An Aggregate Measure of Sleep Health Is Associated With Prevalent and Incident Clinically Significant Depression Symptoms Among Community-Dwelling Older Women

The aims of this study were to examine the association between different types of arthritis and falls and to investigate whether clinically significant depression symptoms (CSDS) moderate these relationships. The study used nationally representative data from the 2008 Health and Retirement Study ( n = 7,715, M age = 75, 62% female, and 90% White). Among the respondents, 42% experienced at least one fall during the previous 2 years. About one third had some form of arthritis: 22% osteoarthritis (OA), 4.8% rheumatoid arthritis (RA), 2.3% both OA and RA, and 7.9% with other arthritis types. About one fifth of respondents had CSDS. OA and CSDS are associated with the odds of falling (17% and 29%, respectively), adjusting for socio-demographic characteristics, lifestyle, health conditions, and psychiatric medications. There was no statistically significant interaction between types of arthritis and CSDS. Health care providers should pay attention to managing arthritis, especially OA, and CSDS to prevent falls among older adults.

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754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽

10.1093/sleep/zsab072.751 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A294-A294

Author(s):

Ivan Vargas ◽

Alexandria Muench ◽

Mark Seewald ◽

Cecilia Livesey ◽

Matthew Press ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Mental Health Care ◽

Primary Care Providers ◽

Depression Symptoms ◽

Care Providers ◽

Mild Depression ◽

Significant Depression ◽

Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

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Multidimensional sleep health and subsequent health-care costs and utilization in older women

SLEEP ◽

10.1093/sleep/zsz230 ◽

2019 ◽

Vol 43 (2) ◽

Cited By ~ 1

Author(s):

Kristine E Ensrud ◽

Allyson M Kats ◽

John T Schousboe ◽

Lisa Langsetmo ◽

Tien N Vo ◽

...

Keyword(s):

Health Care ◽

Depressive Symptoms ◽

Older Women ◽

Health Care Costs ◽

Functional Limitations ◽

Community Dwelling ◽

Medical Conditions ◽

Sleep Health ◽

Five Dimensions ◽

Care Costs

Abstract Study Objectives Determine the association of poor multidimensional sleep health with health-care costs and utilization. Methods We linked 1,459 community-dwelling women (mean age 83.6 years) participating in the Study of Osteoporotic Fractures Year 16 visit (2002–2004) with their Medicare claims. Five dimensions of sleep health (satisfaction, daytime sleepiness, timing, latency, and duration) were assessed by self-report. The number of impaired dimensions was expressed as a score (range 0–5). Total direct health-care costs and utilization were ascertained during the subsequent 36 months. Results Mean (SD) total health-care costs/year (2017 dollars) increased in a graded manner across the sleep health score ranging from $10,745 ($15,795) among women with no impairment to up to $15,332 ($22,810) in women with impairment in three to five dimensions (p = 0.01). After adjustment for age, race, and enrollment site, women with impairment in three to five dimensions vs. no impairment had greater mean total costs (cost ratio [CR] 1.34 [95% CI = 1.13 to 1.60]) and appeared to be at higher risk of hospitalization (odds ratio (OR) 1.31 [95% CI = 0.96 to 1.81]). After further accounting for number of medical conditions, functional limitations, and depressive symptoms, impairment in three to five sleep health dimensions was not associated with total costs (CR 1.02 [95% CI = 0.86 to 1.22]) or hospitalization (OR 0.91 [95% CI = 0.65 to 1.28]). Poor multidimensional sleep health was not related to outpatient costs or risk of skilled nursing facility stay. Conclusions Older women with poor sleep health have higher subsequent total health-care costs largely attributable to their greater burden of medical conditions, functional limitations, and depressive symptoms.

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Comparison of Collaborative Care and Colocation Treatment for Patients With Clinically Significant Depression Symptoms in Primary Care

Psychiatric Services ◽

10.1176/appi.ps.201700569 ◽

2018 ◽

Vol 69 (11) ◽

pp. 1184-1187 ◽

Cited By ~ 8

Author(s):

Michelle A. Blackmore ◽

Kelly E. Carleton ◽

Sarah M. Ricketts ◽

Urvashi B. Patel ◽

Dana Stein ◽

...

Keyword(s):

Primary Care ◽

Collaborative Care ◽

Depression Symptoms ◽

Significant Depression ◽

Clinically Significant

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Amplification of Positivity Therapy for Co-occurring Alcohol Use Disorder with Depression and Anxiety Symptoms: Pilot Feasibility Study and Case Series

Behavior Modification ◽

10.1177/01454455211030506 ◽

2021 ◽

pp. 014544552110305

Author(s):

Elisabeth Akeman ◽

Evan White ◽

Kate Wolitzky-Taylor ◽

Jessica Santiago ◽

Timothy J. McDermott ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Randomized Clinical Trials ◽

Case Series ◽

Depression Symptoms ◽

Treatment Implementation ◽

Significant Depression ◽

Positive Valence ◽

Clinically Significant ◽

Intent To Treat

Positive valence system dysregulation is a relatively unexplored transdiagnostic mechanism and potential treatment target underpinning alcohol use and anxiety and depression symptoms. The current study examined the feasibility and potential benefit of a behavioral intervention focused on amplification of positivity (AMP) with eight adults (five female) diagnosed with alcohol use disorder and clinically significant depression or anxiety (ClinicalTrials.gov: NCT04278365). AMP for alcohol use (AMP-A) was delivered in 11 individual sessions involving positive activity interventions integrated alongside psychoeducation and alcohol use monitoring. Case descriptions are provided to illustrate treatment implementation. Treatment credibility and acceptability, participant endorsement of the therapy, and homework compliance were rated moderate to high. Exploratory, intent-to-treat analyses suggested medium to large effect sizes for post-treatment improvements in alcohol use, depression, anxiety, and positive affect. Results provide initial evidence of feasibility and acceptability of AMP-A and will be useful for informing future randomized clinical trials to examine clinical efficacy.

