived stress; and (c) metabolic risk factors including glycated hemoglobin, high-density lipoprotein, low-density lipoprotein, total cholesterol, body mass index, and hypertension. Variables were examined as predictors of poor sleep quality and OSA symptoms. Groups of variables were added stepwise to a logistic regression. Variance explained by nested models was quantified using McFadden's pseudo R2, and change was formally tested with the log-likelihood ratio test. RESULTS Among 7505 adults, the prevalence of poor sleep quality was 16.9% (95% CI: 16.0, 17.7), and OSA symptoms were present in 7.0% (95% CI: 6.4, 7.6). Psychosocial problems had a strong independent association with both poor sleep quality (pseudo R2 increased from 0.10 to 0.15, p < 0.001) and more OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). Metabolic risk factors had a modest independent association with sleep quality (pseudo R2 increased from 0.14 to 0.15, p < 0.01), but a strong association with OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). CONCLUSION Psychosocial and metabolic risk factors were independently associated with sleep quality and OSA symptoms. This fact implied that OSA symptoms may affect both mental health and physical health. Our findings have public health implications because the number and proportion of the elderly in India is increasing, while the prevalence of metabolic risk factors and psychosocial problems is high already. These facts have the potential to exacerbate not only the burden of sleep disorders and OSA symptoms but also associated cardiovascular and neurologic sequelae, further stretching the Indian health-care system.
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Affiliation(s)
- Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India.
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Kumar
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tiemeier Henning
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ganidagli S, Ozturk E, Ozturk ZA. Risk factors of poor sleep quality in older adults: an analysis based on comprehensive geriatric assessment. Curr Med Res Opin 2023; 39:701-706. [PMID: 36927301 DOI: 10.1080/03007995.2023.2192124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVES Sleep quality is associated with many diseases and conditions that affect individuals' health in various ways. We aimed to investigate the association between sleep quality and common geriatric conditions in older adults. METHODS The study included 237 older adults admitted to the geriatric outpatient clinic of a university hospital. All patients underwent comprehensive geriatric assessment (CGA). The Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life (EQ-5D), Pittsburgh Sleep Quality Index (PSQI), Katz Index of Independence in Activities of Daily Living (ADL) and Lawton and Brody Instrumental Activities of Daily Living (IADL) questionnaires, Tinetti Balance and Gait Assessment (TBGA), and Mini Nutritional Assessment (MNA) were performed on the participants. RESULTS Participants had a mean age of 72.2 ± 6.3 years, and 146 (61.6%) of them had poor sleep quality. Of the participants, 61.2% were female. In the poor sleep quality group, GDS and BAI scores were higher while ADL, IADL, MNA, and EQ-5D index scores were lower. PSQI score had a negative correlation with ADL (r = -.207, p = .01), EQ-5D index (r = -.372, p = .00), MNA (r = -.277, p = .00), and TBGA (r = -.263, p = .41) scores and a positive correlation with GDS (r = .426, p = .00) and BAI (r = .450, p = .00) scores according to the results of correlation analysis. Multivariate logistic regression analysis showed that the presence of diabetes mellitus (DM) and higher GDS and BAI scores were independent variables for poor sleep quality [(p = .48, OR = 1.92; p = .20, OR = 1.11; and p <.01, OR = 1.11, respectively)]. CONCLUSIONS We found that DM and depressive and anxiety symptoms were the risks of poor sleep quality. In addition, participants with poor sleep quality had a worse quality-of-life and nutritional status. Improving sleep quality may be helpful in the management of geriatric syndromes and that sleep quality assessment should be part of CGA.
