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Mo W, Liu X, Yamakawa M, Koujiya E, Takeya Y, Shigenobu K, Adachi H, Ikeda M. Prevalence of sleep disturbances in people with mild cognitive impairment: A systematic review and meta-analysis. Psychiatry Res 2024; 339:116067. [PMID: 38964141 DOI: 10.1016/j.psychres.2024.116067] [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: 11/18/2023] [Revised: 05/28/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024]
Abstract
This review was performed to determine sleep disturbance prevalence in individuals with mild cognitive impairment (MCI). The MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science databases were systematically searched from inception to January 20, 2024. Fifty-two studies fulfilling the eligibility criteria were included. However, six of these studies were excluded from data synthesis due to poor methodological quality. The subjective sleep disturbance prevalence among all individuals with MCI was 35.8 % (95 % CI: 31.9-39.7) across 44 studies, and the objective sleep disturbance prevalence was 46.3 % (95 % CI: 36.3-56.3) across 6 studies. Five studies examined TST and WASO, while three assessed SE. Among all potential objective assessments of sleep disturbance prevalence, only TST, WASO, and SE could be meta-analyzed in MCI because of the limited number of studies available. The estimated sleep disturbance prevalence differed significantly according to measurement method, geographical region, and research design. However, the data source did not significantly influence prevalence estimates. In meta-regression analysis, publication year, participant age, percentage of females, and study quality did not predict prevalence. As subjective and objective sleep disturbances are common in people with MCI, effective intervention strategies should be developed to alleviate them.
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Affiliation(s)
- Wenping Mo
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Xiaoji Liu
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Miyae Yamakawa
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; The Japan Centre for Evidence-Based Practice: A JBI Centre of Excellence, Osaka, Japan.
| | - Eriko Koujiya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yasushi Takeya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Kazue Shigenobu
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Osaka, Japan; Asakayama General Hospital, Osaka, Japan
| | - Hiroyoshi Adachi
- Health and Counseling Center, Osaka University, Osaka, Japan; Department of Psychiatry, Graduate School of Medicine, Osaka University
| | - Manabu Ikeda
- Department of Psychiatry, Graduate School of Medicine, Osaka University
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Hou Z, Chen Y, Sun Y, Song C, Deng H, Cheng N, Han X, Zhang J, Wang Q, Li Y, Yin J, Meng Q. Sleep Duration and Insomnia with Comorbid Depression and Anxiety Symptoms in Chinese Adults: A Cross-Sectional Study. Nat Sci Sleep 2023; 15:1079-1091. [PMID: 38146513 PMCID: PMC10749553 DOI: 10.2147/nss.s440584] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose Depression and anxiety are two highly prevalent mental disorders that commonly coexist. However, little is known about the association between sleep and comorbid depressive and anxiety symptoms (CDAS). Therefore, this study aims to explore the relationship between sleep duration, insomnia and CDAS. Methods This is a cross-sectional study of 22,004 community adults who participated in the China Multi-Ethnic Cohort (CMEC) study. Chinese version of Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2 were used to screen CDAS in community adults. A positive score on each scale was considered indicative of CDAS. All participants received face-to-face interviews, medical examinations, and biochemical examinations to assess sleep duration and insomnia and collect covariates. The self-reported sleep duration was divided into three groups: <7 hr, 7-9 hr and >9 hr groups. Logistic regression was used to analyze the association between sleep duration, insomnia and CDAS. A restricted cubic spline (RCS) was used to explore the dose-response relationship between sleep duration and CDAS. Stratified analysis based on gender and age was conducted. Results Overall, 2.8% (95% CI 2.6%~3.0%) of participants reported having CDAS. After adjusting the potential covariates, sleep duration <7 hr (OR=1.635, 95% CI=1.335~2.004) was significantly associated with CDAS, compared with sleep 7-9 hr. After RCS analysis, there was a nonlinear relationship between sleep duration and CDAS. The increase in the number of types of insomnia, the greater the likelihood of CDAS (p for trend<0.05). In sensitivity analysis, it was found that the results were consistent with those of the main analysis. After stratification by gender and age, the association between sleep duration and CDAS was only observed in female and young and middle-aged adults, not in men and older adults. Conclusion Both insufficient sleep duration and insomnia are associated with a higher prevalence of CDAS in Chinese adults.