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Prevalence of Self-Reported Depression Symptoms and Perceived Anxiety Among Community-Dwelling U.S. Adults Reporting Tinnitus

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00178 ◽

2020 ◽

Vol 5 (4) ◽

pp. 959-970

Author(s):

Kelly M. Reavis ◽

James A. Henry ◽

Lynn M. Marshall ◽

Kathleen F. Carlson

Keyword(s):

Mental Health ◽

Fold Increase ◽

Community Dwelling ◽

Self Report ◽

Depression Symptoms ◽

Community Based Interventions ◽

Data Set ◽

Health Distress ◽

Validated Questionnaire ◽

Mental Health Distress

Purpose The aim of this study was to examine the relationship between tinnitus and self-reported mental health distress, namely, depression symptoms and perceived anxiety, in adults who participated in the National Health and Nutrition Examinations Survey between 2009 and 2012. A secondary aim was to determine if a history of serving in the military modified the associations between tinnitus and mental health distress. Method This was a cross-sectional study design of a national data set that included 5,550 U.S. community-dwelling adults ages 20 years and older, 12.7% of whom were military Veterans. Bivariable and multivariable logistic regression was used to estimate the association between tinnitus and mental health distress. All measures were based on self-report. Tinnitus and perceived anxiety were each assessed using a single question. Depression symptoms were assessed using the Patient Health Questionnaire, a validated questionnaire. Multivariable regression models were adjusted for key demographic and health factors, including self-reported hearing ability. Results Prevalence of tinnitus was 15%. Compared to adults without tinnitus, adults with tinnitus had a 1.8-fold increase in depression symptoms and a 1.5-fold increase in perceived anxiety after adjusting for potential confounders. Military Veteran status did not modify these observed associations. Conclusions Findings revealed an association between tinnitus and both depression symptoms and perceived anxiety, independent of potential confounders, among both Veterans and non-Veterans. These results suggest, on a population level, that individuals with tinnitus have a greater burden of perceived mental health distress and may benefit from interdisciplinary health care, self-help, and community-based interventions. Supplemental Material https://doi.org/10.23641/asha.12568475

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Determinants of handgrip strength in community-dwelling older women

10.1055/s-0038-1647194 ◽

2018 ◽

Author(s):

A Jungert ◽

M Neuhäuser-Berthold

Keyword(s):

Older Women ◽

Handgrip Strength ◽

Community Dwelling

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Faculty Opinions recommendation of Association between mild anemia and executive function impairment in community-dwelling older women: The Women's Health and Aging Study II.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1053918.505869 ◽

2006 ◽

Author(s):

Joseph Mazza

Keyword(s):

Executive Function ◽

Women’S Health ◽

Women's Health ◽

Older Women ◽

Community Dwelling ◽

Mild Anemia ◽

Function Impairment ◽

Aging Study ◽

Executive Function Impairment

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Urinary incontinence onset predictors in community‐dwelling older women: A prospective cohort study

Geriatrics and Gerontology International ◽

10.1111/ggi.14108 ◽

2020 ◽

Author(s):

Koki Okumatsu ◽

Yosuke Osuka ◽

Takao Suzuki ◽

Miji Kim ◽

Narumi Kojima ◽

...

Keyword(s):

Urinary Incontinence ◽

Cohort Study ◽

Older Women ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Community Dwelling

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Multidimensional Sleep Health and Physical Functioning in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1382 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 428-428

Author(s):

Caitlan Tighe ◽

Ryan Brindle ◽

Sarah Stahl ◽

Meredith Wallace ◽

Adam Bramoweth ◽

...

Keyword(s):

Older Adults ◽

Lower Extremity ◽

Grip Strength ◽

Physical Functioning ◽

Gait Speed ◽

The United States ◽

Depression Symptoms ◽

Sleep Health ◽

Lower Extremity Strength ◽

Sleep Parameters

Abstract Prior studies link specific sleep parameters to physical functioning in older adults. Recent work suggests the utility of examining sleep health from a multidimensional perspective, enabling consideration of an individual’s experience across multiple different sleep parameters (e.g., quality, duration, timing). We examined the associations of multidimensional sleep health with objective, performance-based measures of physical functioning in older adults. We conducted a secondary analysis of 158 adults (Mage=71.8 years; 51.9% female) who participated in the Midlife in the United States (MIDUS) 2 and MIDUS Refresher studies. We used data from daily diaries, wrist actigraphy, and self-report measures to derive a composite multidimensional sleep health score ranging from 0-6, with higher scores indicating better sleep health. Physical function was assessed using gait speed during a 50-foot timed walk, lower extremity strength as measured by a chair stand test, and grip strength assessed with dynamometers. We used hierarchical regression to examine the associations between sleep health and gait speed, lower extremity strength, and grip strength. Age, sex, race, education, depression symptoms, medical comorbidity, and body mass index were covariates in each model. In adjusted analyses, better multidimensional sleep health was significantly associated with faster gait speed (B=.03, p=.01). Multidimensional sleep health was not significantly associated with lower limb strength (B=-.12, p=.89) or grip strength (B=.45, p=.40). Gait speed is a key indicator of functional capacity as well as morbidity and mortality in older adults. Multidimensional sleep health may be a therapeutic target for improving physical functioning and health in older adults.

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