title: The contribution of heart failure to sleep disturbances and depressive symptoms in older adults.
abstract: BACKGROUND
  The aim of this study was to explore the associations between physical symptoms, sleep disturbances, and depressive symptoms in community-dwelling elderly individuals, comparing persons with and without heart failure (HF).
  
  
  METHODS
  A total of 613 older adults (mean age 78 years) underwent clinical and echocardiographic examinations. Questionnaires were used to evaluate sleep disturbances and depressive symptoms. A model was developed in those with HF (n = 107) and compared with those without HF (n = 506).
  
  
  RESULTS
  Cardiopulmonary symptoms (ie, dyspnea and nighttime palpitations) and pain had significant direct associations with sleep disturbances, which indirectly affected depressive symptoms. The model was essentially the same in those with and without HF except that the effect of sleep disturbances on depressive symptoms was stronger in those with HF (β = 0.64 vs β = 0.45, P = .006).
  
  
  CONCLUSIONS
  In community-dwelling older adults, regardless of their diagnosis, physical symptoms had a direct effect on sleep disturbances and an indirect effect on depressive symptoms.
authors.affiliation: Department of Cardiology, Linköping University Hospital, S-58185 Linköping, Sweden. peter.johansson@aries.vokby.se
authors.forename: Peter
authors.initials: P
authors.lastname: Johansson
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
authors.forename: Erland
authors.initials: E
authors.lastname: Svensson
authors.forename: Anders
authors.initials: A
authors.lastname: Broström
authors.forename: Urban
authors.initials: U
authors.lastname: Alehagen
authors.forename: Ulf
authors.initials: U
authors.lastname: Dahlström
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D000368:Aged; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006333:Heart Failure / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology