Short Sleep is Associated with More Depressive Symptoms in a Multi-ethnic Cohort of Older Adults

Objectives: To evaluate cross-sectional and prospective associations between short and long sleep duration and depressive symptoms in older adults (aged >65 years).

Methods: The data from a subsample of the racially/ethnically diverse Northern Manhattan Study were analyzed. Depressive symptoms were assessed twice with the Center for Epidemiologic Studies Depression Scale (CES-D), approximately 5 years apart. The presence of depressive symptoms was defined as a CES-D score ≥16 or use of antidepressants. Self-reports of short (<6 h), intermediate (6-8 h) and long (≥9 h) sleep were assessed prior to the initial CES-D. Logistic regression was used to evaluate the cross-sectional associations between short and long sleep durations with depressive symptoms, using intermediate sleep as the reference. The prospective association between sleep duration and depression in a sample of participants without depressive symptoms at first CES-D was also analyzed. All models were adjusted for demographic, behavioral, and vascular risk factors.

Results: The initial sample consisted of 1110 participants: 62% women, 69% Hispanic, 17% black, 14% white. Short sleep was reported by 25%, intermediate sleep by 65%, and long sleep by 9%. Depressive symptoms were described in 25% of the initial sample. Short sleep, but not long sleep, was associated with depressive symptoms at baseline (adjusted OR 1.8, 95% CI 1.3-2.6), and at follow-up (adjusted OR 1.9, 95% CI 1.1-3.5; median follow-up = 5.1 years).

Conclusion: Short sleep duration had a cross-sectional and prospective association with depressive symptoms in an urban multi-ethnic cohort of older adults.