Shufang Deng, Zeping Chen, Wei Zhao, Zhaoheng Chen, Guimin Zhang, Peijuan Li, Ningyuan Lai, Rui Xie
Long-term co-occurrence of sleep disturbance and depressive symptoms was associated with incident OA in middle-aged and older adults. These patterns may help identify adults at elevated risk, but causal effects and the preventive value of sleep or depression interventions require confirmation.
BACKGROUND: Osteoarthritis (OA) is a leading cause of pain and disability in older adults. Sleep disturbance and depressive symptoms are common and have been linked to multiple chronic conditions, yet how their co-developing longitudinal patterns relate to OA onset remains unclear. We aimed to identify joint trajectories of sleep disturbance and depressive symptoms and examine their associations with incident OA.
METHODS: Data were drawn from the English Longitudinal Study of Ageing (ELSA), a nationally representative prospective cohort of community-dwelling adults aged ≥ 50 years. Sleep disturbance and depressive symptoms (CES-D) assessed across three waves over eight years were modeled using group-based multi-trajectory modeling (GBMTM). OA incidence was defined as new-onset OA between Wave 8 and Wave 9 among participants free of OA at Wave 8. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic factors, health behaviors, body mass index, and comorbidities.
RESULTS: A total of 3604 participants were included. Four joint trajectory groups were identified: persistently good sleep/no depressive symptoms; persistently moderate sleep disturbance/low depressive symptoms; persistently poor sleep/moderate depressive symptoms; and persistently poor sleep/persistently high depressive symptoms. Compared with the persistently good sleep/no depressive symptoms group, the fully adjusted odds of incident OA were higher in the persistently poor sleep/persistently high depressive symptoms group (OR = 2.85, 95% CI 1.90-4.28), the persistently poor sleep/moderate depressive symptoms group (OR = 2.14, 95% CI 1.52-3.02), and the persistently moderate sleep disturbance/low depressive symptoms group (OR = 1.56, 95% CI 1.20-2.03).
CONCLUSION: Long-term co-occurrence of sleep disturbance and depressive symptoms was associated with incident OA in middle-aged and older adults. These patterns may help identify adults at elevated risk, but causal effects and the preventive value of sleep or depression interventions require confirmation.