Exacerbated sleep increases the duration of depression in elderly patients

A recent survey from Johns Hopkins found that depression There was a high risk of maintaining depression if they experienced persistent or worsening sleep problems.

Senior research authors Adam Spira, PhD, and colleagues at Johns Hopkins Bloomberg School of Public Health analyzed data from nearly 600 seniors visiting primary care centers in the northeastern United States to analyze sleep difficulties, depression, and We investigated the relationship with the outcome of suicide ideation. The team found some adults over the age of 60 who had a pattern of deterioration insomnia The following year, the symptoms were almost 30 times more likely to be diagnosed with major depression at the end of the year than those who had improved sleep.

Professor Spira of the School of Mental Health at Bloomberg School suggests that for older adults with depression, the symptoms of insomnia provide important clues to the risk of ongoing depression and suicidal ideation. statement.

Spira and colleagues conducted research at 20 primary care sites from May 1999 to August 2001. >At age 60, I lived in the area, spoke English, and met regularly with my doctor.

All patients with oral consent were screened for depressive symptoms on the Epidemiology Research Center Depression Scale. People with a score above 20 and a random 5% sample with a low score were invited.

To measure sleep, researchers used a 24-item version of the sleep-specific item on the Hamilton Rating Scale for Depression. The tests were conducted at baseline, 4 months, 8 months, and 12 months.

The items included an assessment of how the patient slept last week, what time she woke up last morning, and whether she was awake at midnight. The answers are summed to give an overall sleep scale score ranging from 0-6. The higher the score, the poorer the sleep.

Depression was diagnosed at baseline and at 12 months by a trained research assistant using a structured clinical interview with the Axis I DSM-IV diagnosis. The primary outcome was remission, defined as a Hamilton Depression Rating Scale score <10 at 12 months.

For suicidal ideation, the team used a suicidal ideation scale that measured its presence and strength. The scale reflects patients’ desire to live, lack of desire to live, and their belief that the reason for dying outweighed the reason for living.

The overall sample of patients included 599 patients with depression, with 66.1% meeting the criteria for major depression and 33.9% being clinically significant mild depression. The average age of patients was 70.3 years and the majority (71.6%) were female.

Compared with those with improved sleep, those with worsened sleep had major depression diagnoses (aOR, 28.6; 95% CI, 12.15-67.34), clinically significant mild depression diagnoses (aOR, 11.88; 95). % CI, 5.67) -24.89), and 1-year follow-up suicidal ideation (aOR, 1.1; 95% CI, 1.005-1.199). In addition, those with worsening sleep were half as likely to achieve remission (aOR, .52, 95% CI, .46-.57).

The findings highlighted that older patients treated for depression with sleep problems should also receive more clinical attention. Sleep issues should also be considered as a potential way to improve depression outcomes in the elderly.

the study, “Role of persistent and exacerbating sleep disorders in depression remission and suicidal ideation in elderly primary care patients: the PROSPECT studyWas published online in the journal sleep.

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