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Affiliation(s)
- Zhongxin Hou
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Yang Chen
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
- Institute for Acute Communicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People’s Republic of China
| | - Yunrui Sun
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Chongwei Song
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Haoyuan Deng
- Medical Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Nan Cheng
- Department of Hospital Infection, Wuhan Mental Health Center, Wuhan, Hubei, People’s Republic of China
| | - Xiaoyu Han
- Institute for Acute Communicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People’s Republic of China
| | - Jianghui Zhang
- AIDS Care Center, Yunnan Provincial Hospital of Infectious Disease, Anning, Yunnan, People’s Republic of China
| | - Qian Wang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Yi Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Jianzhong Yin
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
- Baoshan College of Traditional Chinese Medicine, Baoshan, Yunnan, People’s Republic of China
| | - Qiong Meng
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
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Chai L. Financial Strain and Psychological Distress Among Middle-Aged and Older Adults: A Moderated Mediation Model. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:1120-1132. [PMID: 37139587 DOI: 10.1080/01634372.2023.2207611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/05/2023]
Abstract
This study investigates the association between financial strain and psychological distress among middle-aged and older adults, exploring how this association is mediated by sleep problems and moderated by marital status. A subsample of 12,095 adults aged 50 and older was selected from the 2018 National Health Interview Survey. Results showed that financial strain was associated with higher psychological distress, and sleep problems partially mediated this association. Marital status moderated the association between sleep problems and psychological distress, and between financial strain and psychological distress, but not between financial strain and sleep problems. These findings partially support the stress-buffering role of marriage. The study offers valuable insights into the complex relationship between financial strain, sleep problems, marital status, and psychological distress among middle-aged and older adults in the United States, highlighting the need for interventions targeting financial stressors and sleep problems, especially for unmarried individuals, to improve mental health outcomes in this population.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
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Mo W, Liu X, Yamakawa M. Prevalence of sleep disturbances in people with mild cognitive impairment: a systematic review protocol. JBI Evid Synth 2023; 21:2211-2217. [PMID: 37338281 DOI: 10.11124/jbies-22-00438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
OBJECTIVE This review will determine the prevalence of sleep disturbances in individuals with mild cognitive impairment. INTRODUCTION Mild cognitive impairment is regarded as a transitional state between normal functioning and dementia, and has a high likelihood of conversion to dementia. Individuals with mild cognitive impairment may suffer more severe sleep disturbances compared with normal older people. In some studies, sleep disturbances were associated with significantly higher odds of mild cognitive impairment. There is a need for prevalence estimates of sleep disturbances in people with mild cognitive impairment based on the currently available literature to guide clinical health care professionals and public health policies. INCLUSION CRITERIA The review will consider studies reporting on the prevalence of sleep disturbances in individuals with mild cognitive impairment, using validated instruments, including subjective and/or objective measures. Studies will be excluded if the participants report sleep-related breathing or movement disorders. Studies using only the Mini-Mental State Examination to diagnose mild cognitive impairment will also be excluded. METHODS The review will follow the JBI methodology for systematic reviews of prevalence and incidence. The MEDLINE (Ovid), Embase, Cochrane Library (CDSR and CENTRAL), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Scopus, and Web of Science Core Collection databases will be systematically searched from inception to the present with no language limitations. Analytical observational studies, including prospective and retrospective cohort, case-control, and cross-sectional studies, will be considered. Two reviewers will independently conduct the study selection, critical appraisal, and data extraction. Methodological quality will be evaluated using the JBI critical appraisal checklist for studies reporting prevalence data. A meta-analysis will be conducted to synthesize the prevalence data, where possible. REVIEW REGISTRATION PROSPERO CRD42022366108.
