Cooccurrence and bidirectional prediction of sleep disturbances and depression in older adults: Meta-analysis and systematic review

The present study pooled the prevalence of sleep disturbances and depression in community-dwelling older adults (mean age >= 60 years) and quantified the strength of evidence of the relationship between these two problems. From 23 cross-sectional studies and five sets of baseline data, a high pooled prevalence of sleep disturbances (30.5%), depressive symptoms (18.1%) and coexisting disorders (10.6%) were found. In the 23 cohort studies, self-reported sleep disturbances increased the risk of the onset of depression (relative risk [RR] = 1.92). Persistent sleep disturbances increased the risk of the development (RR = 3.90), recurrence (RR = 7.70), and worsening (RR = 1.46) of depression in older adults. Little support was found for a predictive role for objective sleep characteristics in the development of depression. Older adults with depression had a higher risk of developing (RR = 1.72) and worsening (RR = 1.73) symptoms of sleep disturbances. This review emphasizes the importance of timely interventions in incipient sleep disturbances and depression among older adults, preventing the development of more serious comorbidities. (C) 2017 Elsevier Ltd. All rights reserved.