Sleep Disturbance, Activities of Daily Living, and Depressive Symptoms among Older Adults

Dec 23, 2017Clinical gerontologist

Sleep Problems, Daily Activities, and Depression Symptoms in Older Adults

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Nightmares were associated with depressive symptoms and suicide risk in older adults.

Insomnia symptoms were linked to both depressive symptoms and suicide risk, as well as the ability to perform daily activities.
Activities of daily living (ADLs) mediated the relationship between insomnia symptoms and depressive symptoms.
The connection between insomnia symptoms and suicidal behavior was significantly mediated by ADLs and depressive symptoms.
Nightmares did not show a direct association with ADLs but were related to both depressive symptoms and suicide risk.

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OBJECTIVE: Research suggests sleep disturbance plays a role in depression and risk for suicidal behavior (i.e., ideation, attempts, death by suicide). How sleep disturbance affects suicide risk is unclear and one's ability to perform activities of daily living (ADLs) may help explain this relation. This study examined associations between sleep problems, ADLs, and either depressive symptoms or suicide risk among older adults. We hypothesized that ADLs would mediate relations between sleep problems and depressive symptoms and suicide risk.

METHOD: Participants (N = 134; age ≥65) were recruited through Amazon's Mechanical Turk. Participants completed questionnaires that assessed insomnia symptoms, nightmares, ADLs, depressive symptoms, and suicidal behaviors.

RESULTS: Nightmares were associated with depressive symptoms and suicide risk but not independently associated with ADLs. Insomnia symptoms were associated with depressive symptoms, suicide risk, and ADLs. ADLs mediated the relation between insomnia symptoms and depressive symptoms. The insomnia symptom-suicidal behavior relation and the nightmare-suicidal behavior relation were significantly mediated by a pathway containing ADLs and depressive symptoms.

DISCUSSION: ADLs help explain how insomnia symptoms and nightmares confer suicide risk among older adults, either independently or in association with depressive symptoms.

CLINICAL IMPLICATIONS: Practitioners should attend to ADL performance when treating older adults with insomnia and depression.

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Sleep Disturbance, Activities of Daily Living, and Depressive Symptoms among Older Adults

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