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Affiliation(s)
- Wenping Mo
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
| | - Xiaoji Liu
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
| | - Miyae Yamakawa
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
- The Japan Centre for Evidence-Based Practice: A JBI Centre of Excellence, Osaka, Japan
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Gao C, Wang L, Tian X, Song GM. Sleep quality and the associated factors among in-hospital nursing assistants in general hospital: A cross-sectional study. Heliyon 2022; 8:e09393. [PMID: 35600445 PMCID: PMC9118489 DOI: 10.1016/j.heliyon.2022.e09393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/04/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
Background Sleep quality and the associated factors in professional nurses have been extensively investigated. However, as an important part of the workforce in hospitals, sleep quality and influencing factors among in-hospital nursing assistants is rarely investigated. Aim This study aimed to assess the sleep quality and the associated factors of in-hospital nursing assistants in general hospital. Methods A cross-sectional survey study was conducted in a tertiary general hospital. Data were collected from 187 in-hospital nursing assistants using convenience sampling from June to July 2018. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate participants’ sleep quality. A multiple linear regression was performed to identify associated factors with sleep quality. Results This study revealed a mean PSQI score of 5.96 ± 3.64 among all participants, of which 62.3% (114/187) participants suffered from impaired sleep quality. In-hospital nursing assistants with significant medical condition, low monthly income, irregular diet and high family burden reported more worse sleep quality. Conclusion The study showed that poor sleep quality is a highly prevalent issue among Chinese in-hospital nursing assistants in general hospital. Measures to enhance nursing assistants’ wellbeing status (health and burden) and improve their salary (monthly income) are recommended.
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Affiliation(s)
- Chang Gao
- Department of Nursing, Tianjin Hospital, Tianjin 300211, China
| | - Li Wang
- Ward I at Department of Upper Extremity Trauma, Tianjin Hospital, Tianjin 300211, China
| | - Xu Tian
- Nursing Department, Universitat Rovira I Virgili, Tarragona 43002, Spain
- Corresponding author.
| | - Guo-Min Song
- Department of Nursing, Tianjin Hospital, Tianjin 300211, China
- Corresponding author.
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Chiao C, Lin WH, Chen YH, Yi CC. Loneliness in older parents: marital transitions, family and social connections, and separate bedrooms for sleep. BMC Geriatr 2021; 21:590. [PMID: 34686133 PMCID: PMC8532569 DOI: 10.1186/s12877-021-02550-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This research innovatively analyzed the marital transitions (i.e., divorce and widowhood) of older Taiwanese parents, their sleep problems and spousal specific characteristics (i.e., separate bedrooms for sleep and marital relationships) as well as their social and family connections, all of which were simultaneously reflected in emotional and social domains of loneliness. METHODS Data are from 1645 older parents from Northern Taiwan. Loneliness was assessed by a De Jong-Gierveld short scale with emotional and social domains. We conducted multivariate logistic regression to examine the associations of marital transitions and family/social connections regarding sleep problems and psychological well-being with loneliness in social and emotional domains. Besides sleep problems and individual socioeconomic status, we included data on couples' sleeping arrangements and marital relationships. RESULTS Social loneliness was significantly associated with being divorced (AOR = 1.80, 95% CI 1.13-2.86) and living alone (AOR = 1.50, 95% CI 1.02-2.23). In contrast, strong family cohesion and frequent weekly contact with friends were associated with lower social loneliness. Married parents who slept in separate bedrooms were more likely than bed-sharing couples to feel emotional and social loneliness, despite adjusting for their sleep problems. Furthermore, satisfactory spousal relationships significantly decreased the magnitude of associations in the social domain. DISCUSSION Our findings support significant associations between loneliness in later life and major marital transitions, family and social connections and sleep problems which differ in social and emotional domains. Independent of relationship satisfaction, separate bedrooms relate to higher risks of emotional loneliness in older adults.