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Affiliation(s)
- Sencer Ganidagli
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
| | - Ercument Ozturk
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
| | - Zeynel Abidin Ozturk
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
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Liu S, Hu Z, Guo Y, Zhou F, Li S, Xu H. Association of sleep quality and nap duration with cognitive frailty among older adults living in nursing homes. Front Public Health 2022; 10:963105. [PMID: 36091504 PMCID: PMC9453392 DOI: 10.3389/fpubh.2022.963105] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/01/2022] [Indexed: 01/24/2023] Open
Abstract
Background Sleep status, including sleep quality and nap duration, may be associated with frailty and cognitive impairment in older adults. Older adults living in nursing homes may be more prone to physical and cognitive frailties. This study aimed to investigate the association between sleep quality and nap duration, and cognitive frailty among older adults living in nursing homes. Methods This study included 1,206 older adults aged ≥ 60 years from nursing homes in Hunan province, China. A simple frailty questionnaire (FRAIL scale) was used and Mini-Mental State Examination was conducted to assess physical frailty and cognitive impairment, respectively, to confirm cognitive frailty. The Pittsburgh Sleep Quality Index was used to assess the sleep quality. Nap duration was classified as follows: no, short (≤30 min), and long (>30 min) napping. Multinomial logistic regression was conducted to estimate the odds ratio (OR) and 95% confidence interval (CI). Results The prevalence of cognitive frailty among the older adults in nursing homes was 17.5%. Approximately 60.9% of the older adults had a poor sleep quality. Among the 1,206 participants, 43.9% did not take naps, 29.1% had short naps, and 26.9% had long naps. After adjusting for all covariates, poor sleep quality (OR 2.53; 95% CI 1.78-3.59; P < 0.001) and long nap duration (OR 1.77; 95% CI 1.19-2.64; P = 0.003) were associated with higher odds of cognitive frailty, but short nap duration (OR 0.60; 95% CI 0.40-0.89; P = 0.012) was associated with low prevalence of cognitive frailty. Conclusion Poor sleep quality and long nap duration are significantly associated with high risk of cognitive frailty among the older adults in nursing homes. Short nap duration was associated with low prevalence of cognitive frailty. However, these associations require further validation in older adults. Clinical trial registration https://osf.io/57hv8.
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Needs and Needs Communication of Nursing Home Residents with Depressive Symptoms: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063678. [PMID: 35329364 PMCID: PMC8949340 DOI: 10.3390/ijerph19063678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 12/03/2022]
Abstract
Nursing home residents are affected by depressive symptoms more often than elders living at home. There is a correlation between unmet needs and depression in nursing home residents, while met needs positively correlate with greater satisfaction and well-being. The study aims to examine the needs of nursing home residents with depressive symptoms and the communication of those needs, as no previous study has explicitly addressed the needs of this group of people and the way they are communicated. We conducted semi-structured interviews with 11 residents of three nursing homes and analyzed them using content-structuring content analysis. The residents reported diverse needs, assigned to 12 categories. In addition, barriers such as health impairments prevented the fulfillment of needs. As to the communication of needs, various interlocutors, facilitators, and barriers were identified. The findings reveal that residents can express their needs and are more likely to do so if the interlocutors are patient and take them seriously. However, lack of confidants, missing or non-functioning communication tools, impatience and perceived lack of understanding on the part of caregivers, and residents’ insecurities limit communication of needs.
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Huang M, Bliwise DL, Hall MH, Johnson DA, Sloan RP, Shah A, Goldberg J, Ko YA, Murrah N, Levantsevych OM, Shallenberger L, Abdulbagki R, Bremner JD, Vaccarino V. Association of Depressive Symptoms with Sleep Disturbance: A Co-twin Control Study. Ann Behav Med 2021; 56:245-256. [PMID: 33991086 PMCID: PMC8887572 DOI: 10.1093/abm/kaab040] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Few studies have comprehensively evaluated the association of depression with sleep disturbance using a controlled twin study design. PURPOSE To cross-sectionally evaluate the association of depression with both objective and subjective sleep disturbance. METHODS We studied 246 members of the Vietnam Era Twin Registry. We measured depressive symptoms using the Beck Depression Inventory-II (BDI) and assessed major depression using structured clinical interviews. Twins underwent one-night polysomnography and 7-day actigraphy to derive measures of objective sleep and completed the Pittsburgh Sleep Quality Index for subjective sleep. Multivariable mixed-effects models were used to examine the association. RESULTS Twins were all male, mostly white (97%), with a mean (SD) age of 68 (2). The mean (SD) BDI was 5.9 (6.3), and 49 (20%) met the criteria for major depression. For polysomnography, each 5-unit higher BDI, within-pair, was significantly associated with 19.7 min longer rapid eye movement (REM) sleep latency, and 1.1% shorter REM sleep after multivariable adjustment. BDI was not associated with sleep architecture or sleep-disordered breathing. For actigraphy, a higher BDI, within-pair, was significantly associated with lower sleep efficiency, more fragmentation and higher variability in sleep duration. BDI was associated with almost all dimensions of self-reported sleep disturbance. Results did not differ by zygosity, and remained consistent using major depression instead of BDI and were independent of the presence of comorbid posttraumatic stress disorder and antidepressant use. CONCLUSIONS Depression is associated with REM sleep disruption in lab and sleep fragmentation and sleep variability at home, but not with sleep architecture or sleep-disordered breathing.
