Anxiety and Depression Symptoms and Every-Night Sleep Medication Use in Older Adults

2019 ◽  
Vol 34 (7) ◽  
pp. 449-455
Author(s):  
Jonathan H. Watanabe ◽  
Diane L. Chau
Keyword(s):  
Older Adults ◽  
Outcome Measure ◽  
Medication Use ◽  
The United States ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Control Analysis ◽  
Night Sleep ◽  
Sleep Medication ◽  
Case Control Analysis

OBJECTIVE: To quantify relationship between anxiety and depression symptoms with every-night sleep medication use in the United States. DESIGN: A case-control analysis to measure association between subjects with anxiety and depression symptoms and sleep medication use. SETTING AND PATIENTS: Older adults (N = 7,590) from the National Health and Aging Trends Study. MAIN OUTCOME MEASURE: Sleep medication use every night. RESULTS: Presence of the four anxiety and depression symptoms was associated with nightly sleep medication use. Those who reported "felt down, depressed, or hopeless" almost every day had an odds ratio (OR) of 3.50 (95% confidence interval [CI] 2.28-5.37) compared with those who did not. Those who reported "little interest or pleasure in doing things" almost every day had an OR of 1.86 (95% CI 1.32-2.61) compared with those with symptoms less often. Those who reported "felt nervous, anxious, or on edge" more than half the days had an OR of 3.43 (95% CI 2.68-4.37) compared with those who experienced the symptom less frequently. Those who reported "unable to stop or control worrying" more than half the days had an OR of 2.91 (95% CI 2.25-3.77) compared with those who did not. CONCLUSION: Older adults with anxiety and depression are more likely to use sleep medications every night. Efforts must be undertaken to reduce anxiety and depression to mitigate excess consumption of sedatives.

scholarly journals Association Between Sleep Medications and Falls and Fall-related Worries in Community-Dwelling Older Adults in the United States

2019 ◽  
Vol 66 (3) ◽  
pp. 23-32
Author(s):  
Kathy Nguyen ◽  
Jonathan Watanabe
Keyword(s):  
United States ◽  
Older Adults ◽  
Medication Use ◽  
Community Setting ◽  
The United States ◽  
Community Dwelling ◽  
Sleep Medication ◽  
Medication Reviews ◽  
Falls In Older Adults ◽  
Nationally Representative

Background Falls are the leading cause of unintentional fatal and nonfatal injuries in seniors. Sleep medications are associated with adverse events risk in older adults. The objective of this study is to quantify the relationship between different levels of sleep medication use with falls and fall-related worries in United States adults aged 65 years and older using a nationally representative sample. Methods Using the 2011 National Health and Aging Trends Study, survey-weighted multiple logistic regression was used to determine the association between participants who reported sleep medication use and the outcomes: falls in the last month, falls in the last year, multiple falls in the last year, fall-related worries, and limitation of activities due to fall-related worries. Results In adjusted analyses, older adults who used sleep medications every night compared to non-users of sleep medications were at increased odds of falls in the last year with an odds ratio (OR) of 1.51 (95% confidence limit [CL] 1.27, 1.78) and of multiple falls with an OR = 1.67 (95% CL 1.35, 2.06). For those who used sleep medications less than every night compared to non-users, there were no statistically significant increased odds of fall outcomes. Older adults who used sleep medication most nights (5–6 nights per week) and every night compared to non-users had increased odds of having fall-related worries with an OR = 1.61 (95% CL 1.06, 2.45) and an OR = 1.32 (95% CL 1.11, 1.58), respectively. Conclusion Older adults who use sleep medication every night are at greater odds of experiencing falls and having fall-related worries. Increased involvement by pharmacists in the community setting and pharmacist-led comprehensive medication reviews are efforts that may reduce sleep medication use and result in fewer falls in older adults.

scholarly journals Multidimensional Sleep Health and Physical Functioning in Older Adults

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.

Improving psychotropic medication use among persons with dementia

2016 ◽  
Vol 28 (10) ◽  
pp. 1587-1588 ◽  
Author(s):  
Donovan T. Maust
Keyword(s):  
United States ◽  
Older Adults ◽  
Nursing Home ◽  
Psychotropic Medication ◽  
Medication Use ◽  
The United States ◽  
Black Box ◽  
Community Settings ◽  
Limited Evidence

The use of psychotropic medication among persons with dementia (PWD) both in nursing home (Wetzels et al., 2011) and community settings (Maust et al., 2016) far exceeds what might be expected based on their limited evidence for benefit (Kales et al., 2015). This relatively high use persists despite years of evidence about the potential harms associated with their use in older adults generally and PWD in particular (e.g. Wang et al., 2001; Schneider et al., 2005). However, the solution to relatively high psychotropic use is not to end all psychotropic use, as there are individual patients for whom use of such medication is appropriate. For example, a policy that defines all antipsychotic use as inappropriate may simply lead to increased use of alternatives with even less evidence of benefit, as suggested by the response to antipsychotics’ black box warning in the United States (Kales et al., 2011).