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Affiliation(s)
- Chi Chiao
- Institute of Health and Welfare Policy, College of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei City, 112 Taiwan, Republic of China
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei City, 112 Taiwan, Republic of China
| | - Wen-Hsu Lin
- Institute of Health and Welfare Policy, College of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei City, 112 Taiwan, Republic of China
| | - Yu-Hua Chen
- Department of Bio-Industry Communication and Development, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei City, 10617 Taiwan, Republic of China
| | - Chin-Chun Yi
- Institute of Sociology, Academia Sinica, No. 128, Sec. 2, Academia Road, Nankang, Taipei City, 11529 Taiwan, Republic of China
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Noguchi T, Saito M, Aida J, Cable N, Tsuji T, Koyama S, Ikeda T, Osaka K, Kondo K. Association between social isolation and depression onset among older adults: a cross-national longitudinal study in England and Japan. BMJ Open 2021; 11:e045834. [PMID: 33737442 PMCID: PMC7978252 DOI: 10.1136/bmjopen-2020-045834] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Social isolation is a risk factor for depression in older age. However, little is known regarding whether its impact varies depending on country-specific cultural contexts regarding social relationships. The present study examined the association of social isolation with depression onset among older adults in England, which has taken advanced measures against social isolation, and Japan, a super-aged society with a rapidly increasing number of socially isolated people. DESIGN Prospective longitudinal study. SETTING We used data from two ongoing studies: the English Longitudinal Study of Ageing (ELSA) and the Japan Gerontological Evaluation Study (JAGES). PARTICIPANTS Older adults aged ≥65 years without depression at baseline were followed up regarding depression onset for 2 years (2010/2011-2012/2013) for the ELSA and 2.5 years (2010/2011-2013) for the JAGES. PRIMARY OUTCOME MEASURE Depression was assessed with eight items from the Centre for Epidemiologic Studies Depression Scale for the ELSA and Geriatric Depression Scale for the JAGES. Multivariable logistic regression analysis was performed to evaluate social isolation using multiple parameters (marital status; interaction with children, relatives and friends; and social participation). RESULTS The data of 3331 respondents from the ELSA and 33 127 from the JAGES were analysed. Multivariable logistic regression analysis demonstrated that social isolation was significantly associated with depression onset in both countries. In the ELSA, poor interaction with children was marginally associated with depression onset, while in the JAGES, poor interaction with children and no social participation significantly affected depression onset. CONCLUSIONS Despite variations in cultural background, social isolation was associated with depression onset in both England and Japan. Addressing social isolation to safeguard older adults' mental health must be globally prioritised.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Japan
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University, Sendai, Japan
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Takaaki Ikeda
- Department of Health Policy Science, Yamagata University Faculty of Medicine Graduate School of Medical Science, Yamagata, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry School of Dentistry, Sendai, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry School of Dentistry, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Cai Y, Wang J, Hou L. Resilience Improves the Sleep Quality in Disabled Elders: The Role of Perceived Stress. Front Psychol 2021; 12:585816. [PMID: 33643125 PMCID: PMC7904684 DOI: 10.3389/fpsyg.2021.585816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/12/2021] [Indexed: 12/12/2022] Open
Abstract
The current research aims to prove the impact of resilience on sleep quality and to investigate the mediating function of perceived stress in the paths from resilience to sleep quality among disabled Chinese elders. The participants were 196 elders with visual and physical disability who resided in the nursing houses in Shanghai, including 102 males and 94 females whose mean age was 74.5 years old (standard deviation = 6.81). All the elders were measured with the 10-item Connor-Davidson Resilience Scale, Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale. The results showed that all the demographic variables were significantly related to perceived stress and PSQI scores. High levels of resilience could significantly enhance the quality of sleep in disabled Chinese elders. In addition, the two-step mediation models also confirmed the impact of resilience on sleep quality as mediated through perceived stress in this special aged population. Better knowledge on the mechanisms of sleep quality among older adults could benefit the prevention and treatment of some geriatric diseases.
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Affiliation(s)
- Yumei Cai
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Junlei Wang
- Law School, East China University of Science and Technology, Shanghai, China
| | - Liwen Hou
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
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Ward M, Turner N, Briggs R, O'Halloran AM, Kenny RA. Resilience does not mediate the association between adverse childhood experiences and later life depression. Findings from the Irish Longitudinal Study on Ageing (TILDA). J Affect Disord 2020; 277:901-907. [PMID: 33065832 DOI: 10.1016/j.jad.2020.08.089] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/19/2020] [Accepted: 08/31/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Resilience has been found to moderate the association between childhood trauma and later depression. We examined whether resilience mediates the association between Adverse Childhood Experiences (ACEs) and later life depression among older adults. METHODS Data were from The Irish Longitudinal Study on Ageing (TILDA), a prospective study of 8,500 community-dwelling adults aged ≥ 50 years. Negative binomial regressions were used to examine the relationships between ACEs, resilience, and depression and path analysis was conducted to test the potential mediating effect of resilience on the association between ACEs and depressive symptoms. RESULTS Mean CES-D8 depression score was 3.3 from a maximum of 24. The average resilience score from a maximum of 15 was 8.9. 26.0% of participants had experienced at least one ACE before the age of 18. A history of ACEs was associated with increased depressive symptomology. The strongest association was between physical abuse and depressive symptoms followed by sexual abuse, parental drug or alcohol use, and childhood poverty. Our path analyses showed that there was no evidence that resilience mediated the association between ACEs and depressive symptoms among this cohort. LIMITATIONS Information on ACEs was collected retrospectively. The resilience measure depended on experience of stressful life events in the last five years and therefore some participants were excluded. CONCLUSIONS ACEs were associated with an increased likelihood of late-life depressive symptoms. Higher resilience was associated with decreased likelihood of late-life depressive symptoms. A history of ACEs is associated with lower resilience. The association between ACEs and late-life depressive symptoms is not mediated by resilience.
