Key result
Heart failure was associated with a stronger effect of sleep disturbances on depressive symptoms compared to older adults without heart failure (β=0.64 vs β=0.45, P=.006).
Observational (n=613)
Physical symptoms directly affect sleep disturbances and indirectly affect depressive symptoms in older adults, with the impact of sleep disturbances on depression being significantly stronger in those with heart failure.
May warrant sleep evaluation in depressed older adults with heart failure; extends cross-sectional evidence but leaves causal inference open.
BACKGROUND: The aim of this study was to explore the associations between physical symptoms, sleep disturbances, and depressive symptoms in community-dwelling elderly individuals, comparing persons with and without heart failure (HF). METHODS: A total of 613 older adults (mean age 78 years) underwent clinical and echocardiographic examinations. Questionnaires were used to evaluate sleep disturbances and depressive symptoms. A model was developed in those with HF (n = 107) and compared with those without HF (n = 506). RESULTS: Cardiopulmonary symptoms (ie, dyspnea and nighttime palpitations) and pain had significant direct associations with sleep disturbances, which indirectly affected depressive symptoms. The model was essentially the same in those with and without HF except that the effect of sleep disturbances on depressive symptoms was stronger in those with HF (β = 0.64 vs β = 0.45, P = .006). CONCLUSION: In community-dwelling older adults, regardless of their diagnosis, physical symptoms had a direct effect on sleep disturbances and an indirect effect on depressive symptoms.
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Johansson et al. (2012) conducted an observational in Heart failure (n=613). Heart failure vs. No heart failure was evaluated on Effect of sleep disturbances on depressive symptoms (β = 0.64 vs β = 0.45, p=.006). Heart failure was associated with a stronger effect of sleep disturbances on depressive symptoms compared to older adults without heart failure (β=0.64 vs β=0.45, P=.006).
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