ABSTRACT

Insomnia, a prevalent sleep disorder in the elderly, often co-exists with chronic conditions and depression, creating a complex clinical picture. This study aimed to investigate the longitudinal associations between chronic conditions, depression, and insomnia in older adults. We conducted a prospective observational study of 52 community-dwelling adults aged 65 and above without diagnosed dementia. Participants were interviewed at baseline and after 12 months for insomnia symptoms (Insomnia Severity Index, ISI), depression (Patient Health Questionnaire-9, PHQ-9), and presence of chronic conditions (self-reported and confirmed through medical records). We employed linear mixed-effects models to analyze the longitudinal associations between chronic conditions, depression, and insomnia severity while adjusting for relevant demographic and health factors. At baseline, 58% of participants reported clinically significant insomnia (ISI score ≥ 8). The most prevalent chronic conditions were hypertension (42%), arthritis (38%), and diabetes (25%). Depression was present in 18% of participants. We observed significant longitudinal associations between the number of chronic conditions and insomnia severity (β = 0.21, p < 0.001), and between depression and insomnia severity (β = 0.43, p < 0.001). Interestingly, the interaction between chronic conditions and depression further amplified the impact on insomnia severity (β = 0.10, p = 0.021). These associations remained significant after adjusting for age, gender, education, and other co-morbidities. Our findings highlight the interconnectedness of chronic conditions, depression, and insomnia in older adults. The presence of both chronic conditions and depression synergistically enhances insomnia severity, emphasizing the need for a holistic approach to managing these co-occurring conditions. Our study findings can inform tailored interventions for improving sleep quality in elderly patients, potentially encompassing treatment for chronic conditions, depression management, and sleep-specific therapies.Keywords: Insomnia, elderly, chronic conditions, depression, longitudinal study

Keywords

Insomnia, elderly, depression.

MJE-014