The Influence of Social Networks and Supports on Depression Symptoms: Differential Pathways for Older Korean Immigrants and Non-Hispanic White Americans

2016 ◽  
Vol 17 (1) ◽  
pp. 13-23 ◽  
Author(s):  
Haesang Jeon ◽  
James Lubben
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Social Networks ◽  
Los Angeles ◽  
The United States ◽  
Korean Immigrants ◽  
Equation Modeling ◽  
Depression Symptoms ◽  
Older Korean Immigrants ◽  
Hispanic White

Objectives: The current cross-cultural study examines the pathways underlying different formations of social networks and social support systems, which affect depression symptoms among older Korean immigrants and non-Hispanic Whites in the United States.Method: Data for this study came from a panel survey of 223 older Korean American immigrants and 201 non-Hispanic White older adults 65 years of age and older living in Los Angeles. Structural equation modeling (SEM) is used to test the proposed conceptual model designed to explain the direct and indirect relationships between social networks and social support on depression symptoms.Results: Empirical evidence from this study indicated different effect of one’s social networks and social support on depression by race/ethnicity.Discussion: The work discussed in this article pointed to the need to recognize the role of culture in assessing the relationships between social networks, social support, and health among older adults.

scholarly journals Anxiety and depression symptoms in older adults during coronavirus disease 2019 pandemic: A community-based cross-sectional study

2021 ◽  
Vol 9 ◽  
pp. 205031212110400
Author(s):  
Kemal Jemal ◽  
Tinsae Abeya Geleta ◽  
Berhanu Senbeta Deriba ◽  
Mukemil Awol
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
High Morbidity ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Symptoms Of Depression

Objectives: The coronavirus disease 2019 pandemic has caused high morbidity and mortality in older adults over the world. Because the coronavirus disease 2019 pandemic greatly affects older adults who have a preexisting health condition, they are generally susceptible to a high incidence of severe symptoms of anxiety and depression. Therefore, we aimed to assess the prevalence of anxiety and depression symptoms in older adults during the coronavirus disease 2019 pandemic. Methods: Community-based cross-sectional study was completed in August 2020. Standardized and pretested General Anxiety Disorder–7 and Geriatric Depression Scale were used to screen the symptoms of anxiety and depression, respectively. Data were entered into EpiData (version 4.3.2) and transferred to SPSS (version 24) for further analysis. Bivariate and multivariate logistic regression analyses were carried out to determine the significantly associated variables with a 95% confidence interval at p < 0.05. Results: Of the total older adults interviewed, 68.7% had developed symptoms of anxiety and 59.9% had symptoms of depression during the coronavirus disease 2019 pandemic. Female participants, having a chronic disease and poor knowledge of the coronavirus disease 2019 pandemic, were significantly associated with anxiety symptoms. Age category of 81 to 90 and above 90, lack of social support, and having a chronic disease were significantly associated with symptoms of depression. Conclusion: The symptoms of anxiety and depression among older adults in the North Shoa Zone during coronavirus disease 2019 were higher than before the coronavirus disease 2019 happened. The results were evidence points for developing a psychological intervention to tackle the older adults’ mental health needs in the community during and after the coronavirus disease 2019 pandemic.

Differences in anxiety and depression symptoms: comparison between older and younger clinical samples

2015 ◽  
Vol 27 (9) ◽  
pp. 1523-1532 ◽  
Author(s):  
Viviana M. Wuthrich ◽  
Carly J. Johnco ◽  
Julie L. Wetherell
Keyword(s):  
Older Adults ◽  
Mood Disorders ◽  
Interpersonal Relationships ◽  
Age Groups ◽  
Anxiety And Depression ◽  
Clinical Samples ◽  
Depression Symptoms ◽  
Social Situations ◽  
Younger Adults ◽  
Symptom Profiles

