Insomnia and Daytime Sleepiness Are Risk Factors for Depressive Symptoms in the Elderly
Isabelle Jaussent,Jean Bouyer,Marie-Laure Ancelin,Tasnime N. Akbaraly,Tasnime N. Akbaraly,Karine Pérès,Karen Ritchie,Karen Ritchie,Alain Besset,Yves Dauvilliers +9 more
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TLDR
Insomnia symptoms, EDS, and the use of medication independently increase the risk of subsequent depression in the elderly, and disturbed sleep and prolonged use of sleep medication may be early indicators or potentially reversible risk factors for depression.Abstract:
STUDY OBJECTIVES: Previous studies have reported that insomnia and excessive daytime sleepiness (EDS) may predict depression in adults However, these associations have not been investigated in community-dwelling elderly taking into account insomnia symptoms, EDS, and sleep medication DESIGN: Four-year longitudinal study SETTING: The French Three-City Study PARTICIPANTS: 3824 subjects aged ≥ 65 years and free of depressive symptoms at baseline MEASUREMENTS AND RESULTS: Questionnaires were used to evaluate "insomnia symptoms", EDS, and sleep medication at baseline Depressive symptoms (DEP-s) were assessed using the Center for Epidemiologic Studies-Depression scale at baseline, and at 2-year and 4-year follow-up Logistic regression models controlling for potential confounders were generated to determine whether sleep disturbances were associated with incident DEP-s and to determine the effect of individual insomnia symptoms Insomnia symptoms and EDS independently increased the risk of incident DEP-s (OR=123, 95% CI=101-149 and OR=205, 95% CI=130-323, respectively) Poor sleep quality and difficulty in initiating and in maintaining sleep-but not early morning awakening-were identified as risk factors of DEP-s, with risk increasing with the frequency of insomnia symptoms Sleep medication was not only a risk factor for DEP-s independent of insomnia symptoms (OR=162, 95% CI=126-209), but also independent of EDS (OR=171 95%=133-220) CONCLUSIONS: Insomnia symptoms, EDS, and the use of medication independently increase the risk of subsequent depression in the elderly In clinical practice, disturbed sleep and prolonged use of sleep medication may be early indicators or potentially reversible risk factors for depression, suggesting the need for further clinical interventional researchread more
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TL;DR: The CES-D scale as discussed by the authors is a short self-report scale designed to measure depressive symptomatology in the general population, which has been used in household interview surveys and in psychiatric settings.
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The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI
Yves Lecrubier,David V. Sheehan,E Weiller,P. Amorim,I. Bonora,K. Harnett Sheehan,J. Janavs,Dunbar Geoffrey Charles +7 more
TL;DR: The Mini International Neuropsychiatric Interview (MINI) as mentioned in this paper is a short diagnostic structured interview (DSI) developed in France and the United States to explore 17 disorders according to Diagnostic and Statistical Manual (DSM)-III-R diagnostic criteria.
Journal ArticleDOI
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Journal ArticleDOI
Depression in Late Life: Review and Commentary
TL;DR: The extant evidence regarding the etiology of depression in late life from a biopsychosocial perspective is presented and the current therapies prescribed for depressed elders, ranging from medications to group therapy are presented.