Dataset Information

Cancer Bereavement and Depression Symptoms in Older Spouses: The Possible Modifying Role of the Circadian Rest-Activity Rhythm.

ABSTRACT:

Objectives

This study examines the associations of cancer death and aspects of the 24-h circadian rest-activity rhythm (RAR) on depression symptoms in older spouses.

Methods

Participants included 46 adults aged 60-94 years (M = 73 years) who experienced the death of a spouse. We tested a multivariate model using cancer death (vs. non-cancer death) and RAR variables as correlates of depression symptoms while controlling for age, sex, physical illness burden, and preparedness for death. We also present a case example to describe the behavioral activity patterns of a participant bereaved by cancer.

Results

Cancer death was associated with elevated levels of depression symptoms. However, the timing of the RAR moderated this association. Cancer bereavement was associated with depression symptoms when participants "settled-down" after 11:00 PM. The case example illustrates how intrusive thoughts about death quality impacts a widower's drive to stay busy with daily activities.

Conclusions

Settling down earlier in the evening is important for older spouses bereaved by cancer, in terms of fewer symptoms of depression.

Clinical implications

Objectively specifying the activity patterns of older spouses bereaved by cancer is a promising avenue for interventions that aim to reduce depression symptoms.

SUBMITTER: Stahl ST

PROVIDER: S-EPMC7886956 | biostudies-literature | 2021 Mar-Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Cancer Bereavement and Depression Symptoms in Older Spouses: The Possible Modifying Role of the Circadian Rest-Activity Rhythm.

Stahl Sarah T ST Neagoe Ioana I Smagula Stephen F SF Posluszny Donna D Bovbjerg Dana H DH

Clinical gerontologist 20200828 2

<h4>Objectives</h4>This study examines the associations of cancer death and aspects of the 24-h circadian rest-activity rhythm (RAR) on depression symptoms in older spouses.<h4>Methods</h4>Participants included 46 adults aged 60-94 years (<i>M</i> = 73 years) who experienced the death of a spouse. We tested a multivariate model using cancer death (vs. non-cancer death) and RAR variables as correlates of depression symptoms while controlling for age, sex, physical illness burden, and preparedness ...[more]

PMID: 32856562

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Project description:Rest-activity rhythm (RAR) disturbances are associated with mood disorders. But there remains a need to identify the particular RAR profiles associated with psychiatric symptom dimensions. Establishing such profiles would support the development of tools that track the 24-h sleep-wake phenotypes signaling clinical heterogeneity. We used data-driven clustering to identify RAR profiles in 145 adults aged 36-82 years (mean = 60, standard deviation = 9). Then we evaluated psychiatric symptom dimensions (including positive and negative affect, depressive, manic-hypomanic, panic-agoraphobic, and substance use symptoms) associated with these empirically-derived RAR profiles. Clustering identified three sub-groups characterized, on average, by: (1) earlier and more robust RARs ("earlier/robust," n = 55, 38%); (2) later and irregular RARs ("later/irregular," n = 31, 21%); and (3) later RARs and a narrower active period ("later/narrower," n = 59, 41%). Compared with the "earlier/robust" group: the "later/irregular" group had higher levels of lifetime manic-hypomanic symptoms (β (standard error) = 0.80 (0.22) higher standardized symptom units, p = 0.0004) and lifetime depression symptoms (β (standard error) = 0.73 (0.21) higher standardized symptom units, p = 0.0009); the "later/narrower" group had more lifetime depression symptoms (β (standard error) = 0.48 (0.18) higher standardized symptom units, p = 0.0076). These associations persisted after adjustments for sleep continuity and duration, suggesting that RARs are distinct behavioral correlates of clinical heterogeneity. Longitudinal studies are needed to confirm whether RAR characteristics contribute to the risk of manic and/or depressive episodes, and whether they reflect the consequences of psychiatric disturbance (e.g., on quality of life or disability). Opportunities to monitor or intervene on objectively-assessed RARs could facilitate better mental health related outcomes.

Project description:BackgroundRest-activity rhythm (RAR), a manifestation of circadian rhythms, has been associated with morbidity and mortality risk. However, RAR patterns in the general population and specifically the role of demographic characteristics in RAR pattern have not been comprehensively assessed. Therefore, we aimed to describe RAR patterns among non-institutionalized US adults and age, sex, and race/ethnicity variation using accelerometry data from a nationally representative population.MethodsThis cross-sectional study was conducted using the US National Health and Nutrition Examination Survey (NHANES) 2011-2014. Participants aged ≥20 years who were enrolled in the physical activity monitoring examination and had at least four 24-h periods of valid wrist accelerometer data were included in the present analysis. 24-h RAR metrics were generated using both extended cosinor model (amplitude, mesor, acrophase and pseudo-F statistic) and nonparametric methods (interdaily stability [IS] and intradaily variability [IV]). Multivariable linear regression was used to assess the association between RAR and age, sex, and race/ethnicity.ResultsEight thousand two hundred participants (mean [SE] age, 49.1 [0.5] years) were included, of whom 52.2% were women and 67.3% Whites. Women had higher RAR amplitude and mesor, and also more robust (pseudo-F statistic), more stable (higher IS) and less fragmented (lower IV) RAR (all P trend < 0.001) than men. Compared with younger adults (20-39 years), older adults (≥ 60 years) exhibited reduced RAR amplitude and mesor, but more stable and less fragmented RAR, and also reached their peak activity earlier (advanced acrophase) (all P trend < 0.001). Relative to other racial/ethnic groups, Hispanics had the highest amplitude and mesor level, and most stable (highest IS) and least fragmented (lowest IV) RAR pattern (P trend < 0.001). Conversely, non-Hispanic blacks had the lowest peak activity level (lowest amplitude) and least stable (lowest IS) RAR pattern (all P trend < 0.001).ConclusionsIn the general adult population, RAR patterns vary significantly according to sex, age and race/ethnicity. These results may reflect demographic-dependent differences in intrinsic circadian rhythms and may have important implications for understanding racial, ethnic, sex and other disparities in morbidity and mortality risk.

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Dataset Information

Cancer Bereavement and Depression Symptoms in Older Spouses: The Possible Modifying Role of the Circadian Rest-Activity Rhythm.

Objectives

Methods

Results

Conclusions

Clinical implications

Publications

Cancer Bereavement and Depression Symptoms in Older Spouses: The Possible Modifying Role of the Circadian Rest-Activity Rhythm.

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