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Affiliation(s)
- Minxuan Huang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Donald L Bliwise
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Martica H Hall
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Richard P Sloan
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Amit Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine (Cardiology), School of Medicine, Emory University, Atlanta, GA, USA.,Atlanta Veteran Affairs Medical Center, Decatur, GA, USA
| | - Jack Goldberg
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.,Vietnam Era Twin Registry, Seattle Epidemiologic Research and Information Center, US Department of Veterans Affairs, Seattle, WA, USA
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nancy Murrah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Oleksiy M Levantsevych
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rami Abdulbagki
- Department of Pathology, Georgia Washington University Hospital, Washington, DC, USA
| | - J Douglas Bremner
- Atlanta Veteran Affairs Medical Center, Decatur, GA, USA.,Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine (Cardiology), School of Medicine, Emory University, Atlanta, GA, USA
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11
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Dasdemir Ilkhan G, Celikhisar H. The effect of incontinence on sleep quality in the elderly. Int J Clin Pract 2021; 75:e13965. [PMID: 33368941 DOI: 10.1111/ijcp.13965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE This study was conducted to determine the frequency of incontinence in elderly people living in nursing homes and the effect of incontinence on the quality of life and sleep quality. MATERIAL AND METHOD This study was carried out with a total of 1150 individuals aged 65 and over, living in four nursing homes. Pittsburg Sleep Quality Index (PSQI), International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and Incontinence Quality of Life Scale (IQOL) were used as data collection tools. The data were collected after obtaining ethics committee and institutional approvals and written consents of the elderly participants. RESULTS The mean age of 1150 elderly individuals included in the study was 75.49 ± 8.62 years. The mean PSQI score of the elderly was 8.33 ± 4.16 and 83.5% of them had poor sleep quality. It was determined that 87.0% of the elderly woke up at night and the most common reason for waking up was the need to use the toilet (60.0%). It was found that the mean ICIQ-SF score of the individuals was 10.65 ± 4.40 and 80.9% of them had bothersome urinary incontinence. The average IQOL score of individuals with incontinence was 63.39 ± 11.26. CONCLUSION It was determined that almost all of the elderly people included in the present study had sleep problems and 20.0% had incontinence. It was found that sleep quality is not affected by incontinence in the elderly, but the quality of life decreases because of incontinence.
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Affiliation(s)
- Gulay Dasdemir Ilkhan
- Chest Diseases Department, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Hakan Celikhisar
- Department of Chest Diseases, Izmir Metropolitan Municipality Esrefpasa Hospita, Izmir, Turkey
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12
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Hu Z, Zhu X, Kaminga AC, Zhu T, Nie Y, Xu H. Association between poor sleep quality and depression symptoms among the elderly in nursing homes in Hunan province, China: a cross-sectional study. BMJ Open 2020; 10:e036401. [PMID: 32665347 PMCID: PMC7359068 DOI: 10.1136/bmjopen-2019-036401] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To examine the association between the prevalence of poor sleep quality and depression symptoms among the elderly in the nursing homes of Hunan province in China. DESIGN, SETTING AND PARTICIPANTS This was a cross-sectional study investigating 817 elderly people from 24 nursing homes in China's Hunan province. MAIN OUTCOME MEASURES Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) such that poor sleep quality was defined as PSQI Score >5. In addition, depression symptoms were assessed using the Geriatric Depression Scale (GDS). Linear regression models and binary logistic regression models were used to analyse the relationship between the prevalence of poor sleep quality and depression symptoms. RESULTS The mean PSQI Score was 8.5±4.9, and the prevalence of poor sleep quality was 67.3%. Additionally, the mean GDS Score was 9.8±7.5, and the prevalence of depression symptoms was 36.0%. Elderly people with poor sleep quality had increased GDS Score (mean difference=2.54, 95% CI 1.66 to 3.42) and increased risk of depression symptoms (OR=3.19, 95% CI 2.04 to 4.98) after controlling for demographics, chronic disease history, lifestyle behaviours, social support, activities of daily living and negative life events. CONCLUSIONS The prevalence of poor sleep quality was relatively high, and this was associated with increased depression symptoms. Therefore, poor sleep quality could be speculated as a marker of current depression symptoms in the elderly.