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Affiliation(s)
- Mark Ward
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College Dublin, Ireland.
| | - Niall Turner
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College Dublin, Ireland
| | - Robert Briggs
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College Dublin, Ireland; Department of Medical Gerontology, Trinity College Dublin, Ireland
| | - Aisling M O'Halloran
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College Dublin, Ireland; Department of Medical Gerontology, Trinity College Dublin, Ireland
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Zhang YS, Jin Y, Rao WW, Jiang YY, Cui LJ, Li JF, Li L, Ungvari GS, Ng CH, Li KQ, Xiang YT. Prevalence and socio-demographic correlates of poor sleep quality among older adults in Hebei province, China. Sci Rep 2020; 10:12266. [PMID: 32703962 PMCID: PMC7378171 DOI: 10.1038/s41598-020-68997-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 06/23/2020] [Indexed: 01/28/2023] Open
Abstract
Poor sleep quality is associated with negative health outcomes and high treatment burden. This study investigated the prevalence of poor sleep quality and its socio-demographic correlates among older adults in Hebei province, which is a predominantly agricultural region of China. A large-scale cross-sectional epidemiological survey was conducted from April to August 2016. The study used a multistage, stratified, cluster random sampling method. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). A total of 3,911 participants were included. The prevalence of poor sleep quality (defined as PSQI > 7) was 21.0% (95% CI 19.7–22.2%), with 22.3% (95% CI 20.9–23.8%) in rural areas and 15.9% (95% CI 13.4–18.4%) in urban areas. Multivariable logistic regression analyses found that female gender (P < 0.001, OR 2.4, 95% CI 2.00–2.82), rural areas (P = 0.002, OR 1.5, 95% CI 1.14–1.86), presence of major medical conditions (P < 0.001, OR 2.4, 95% CI 2.02–2.96) and family history of psychiatric disorders (P < 0.001, OR 2.7, 95% CI 1.60–4.39) were independently associated with higher risk of poor sleep quality. Poor sleep quality was common among older adults in Hebei province of China. Regular assessment of sleep quality and accessible sleep treatments for older population should be provided in agricultural areas of China.
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Affiliation(s)
- Yun-Shu Zhang
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China
| | - Yu Jin
- Unit of Psychiatry, Centre for Precision Medicine Research and Training, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau SAR, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Centre for Precision Medicine Research and Training, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau SAR, China
| | - Yuan-Yuan Jiang
- Unit of Psychiatry, Centre for Precision Medicine Research and Training, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau SAR, China
| | - Li-Jun Cui
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China
| | - Jian-Feng Li
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China
| | - Lin Li
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia.,University of Notre Dame, Australia, Fremantle, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Ke-Qing Li
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Centre for Precision Medicine Research and Training, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau SAR, China. .,Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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Association between Neighborhood Environment and Quality of Sleep in Older Adult Residents Living in Japan: The JAGES 2010 Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041398. [PMID: 32098114 PMCID: PMC7068387 DOI: 10.3390/ijerph17041398] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/11/2022]
Abstract
Poor sleep is associated with lifestyle, however, few studies have addressed the association between sleep quality and the neighborhood environment. This study aimed to investigate the associations between living environment factors and sleep quality in older people. Participants were community-dwelling people aged ≥65 years who participated in the 2010 Japanese Gerontological Evaluation Study. The data of 16,650 people (8102 men, 8548 women) were analyzed. Sleep quality (good or poor) was evaluated using a self-administered questionnaire. Multilevel Poisson regression analysis stratified by depressive status (measured by the Geriatric Depression Scale-15 [GDS]) was conducted with sleep quality as the dependent variable and social and physical environmental factors as explanatory variables. The 12,469 non-depressive respondents and 4181 depressive respondents were evaluated. The regression analysis indicated that non-depressive participants slept better if they lived in environments with few hills or steps (prevalence ratio [PR] = 0.75, 95% CI: 0.56–0.9) and with places where they felt free to drop in (PR = 0.51, 95% CI: 0.26–0.98). For depressive participants, these associations were not evident. Living alone, poor self-rated health, low income, and unemployment were associated with poor sleep quality. In addition to support with these individual factors, improving environmental factors at the neighborhood level may improve the sleep quality of community-dwelling older adults.
