Association Between Sleep And Depression In Older Adults: A Cross-Sectional Study From The ELSI-Brazil Cohort

Abstract

Background: The relationship between depression and sleep is bidirectional, but sleep disturbances may precede depressive episodes. Joo et al. (2022) found that men and women from a Korean population with poor sleep quality are seven times more likely to be depressed. This study aims to replicate the previous model in the ELSI-Brazil population considering potential cross-cultural differences.

Methods: A cross-sectional analysis of Wave 2 of ELSI-Brazil (2019–2021) was performed including 6365 participants aged 50 or older. Demographic, socioeconomic, and health-related characteristics were described. Multivariable logistic regression was used to analyze the association between depression and poor sleep quality.

Results: The prevalence of poor sleep quality in this elderly population was 15.6%. Patients with poor sleep quality were four times more likely to be depressed. A significant interaction was found between sex and sleep quality in the association with depression (p=0.04). The adjusted model stratified by sex found that men and women with poor sleep quality were three (OR = 3.11 [95% CI 2.39–4.05]) and four (OR = 4.39 [95% CI 3.60–5.35]) times more likely to be depressed respectively.

Conclusion: We found a significant sleep-depression association among Brazilian elders, particularly impacting women. Gender-specific interventions for sleep-related mental health are crucial. Despite limitations, the study provides valuable insights emphasizing the need for tailored public health measures, especially in nursing homes, to prevent depression and improve the quality of life in this vulnerable group.