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Affiliation(s)
- Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health,Central South University, Changsha, Hunan, China
| | - Xidi Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health,Central South University, Changsha, Hunan, China
| | - Atipatsa Chiwanda Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
| | - Tingting Zhu
- Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China
| | - Yu Nie
- Educational Administration Office, The Second Xiangya Hospital, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health,Central South University, Changsha, Hunan, China
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13
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Košćec Bjelajac A, Holzinger B, Despot Lučanin J, Delale EA, Lučanin D. Sleep Quality and Daytime Functioning in Older European Adults. EUROPEAN PSYCHOLOGIST 2020. [DOI: 10.1027/1016-9040/a000406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Abstract. The aim of this article was to review research studies related to the issues of sleep in older adults, examining the relationship between sleep quality and a set of psychological variables of daytime functioning in healthy older adults: quality of life, subjective health, functional ability, cognitive function, and emotional state, in Europe. Combined scoping review search strategies resulted in a total of 84 articles selected for review. We conclude there is a considerable amount of European research on sleep quality and its correlates in older adults’ population. Studying these relationships may be the basis for the targeted planning of psychological interventions aiming at raising the quality of life in older adults. The selected domains of older adults’ everyday functioning were all well represented in the retrieved research studies.
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Affiliation(s)
- Adrijana Košćec Bjelajac
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | | | | | | | - Damir Lučanin
- Department of Health Psychology, University of Applied Health Sciences, Zagreb, Croatia
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14
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Zhu X, Hu Z, Nie Y, Zhu T, Chiwanda Kaminga A, Yu Y, Xu H. The prevalence of poor sleep quality and associated risk factors among Chinese elderly adults in nursing homes: A cross-sectional study. PLoS One 2020; 15:e0232834. [PMID: 32413064 PMCID: PMC7228093 DOI: 10.1371/journal.pone.0232834] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 04/22/2020] [Indexed: 11/25/2022] Open
Abstract
Background Sleep problems have become the most common complaints among the elderly. There are a few studies that explored the prevalence of poor sleep quality and its associated factors among the elderly in nursing homes. Therefore, this study aimed to examine the prevalence of poor sleep quality and its associated factors among the Chinese elderly in nursing homes. Methods A total of 817 elderly residents, from 24 nursing homes, were included in this cross-sectional study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep quality was defined as PSQI >5. Multiple binary logistic regression was used to estimate the strength of the association between risk factors and poor sleep quality in terms of adjusted odds ratios (AORs) and their 95% confidence intervals (CIs), and interactions of risk factors for poor sleep quality were also examined. Results The prevalence of poor sleep quality was 67.3% (95% CI: 64.0, 70.5%) among the Chinese elderly in nursing homes. Multiple binary logistic regression results showed that participants with the following characteristics had an increased risk of poor sleep quality after adjustments for other confounders: being 70–79 years old (AOR: 1.78, 95% CI: 1.08, 2.92) or 80 years old and above (AOR: 2.67, 95% CI: 1.68, 4.24); having one to two kinds of chronic diseases (AOR: 2.05, 95% CI: 1.39, 3.01) or three or more kinds of chronic diseases (AOR: 2.35, 95% CI: 1.39, 4.00); depression symptoms (AOR: 1.08, 95% CI: 1.04, 1.11), anxiety symptoms (AOR: 1.11, 95% CI: 1.05, 1.18), and social support(AOR: 0.97, 95% CI: 0.95, 0.99). Additive interactions were detected between age and anxiety symptoms (AOR: 8.34, 95% CI: 4.43, 15.69); between chronic disease and anxiety symptoms (AOR: 8.61, 95% CI; 4.28, 17.31); and between social support and anxiety symptoms (AOR: 6.43, 95% CI: 3.22, 12.86). Conclusions The prevalence of poor sleep quality among the elderly in nursing homes is relatively high. Besides, anxiety symptoms has additive interactions with age, chronic disease and social support for poor sleep quality. These findings have significant implications for interventions that aim to improve sleep quality among elderly residents in nursing homes.
