Depressive Symptoms and Circadian Activity Rhythm Disturbances in Community-Dwelling Older Women

Current Opinion in Psychiatry

2016

Purpose of review Rest-activity rhythm (RAR) measurements may aid in the detection of depression risk and serve as an important target for depression prevention. This review evaluates the strength of current evidence supporting these potential applications. Recent findings Depression is associated with lower activity levels, that is less regularly patterned, and potentially shifted earlier or later in the day. Specific RAR patterns (combinations of several RAR characteristics) in patients with clinical depression may be unique or partially shared across disorders. Longitudinal research is limited but provides initial evidence that multiple distinct RAR patterns are associated with the risk of developing depression symptoms. Summary RARs measures provide a comprehensive and objective assessment of depression’s behavioral manifestations, and therefore may be useful as monitoring tool, providing additional information to help clinicians tailor behavioral treatments to specific patients. RARs also appear to contribute to depression risk and may be an important target for depression prevention. But research has not established valid predictive metrics using RARs to diagnose depression or detect depression risk. Future research should prioritize establishing the specific RAR patterns related to depression risk in high risk groups, and should seek to place this risk within the known psychosocial and neurobiological risk architecture of depression.

Section: Evidence For Rars As a Marker Of Depressionmentioning

confidence: 99%

Opportunities for clinical applications of rest-activity rhythms in detecting and preventing mood disorders

Current Opinion in Psychiatry

2016

“…Activity rhythm disturbances are associated with depressed mood (Luik, Zuurbier et al, 2013; Maglione, Ancoli-Israel et al, 2013; Robillard, Naismith et al, 2014; Luik, Zuurbier et al, 2015). These prior studies have identified particular activity rhythm characteristics (such as rhythm height, robustness, or timing) linked to depression.…”

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confidence: 99%

Latent activity rhythm disturbance sub-groups and longitudinal change in depression symptoms among older men

Chronobiology International

Boudreau

Stone

et al. 2015

Self Cite

Activity rhythms disturbances and depression often co-occur among older adults. However, little is known about how activity rhythm disturbances themselves co-occur, or how disturbances to multiple aspects of the activity rhythm relate to depression over time. In the current study, we performed a Latent Class Analysis to derive sub-groups of older men (total n=2933, mean age=76.28, SD=5.48) who shared similar patterns of activity rhythm disturbances (defined as extreme values of modeled activity rhythm parameters). We found eight sub-groups with distinct combinations of activity rhythm disturbances: one had all normative activity rhythm parameters (32.09%), one had only lower activity (10.06%), three had earlier activity (totaling 26.96%), and three had later activity (totaling 30.89%). Groups with similar timing were distinguished depending on whether the relative length of the active period was shorter and/or if the activity rhythm had lesser amplitude/robustness. We next examined whether the derived activity rhythm sub-groups were associated with different rates of change in depression symptom levels over an average of 5.5 (0.52 SD) follow-up years. The sub-group with lower activity only had faster increases in depressive symptoms over time (compared to the group with normative rhythm parameters), but this association was accounted for by adjustments for concurrently assessed health status covariates. Independent of these covariates, we found four activity rhythm disturbance sub-groups that experienced faster depressive symptom increases (compared with the normative sub-group): These included all three sub-groups that had later activity timing, and one sub-group that had earlier activity timing plus a shorter active period and a dampened rhythm. Low activity rhythm height/robustness with normal timing therefore may mark depression risk that is attributable to co-occurring disease processes; in contrast, having late or combined early/compressed/dampened activity rhythms may independently contribute to depression symptom development. Our findings suggest that activity rhythm related depression risk is heterogeneous, and may be detected when multiple aspects of rhythm timing are delayed or when early timing is accompanied by compressed/dampened activity rhythms. Future studies should consider how distinct combinations of altered activity rhythm timing and height/robustness develop and conjointly determine health risks. Future research is also needed to determine whether/how activity rhythms can be modified to improve depression outcomes.

“…Rhythm amplitude, robustness and timing of peak activity have also been shown to predict incident dementia among older women 9 . A recent cross-sectional study demonstrated that older women with greater levels of depressive symptoms were more likely to have circadian rhythm disturbances, specifically lower amplitude and less robust CARs 10 . No previous research has reported cross-sectional associations of CARs and depression in older men.…”

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confidence: 99%

Circadian Rest–Activity Rhythms Predict Future Increases in Depressive Symptoms Among Community-Dwelling Older Men

The American Journal of Geriatric Psychiatry

Ancoli‐Israel

Blackwell

et al. 2015

Self Cite

Objectives Circadian rest-activity rhythms (CARs) have been cross-sectionally associated with depressive symptoms, however no longitudinal research has examined whether CARs are a risk factor for developing depressive symptoms. Methods We examined associations of CARs (measured with actigraphy over a mean of 4.8 days) with depressive symptoms (measured with the Geriatric Depression Scale) among 2892 community-dwelling older men (mean age: 76.2 +/− 5.5) from the MrOS Sleep Study who were without cognitive impairment. Among 2124 men with minimal (0–2) symptoms at baseline, we assessed associations between CAR parameters and increases to mild (3–5) or clinically significant (≥6) symptoms after an average of 1.2 (+/− 0.32) years later. Results Cross-sectional associations between rhythm height parameters were independent of chronic diseases, lifestyle, sleep, and self-reported physical activity covariates. For example, men in the lowest mesor quartile had 2 times the adjusted odds (Adjusted Odds Ratio (AOR)=2.04, 95% CI 1.36–3.04, p=0.0005) of having prevalent clinically significant symptoms (compared to minimal). Longitudinally, low CAR robustness (being in the lowest quartile of the pseudo-F statistic) was independently associated with increasing odds of developing symptoms (i.e. AOR for having clinically significant depressive symptoms at follow-up=2.58, 95% CI 1.11–5.99, p=0.03). Conclusion CAR disturbances are indicative of depressive symptomology. Low CAR robustness may independently contribute to the risk of worsening depression symptomology.