title: Inflammation, sleep disturbances, and depressed mood among community-dwelling older men.
abstract: OBJECTIVE
  High rates of sleep disturbances occur in depression. Sleep disturbances are linked to heightened inflammation. We sought to determine if sleep disturbances explain a portion of the putative inflammation - depression association among older adults. In late life, age-related immunoregulation changes may modify the inflammation-depression relationship.
  
  
  METHODS
  Cross-sectional associations of a panel of serum inflammatory markers with probable depression (measured with the Geriatric Depression Scale) were assessed among 2560 community-dwelling older men. We tested whether inflammatory marker - probable depression associations were independent of chronic diseases, as well as objective and subjectively measured sleep disturbances. We also tested whether inflammation-probable depression associations were moderated by age.
  
  
  RESULTS
  Inflammatory markers were not independently associated with higher odds of probable depression. A significant age by C-reactive protein (CRP) interaction (p=0.01) was detected such that the strength of the CRP-probable depression association decreased with age. When stratifying by the median age of 76, elevated odds of probable depression were found for men with CRP levels above the median only among the younger group (OR=2.08, 95% CI 1.18-3.69). In the final adjusted model, independent effects of chronic diseases and subjective sleep disturbances contributed to a total of 37% attenuation of the original OR (adjusted OR=1.68, 95% CI 0.911-3.10, p=.09).
  
  
  CONCLUSIONS
  In late-life, associations between inflammatory markers and mood may be explained by both chronic diseases and subjectively reported sleep disturbances. Our findings indicate that the association of CRP with probable depression diminishes in strength with age.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Smagula
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; Department of Medicine, University of California San Diego, La Jolla, CA, United States.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.affiliation: Division of Epidemiology, Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, United States.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.affiliation: Center for Musculoskeletal Health, Medicine and Rheumatology, University of California at Davis School of Medicine, Sacramento, CA, United States.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Lane
authors.affiliation: Division of Sleep Medicine, Brigham and Women's Hospital, Beth Israel Deaconess Medical Center, Boston, MA, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.affiliation: Research Institute, California Pacific Medical Center, San Francisco, CA, United States.
authors.forename: Katie L
authors.initials: KL
authors.lastname: Stone
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States. Electronic address: jcauley@edc.pitt.edu.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000209:etiology*; D006801:Humans; D057187:Independent Living; D007249:Inflammation / Q000097:blood / Q000523:psychology*; D008297:Male; D016017:Odds Ratio; D012893:Sleep Wake Disorders / Q000097:blood / Q000150:complications* / Q000209:etiology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Aging; Depression; Epidemiology; Inflammation; Late-life; Sleep
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