ABSTRACT
Objetivos: El objetivo de este estudio fue determinar si los síntomas de insomnio y la intensidad de los eventos de vida estresantes se asocian de forma independiente con los síntomas depresivos en ancianos hipertensos que viven en la comunidad. Métodos: Estudio de tipo observacional transversal. Los participantes fueron 438 ancianos con hipertensión arterial que completaron cuestionarios sobre síntomas depresivos, eventos estresantes, síntomas de insomnio y características sociodemográficas. Se realizó un análisis de conglomerados para obtener grupos según los síntomas de insomnio. Se identificaron los siguientes grupos: mala calidad del sueño, despertar temprano y buena calidad del sueño. Las asociaciones se probaron mediante un análisis de regresión lineal y un análisis de regresión de Poisson múltiple. Resultados: Los factores que contribuyeron de manera independiente al aumento de los síntomas depresivos fueron: pertenecer al grupo de mala calidad del sueño (p<0,001) y al grupo despertar temprano (p=0,005), reportando mayor intensidad de eventos de vida estresantes (p<0,001) y tener menos escolaridad (p=0,003). Conclusión: Las personas mayores con hipertensión arterial necesitan un abordaje integral de su atención en salud, considerando los síntomas depresivos y su relación con la intensidad de los eventos estresantes, los síntomas de insomnio y la escolaridad.(AU)
Objectives: The aim of this study was to determine whether symptoms of insomnia and intensity of stressful life events are independently associated with depressive symptoms in community-dwelling hypertensive older adults. Methods: This was an observational cross-sectional study. Participants were 438 older adults with arterial hypertension who completed questionnaires about depressive symptoms, stressful events, self-reported symptoms of insomnia and socio-demographic characteristics. Cluster analysis was performed to obtain groups according to insomnia symptoms. The following groups were identified: Poor Sleep Quality, Early Waking and Good Sleep Quality. Associations were tested using linear regression analysis and multiple Poisson regression analysis. Results: The factors that independently contributed to the increase of depressive symptoms were belonging to the Poor Sleep Quality group (P<.001) and Early Waking group (P=.005), reporting higher intensity of stressful life events (P<.001) and having less schooling (P=.003). Conclusion: older adults with hypertension need a comprehensive approach to their health care that considers depressive symptoms and their relationship with intensity of stressful events, insomnia symptoms and schooling.(AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Depression , Sleep Initiation and Maintenance Disorders , Hypertension , Demography , Stress, Psychological , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
The objective is to investigate the mediating roles of living alone and personal network in the relationship between physical frailty and activities of daily living (ADL) limitations among older adults. 2271 individuals were classified as vulnerable (pre-frail or frail) or robust. Mediating variables were living alone and personal network. Katz Index and Lawton-Brody scale were used to assess ADL. Mediating effects were analyzed with beta coefficients from linear regression models using the bootstrapping method. Mediation analysis showed significant mediating effects of living alone (ß = .011; 95% CI = .004; .018) and personal network (ß = .005; 95% CI = .001; .010) on the relationship between physical frailty and basic ADL limitations. Mediation effects of living alone and personal network on the relationship between physical frailty and instrumental ADL limitations were ß = -.074 (95% CI=-.101; -.046) and ß = -.044 (95% CI = -.076; -.020), respectively. Physically vulnerable older adults who lived alone or had poor personal network were more dependent on basic and instrumental ADL.