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Affiliation(s)
- Xidi Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yu Nie
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Tingting Zhu
- Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China
| | - Atipatsa Chiwanda Kaminga
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yunhan Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- * E-mail:
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15
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Yilmaz N, Karaca SN. Dissatisfaction with life and absence of leisure time activity: clues to overt depression and occult suicide risk in elderly individuals without significant disabling disease. Psychogeriatrics 2020; 20:337-344. [PMID: 31930627 DOI: 10.1111/psyg.12504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/12/2019] [Accepted: 12/10/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Depression is a major public health problem in all ages. Besides other chronic physical diseases, it is one of the most common psychiatric disorders observed in the elderly. In this study, it was aimed to determine the prevalence of depressive symptoms and related factors and to draw attention to occult suicide probability in elderly people without significant disabling disease. METHODS Individuals aged 65 and over, who were randomly selected from a family healthcare centre, were enrolled into the study. Geriatric Depression Scale (GDS) was used to assess prevalence of depression and Suicide Probability Scale (SPS) for risk of suicide. RESULTS There were 323 elderly (F/M: 150/173). Mean age was 73.3 ± 6.1 years. The majority had chronic physical illnesses (77.7%). Mean GDS and SPS scores were 11.07 ± 4.6 and 62.91 ± 8.24, respectively. Prevalence of depression was 27.6%. In multivariable logistic regression analysis, living without a spouse (P = 0.047, Exp(B) = 1.744, 95% CI = 1.008-3.01), dissatisfaction with life (P ˂ 0.001, Exp(B) = 5.327, 95% CI = 3.02-9.36) and having no leisure time activity (P = 0.047, Exp(B) = 1.846, 95% CI = 1.009-3.37) were found to be the independent predictors of presence of depression, as indicated by GDS. In logistic regression analysis, dissatisfaction with life (P ˂ 0.001, Exp(B) = 2.631, 95% CI = 1.53-4.50) was found to be an independent predictor of high SPS scores. CONCLUSION In elderly individuals without overt disabling disease, dissatisfaction with life, absence of leisure time activities, and a life without a partner seem to significantly increase the likelihood of overt depression. On the other hand, there is occult increase in suicide risk in the presence of dissatisfaction with their lives in the elderly.
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Affiliation(s)
- Nuryil Yilmaz
- Department of Psychiatry, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Sanem Nemmezi Karaca
- Department of Family Medicine, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
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16
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Nogueira BOCL, Li L, Meng LR, Ungvari GS, Forester BP, Chiu HFK, Kuok KCF, Tran L, Liu ZM, Xiang YT. Prevalence of Sleep Disturbances and Their Associations With Demographic and Clinical Characteristics and Quality of Life in Older Adults in Macao. Perspect Psychiatr Care 2018; 54:46-53. [PMID: 27966223 DOI: 10.1111/ppc.12199] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/01/2016] [Accepted: 10/26/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To examine the prevalence of sleep disturbances (difficulty initiating sleep [DIS], difficulty maintaining sleep [DMS], and early morning awakening [EMA]), their socio-demographic and clinical correlates, and quality of life (QOL) in older adults in Macao. DESIGN AND METHODS Four hundred fifty-one subjects were interviewed using standardized instruments. FINDINGS The prevalence of at least one type of sleep disturbance was 38.1%; the figures of DIS, DMS, and EMA were 18.6, 31.3, and 23.9%, respectively. Female sex and depressive symptoms were independently associated with more frequent sleep disturbances. Sleep disturbances were independently associated with lower physical QOL. PRACTICE IMPLICATIONS Sleep disturbances are common in older adults in Macao. Appropriate strategies should be implemented to prevent and treat sleep disturbances and concerted attempts should be made to improve access to treatment.