ABSTRACTBackground:Anxiety and depression symptoms change over the lifespan and older adults use different terms to describe their mental health, contributing to under identification of anxiety and depression in older adults. To date, research has not examined these differences in younger and older samples with comorbid anxiety and depression.Methods:One hundred and seven treatment-seeking participants (47 older, 60% female, and 60 younger, 50% female) with anxiety and mood disorders completed the Anxiety Disorders Interview Schedule and a symptom checklist to examine differences in symptom severity, symptom profiles and terms used to describe anxiety and mood.Results:The findings indicated several key differences between the presentation and description of anxiety and depression in younger and older adults. Older adults with Social Phobia reported fearing a narrower range of social situations and less distress and interference. Older adults with Generalized Anxiety Disorder (GAD) reported less worry about interpersonal relationships and work/school than younger adults, however, there were no differences between age groups for behavioral symptoms endorsed. Further older adults reported phobia of lifts/small spaces more frequently than younger adults. Depressed older depressed adults also reported more anhedonia compared to younger adults, but no differences in terms of reported sadness were found. Finally, older and younger adults differed in their descriptions of symptoms with older adults describing anxiety as feeling stressed and tense, while younger adults described anxiety as feeling anxious, worried or nervous.Conclusions:Clinicians need to assess symptoms broadly to avoid missing the presence of anxiety and mood disorders especially in older adults.

scholarly journals The multifaceted impact of anxiety and depression on patients with rheumatoid arthritis

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Steve Peterson ◽  
James Piercy ◽  
Stuart Blackburn ◽  
Emma Sullivan ◽  
Chetan S. Karyekar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Multinomial Logistic Regression ◽  
The United States ◽  
Anxiety And Depression ◽  
Relative Risk Ratio ◽  
Depression Symptoms ◽  
Patient Anxiety ◽  
Patient Reported ◽  
The Usa ◽  
The Impact

Abstract Background The prevalence of mood disturbances such as anxiety and depression is greater in rheumatoid arthritis (RA) patients than in the general population. Given this association, the primary aim of this study was to assess the incremental impact of anxiety or depression on patients with RA from the United States of America (USA) and Europe, independent of the impact of the underlying RA disease. Methods Rheumatologists (n = 408) from the USA and 5 European countries completed patient record forms for a predetermined number of RA patients who consulted consecutively during the study period; these patients completed patient-reported questionnaires. Descriptive statistics and multivariate regression were used to investigate the relationship between anxiety and depression with treatment and economic outcomes in RA patients. Results Of 1015 physician and patient pairs who completed all relevant questionnaire sections, 390 (38.4%) patients self-reported anxiety or depression, while 180 (17.7%) patients were reported to have anxiety or depression by their physicians. Controlling for age, gender, body mass index and clinical factors (flaring and severity), multiple regression analyses suggested that patients with anxiety or depression more often experienced treatment dissatisfaction (odds ratio [OR] 2.28; P < .001), had greater impairment in work (coefficient [β] = 11.82; P = .001) and usual activity (β = 14.73; P < .001), greater disability (β = .35; P < .001), and more often reported unemployment (OR 1.74; P = .001). Multinomial logistic regression revealed discordance between physician and patient satisfaction with treatment. For patients reporting anxiety or depression, physicians were more often satisfied with achievement of current disease control than patients (relative risk ratio 2.19; P = .002). Conclusion Concomitant anxiety or depression was associated with a significant incremental impact on the health-related quality of life and economic aspects of life of patients with RA. In light of observed differences between physician recognition of patient anxiety and/or depression versus patient reporting of anxiety and/or depression symptoms, further research is warranted to develop optimal screening and management of depression and anxiety in patients with RA.

scholarly journals Falls Among High- and Low- Frequency Sleep Medication Users With and Without Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 197-197
Author(s):  
Alexandra Wennberg ◽  
Loretta Anderson
Keyword(s):  
Older Adults ◽  
National Health ◽  
High Frequency ◽  
Medication Use ◽  
Low Frequency ◽  
Sleep Medication ◽  
Risk Of Falls ◽  
Falls In Older Adults ◽  
Adjusted Model

Abstract Difficulty with sleep and falls are prevalent among older adults. Sleep medication use is associated with falls in older adults, but little is known about its impact in older adults with dementia. We used data from the 2011 National Health and Aging Trends Study to assess the association of low- versus high- frequency sleep medication use with falls in older adults with self-reported dementia. In our fully adjusted model, among those with dementia, high-frequency sleep medication users were more likely to fall than low-frequency sleep medication users (OR=3.86, 95% CI: 1.31, 11.37). Among those without dementia, high-frequency sleep medication users were more likely to fall than low-frequency sleep medication users (OR=1.40, 95% CI: 1.11, 1.77). Reducing sleep medication use in older adults with and without dementia may help reduce the risk of falls and fall-related outcomes in older adults.

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