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Lu L, Wang SB, Rao W, Zhang Q, Ungvari GS, Ng CH, Kou C, Jia FJ, Xiang YT. The Prevalence of Sleep Disturbances and Sleep Quality in Older Chinese Adults: A Comprehensive Meta-Analysis. Behav Sleep Med 2019; 17:683-697. [PMID: 29851516 DOI: 10.1080/15402002.2018.1469492] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: This is a meta-analysis of the pooled prevalence of insomnia-specific sleep disturbances (sleep disturbances thereafter) and sleep quality in older Chinese adults. Method: Both English (PubMed, Embase and PsycINFO) and Chinese (Chinese National Knowledge Infrastructure [CNKI], WanFang and SinoMed) databases were systematically searched. Data extraction and quality assessment were independently performed by two investigators. Random-effects model was performed to pool the prevalence of sleep disturbances and sleep quality. Subgroup and meta-regression analyses were performed to explore the source of heterogeneity. Funnel plots, Egger's regression model, and Begg's test were used to assess publication bias. Results: A total of 47 studies were included. The pooled prevalence of sleep disturbances was 35.9% (95% CI: 30.6%-41.2%). Older adults in rural areas had higher prevalence of sleep disturbances than their counterparts in urban areas. Sleep quality was measured by the Pittsburgh Sleep Quality Assessment (PSQI) in all studies with available data. In the 27 studies with available data, the pooled mean PSQI total score was 6.64 (95% CI: 6.14-7.13). There was no significant difference between genders and between rural and urban areas. Compared to men, women had higher mean scores in sleep latency (Q = 23.62, p < 0.001), sleep efficiency (Q = 12.08, p = 0.001), and use of sleep-promoting medications (Q = 4.07, p = 0.044). Conclusion: Sleep disturbances are common in older Chinese adults, particularly in older women.
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Affiliation(s)
- Li Lu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau , Macao SAR , China
| | - Shi-Bin Wang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau , Macao SAR , China.,Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences , Guangzhou, China
| | - Wenwang Rao
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau , Macao SAR , China.,Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun , China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders, China & Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University , Beijing , China
| | - Gabor S Ungvari
- University Notre Dame Australia, Graylands Hospital , Perth , Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne , Melbourne , Australia
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun , China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences , Guangzhou, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau , Macao SAR , China
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Bendayan R, Kelly A, Hofer SM, Piccinin AM, Muniz-Terrera G. Memory Decline and Depression Onset in U.S. and European Older Adults. J Aging Health 2018; 32:189-198. [PMID: 30466361 PMCID: PMC7008550 DOI: 10.1177/0898264318813019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: We explore the association between different patterns of change in depressive symptoms and memory trajectories in US and European Mediterranean (Spain, France, Italy, and Israel) and non-Mediterranean (Sweden, Denmark, Netherlands, Germany, Belgium, Switzerland, and Austria) older adults. Methods: Samples consisted of 3,466 participants from the Health Retirement Study (HRS) and 3,940 participants from the Survey of Health, Aging and Retirement (SHARE). Individuals were grouped as follows: non-case depression (NO DEP), persistent depression (DEP), depression onset (ONSET), depression recovery (RECOV), and fluctuating (FLUCT). Memory was measured using immediate and delayed recall tests. Linear mixed models were used. Results: DEP and RECOV had significantly lower baseline memory scores compared to NO DEP, at intercept level. At slope level, ONSET had a significantly faster decline in both tasks compared to NO DEP. Discussion: Cross-cohort robust and consistent new empirical evidence on the association between depression onset and faster decline in memory scores is provided.