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Affiliation(s)
- Bernice O C Lam Nogueira
- Associate Professor, School of Health Sciences, Macao Polytechnic Institute.,Macao Sino-Portuguese Nurses Association, Macao SAR, China
| | - Lu Li
- PhD Student, Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Li-Rong Meng
- Professor, School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China
| | - Gabor S Ungvari
- Professor, University of Notre Dame Australia/Marian Centre.,School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Brent P Forester
- Assistant Professor, Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA.,Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Helen F K Chiu
- Professor, Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kenny C F Kuok
- Lecturer, School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China
| | - Linda Tran
- Vice-President, Macao Sino-Portuguese Nurses Association, Macao SAR, China
| | - Zhao-Min Liu
- Professor, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
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17
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Liu Y, Li T, Guo L, Zhang R, Feng X, Liu K. The mediating role of sleep quality on the relationship between perceived stress and depression among the elderly in urban communities: a cross-sectional study. Public Health 2017; 149:21-27. [PMID: 28528223 DOI: 10.1016/j.puhe.2017.04.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 03/22/2017] [Accepted: 04/07/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aims to investigate the relationship between perceived stress, sleep quality, and depression among the elderly in urban communities, and further to determine whether sleep quality can serve as a mediator among the elderly in urban communities. STUDY DESIGN A cross-sectional survey. METHODS Between May and July in 2015, we conducted a cross-sectional survey among 1050 community residents aged ≥60 years from Liaoning province, China. The Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Epidemiological Studies Depression Scale were used to estimate perceived stress, sleep quality, and depression, respectively. The data were analyzed with correlation, multiple linear regression, and structural equation modeling. RESULTS Of the 1050 participants surveyed, 1032 completed responses were ultimately acquired (98.3% effective response rate) and were included in the data analysis. Results revealed that the scores of perceived stress and sleep quality were positively correlated with Epidemiological Studies Depression Scale score. Sense of uncontrol, sense of nervous, sleep duration, and daytime dysfunction were identified as significant predictors of depression among the elderly. The effect of perceived stress on depression was partly mediated by sleep quality. CONCLUSIONS Our study reveals that not all dimensions of sleep quality are relevant factors affecting depression in the elderly, and there may be partial mediation effects of sleep quality, mainly through sleep duration and daytime dysfunction, within the impact of perceived stress on depression. This signifies that coping with perceived stress can be expected to ameliorate the severity of depression in the elderly by the intermediary role of sleep quality as well as the direct effect. However, longitudinal research is needed to confirm these findings and to investigate other mediators between perceived stress and depression among the elderly.
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Affiliation(s)
- Y Liu
- College of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, PR China
| | - T Li
- College of Nursing, Daqing School of Harbin Medical University, Daqing, Harbin, PR China
| | - L Guo
- Geriatric Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - R Zhang
- College of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, PR China
| | - X Feng
- College of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, PR China
| | - K Liu
- Department of Community Health Nursing, Jinzhou Medical University, Jinzhou, Liaoning 121001, PR China.
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18
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Bao YP, Han Y, Ma J, Wang RJ, Shi L, Wang TY, He J, Yue JL, Shi J, Tang XD, Lu L. Cooccurrence and bidirectional prediction of sleep disturbances and depression in older adults: Meta-analysis and systematic review. Neurosci Biobehav Rev 2017; 75:257-273. [PMID: 28179129 DOI: 10.1016/j.neubiorev.2017.01.032] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 01/08/2017] [Accepted: 01/23/2017] [Indexed: 02/05/2023]
Abstract
The present study pooled the prevalence of sleep disturbances and depression in community-dwelling older adults (mean age≥60years) and quantified the strength of evidence of the relationship between these two problems. From 23 cross-sectional studies and five sets of baseline data, a high pooled prevalence of sleep disturbances (30.5%), depressive symptoms (18.1%) and coexisting disorders (10.6%) were found. In the 23 cohort studies, self-reported sleep disturbances increased the risk of the onset of depression (relative risk [RR]=1.92). Persistent sleep disturbances increased the risk of the development (RR=3.90), recurrence (RR=7.70), and worsening (RR=1.46) of depression in older adults. Little support was found for a predictive role for objective sleep characteristics in the development of depression. Older adults with depression had a higher risk of developing (RR=1.72) and worsening (RR=1.73) symptoms of sleep disturbances. This review emphasizes the importance of timely interventions in incipient sleep disturbances and depression among older adults, preventing the development of more serious comorbidities.
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Affiliation(s)
- Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China.
| | - Ying Han
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Jun Ma
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Ru-Jia Wang
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Le Shi
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Tong-Yu Wang
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Jia He
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Jing-Li Yue
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Xiang-Dong Tang
- Sleep Medicine Center, West China Hospital, Sichuan University, Sichuan 610041, China
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China; Peking-Tsinghua Center for Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China.
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Becker NB, Jesus SN, João KADR, Viseu JN, Martins RIS. Depression and sleep quality in older adults: a meta-analysis. PSYCHOL HEALTH MED 2016; 22:889-895. [DOI: 10.1080/13548506.2016.1274042] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Nathália B. Becker
- Department of Psychology, Research Centre for Spatial and Organizational Dynamics, University of Algarve, Campus de Gambelas, Building 9, Faro, Portugal
| | - Saul N. Jesus
- Department of Psychology, Research Centre for Spatial and Organizational Dynamics, University of Algarve, Campus de Gambelas, Building 9, Faro, Portugal
| | - Karine A. D. R. João
- Department of Psychology, Research Centre for Spatial and Organizational Dynamics, University of Algarve, Campus de Gambelas, Building 9, Faro, Portugal
| | - João N. Viseu
- Department of Psychology, Research Centre for Spatial and Organizational Dynamics, University of Algarve, Campus de Gambelas, Building 9, Faro, Portugal
| | - Rute I. S. Martins
- Clinical and Health Psychology, Research Centre for Spatial and Organizational Dynamics, University of Algarve, Campus de Gambelas, Building 9, Faro, Portugal
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21
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Relationships Among Daytime Napping and Fatigue, Sleep Quality, and Quality of Life in Cancer Patients. Cancer Nurs 2016; 39:383-92. [DOI: 10.1097/ncc.0000000000000299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Are nappers unhealthy? Menopause 2016; 23:938-41. [DOI: 10.1097/gme.0000000000000717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Arslantas D, Ünsal A, Ozbabalık D. Prevalence of depression and associated risk factors among the elderly in Middle Anatolia, Turkey. Geriatr Gerontol Int 2013; 14:100-8. [DOI: 10.1111/ggi.12065] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Didem Arslantas
- Department of Public Health; Eskisehir Osmangazi University Medical Faculty; Meselik-Eskisehir Turkey
| | - Alaettin Ünsal
- Department of Public Health; Eskisehir Osmangazi University Medical Faculty; Meselik-Eskisehir Turkey
| | - Demet Ozbabalık
- Department of Neurology; Eskisehir Osmangazi University Medical Faculty; Meselik-Eskisehir Turkey
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Diamanti C, Manali E, Ginieri-Coccossis M, Vougas K, Cholidou K, Markozannes E, Bakakos P, Liappas I, Alchanatis M. Depression, physical activity, energy consumption, and quality of life in OSA patients before and after CPAP treatment. Sleep Breath 2013; 17:1159-68. [PMID: 23386373 DOI: 10.1007/s11325-013-0815-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 12/17/2012] [Accepted: 01/23/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND A variety of studies have demonstrated improvement in quality of life and depressive symptoms in obstructive sleep apnea (OSA) patients after continuous positive airway pressure (CPAP) treatment. However, very little is known about the effect of OSA treatment on physical activity and energy consumption. OBJECTIVES The aim of this study was to evaluate the changes in depression, physical activity, energy expenditure, and quality of life (QoL) in OSA patients before and after CPAP therapy. METHODS Forty-one patients with OSA as revealed by polysomnography, were included to the study. They responded to the generic World Health Organization Quality of Life (WHOQoL) questionnaire, to the specific-disease Quebec Sleep Questionnaire, and to Center for Epidemiologic Studies Depression Scale (CES-D) in order to evaluate QoL and the incidence of depression. In addition, all patients wore an accelerometer which measured physical activity and energy expenditure during a week. At least 6 months after initiation of CPAP treatment (mean time, 9 months) we re-examined 24 patients who met the compliance with the treatment criteria. RESULTS Patients after CPAP therapy had significantly higher scores in all domains of the Quebec Sleep Questionnaire and in the domains of physical health/level of independence and psychological health/spirituality of the WHOQoL. Depression scores were also better in CES-D after treatment. However, despite the improvement in QoL and psychological status, CPAP therapy had no impact on physical activity and energy expenditure. CONCLUSIONS CPAP therapy improves QoL and lessens depressive symptoms in our group of well-treated OSA patients. However, physical activity and energy expenditure did not present statistically significant improvement in the same group of OSA patients.
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Affiliation(s)
- C Diamanti
- 1st Department of Respiratory Medicine, Medical School, "Sotiria" Hospital for Chest Diseases, National and Kapodistrian University of Athens, 152, Mesogion Av, 115 27, Athens, Greece,
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