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Affiliation(s)
- Rebecca Bendayan
- MRC Unit for Lifelong Health and Ageing at UCL, UK.,Department Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK
| | - Amanda Kelly
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Scott M Hofer
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Andrea M Piccinin
- Department of Psychology, University of Victoria, British Columbia, Canada
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Marques A, Peralta M, Martins J, Loureiro V, Almanzar PC, de Matos MG. Few European Adults are Living a Healthy Lifestyle. Am J Health Promot 2018; 33:391-398. [PMID: 30012013 DOI: 10.1177/0890117118787078] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE This study aimed to measure healthy lifestyle for European adults. DESIGN Cross-sectional study. SETTINGS In 20 European countries. PARTICIPANTS A total of 34 993 (16 749 men, 18 244 women) European adults. MEASURES Data were from the 2014 European Social Survey (n = 34 993) on 4 modifiable behaviors (physical activity, fruit and vegetable consumption, not drinking alcohol to excess, and not smoking) as well as sleep quality. ANALYSIS Behaviors were combined and formed a healthy lifestyle measure. Binary logistic regression was done to determine associations of healthy lifestyle and sociodemographic characteristics. RESULTS Only 5.8% of the adults reported a healthy lifestyle. The prevalence of having a healthy lifestyle varied among European countries. The lowest rates were in Hungary (1.3%) and Czech Republic (1.9%). The highest rates were in United Kingdom (8.6%) and Finland (9.2%). Those who presented a higher likelihood of having a healthy lifestyle were middle age (odds ratio [OR] = 1.20), older people (OR = 1.34), having higher household income (OR = 1.33), being a student (OR = 1.38), and retired (OR = 1.31). Those less likely to have a healthy lifestyle were lived without a partner (OR = 0.82), unemployed (OR = 0.73), and lived in rural areas (OR = 0.86). CONCLUSIONS Few European adults were practicing 5 healthy behaviors. This should be a message for governments and be considered in the establishment of preventive public policies in the areas of health and health education.
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Affiliation(s)
- Adilson Marques
- 1 Centro Interdisciplinar do Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
- 2 Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
- 3 Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Miguel Peralta
- 1 Centro Interdisciplinar do Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - João Martins
- 4 Laboratório de Pedagogia, Faculdade de Motricidade Humana e UIDEF, Instituto de Educação, Universidade de Lisboa, Lisboa, Portugal
| | - Vânia Loureiro
- 5 Escola Superior de Educação, Instituto Politécnico de Beja, Beja, Portugal
| | - Paola Cortés Almanzar
- 6 Centro Universitario de la Costa, Universidad de Guadalajara, Puerto Vallarta, México
| | - Margarida Gaspar de Matos
- 3 Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- 7 Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
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The bidirectional relationship between sleep duration and depression in community-dwelling middle-aged and elderly individuals: evidence from a longitudinal study. Sleep Med 2018; 52:221-229. [PMID: 29861378 DOI: 10.1016/j.sleep.2018.03.011] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/24/2018] [Accepted: 03/13/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND There are several studies that have focused on the relationship between sleep duration and depression, however, only a few prospective studies have centered on the bidirectional relationship between them. This four-year longitudinal study aimed to identify the association between sleep duration and depression in community-dwelling mid-age and elderly individuals. METHODS 10,704 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included for baseline and four-year follow up. Of these individuals, 7866 and 2956 were used to identify the effects of sleep duration on onset and recurrent depression respectively. 4504 individuals with normal sleep duration at baseline were included to examine the effects of depression on changes of sleep time. The 10-item version of the Centre for Epidemiological Studies Depression scale (CESD-10) was used to access depressive symptoms, as well sleep duration was self-reported. RESULTS Participants with short sleep duration (<5 and 5-6 h) had a higher risk of depression onset (OR 1.69 [1.36-2.11], 1.48 [1.19-1.84]) and recurrent depression (OR 1.44 [1.12-1.86], 1.32 [1.00-1.74]) compared to participants with normal sleep durations (7-8 h). Long sleep durations (>9 h) had no significant risks for depression. Males and the elderly (over 60 years-old) were more sensitive to short sleep durations and experienced a higher incidence of depression. Individuals with depression were more likely to have short sleep durations instead of long ones (RRR 1.20 [1.02-1.43]). CONCLUSIONS The present study identified the bidirectional relationship between sleep duration and depression. Short sleep durations were a risk factor for the onset and recurrent depression. Conversely, depression induced short sleep durations rather than excessive sleep durations. Future studies need to focus on identifying the mechanism between sleep duration and depression, and develop additional evidence-based cost-effective interventions to prevent depression and sleep problems.
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