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Smagula SF, Hasler BP, Schulz R, et al. Activity patterns related to depression symptoms in stressed dementia caregivers. Int Psychogeriatr. 2019;1-8doi: 10.1017/S1041610219001601.
Smagula, S. F., Hasler, B. P., Schulz, R., Graves, J. L., Reynolds, C. F., Aizenstein, H. J., Buysse, D. J., Krafty, R. T., & Hall, M. H. (2019). Activity patterns related to depression symptoms in stressed dementia caregivers. International psychogeriatrics, 1-8. https://doi.org/10.1017/S1041610219001601
Smagula, Stephen F, et al. "Activity patterns related to depression symptoms in stressed dementia caregivers." International psychogeriatrics vol. (2019): 1-8. doi: https://doi.org/10.1017/S1041610219001601
Smagula SF, Hasler BP, Schulz R, Graves JL, Reynolds CF, Aizenstein HJ, Buysse DJ, Krafty RT, Hall MH. Activity patterns related to depression symptoms in stressed dementia caregivers. Int Psychogeriatr. 2019 Oct 29;1-8. doi: 10.1017/S1041610219001601. Epub 2019 Oct 29. PMID: 31658928; PMCID: PMC7188574.
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Int Psychogeriatr. 2019 Oct 29;1-8. doi: 10.1017/S1041610219001601. Epub 2019 Oct 29.

Activity patterns related to depression symptoms in stressed dementia caregivers.

International psychogeriatrics

Stephen F Smagula, Brant P Hasler, Richard Schulz, Jessica L Graves, Charles F Reynolds, Howard J Aizenstein, Daniel J Buysse, Robert T Krafty, Martica H Hall

Affiliations

  1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
  2. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
  3. Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.

PMID: 31658928 PMCID: PMC7188574 DOI: 10.1017/S1041610219001601

Abstract

OBJECTIVES: Self-reported activity restriction is an established correlate of depression in dementia caregivers (dCGs). It is plausible that the daily distribution of objectively measured activity is also altered in dCGs with depression symptoms; if so, such activity characteristics could provide a passively measurable marker of depression or specific times to target preventive interventions. We therefore investigated how levels of activity throughout the day differed in dCGs with and without depression symptoms, then tested whether any such differences predicted changes in symptoms 6 months later.

DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We examined 56 dCGs (mean age = 71, standard deviation (SD) = 6.7; 68% female) and used clustering to identify subgroups which had distinct depression symptom levels, leveraging baseline Center for Epidemiologic Studies of Depression Scale-Revised Edition and Patient Health Questionnaire-9 (PHQ-9) measures, as well as a PHQ-9 score from 6 months later. Using wrist activity (mean recording length = 12.9 days, minimum = 6 days), we calculated average hourly activity levels and then assessed when activity levels relate to depression symptoms and changes in symptoms 6 months later.

RESULTS: Clustering identified subgroups characterized by: (1) no/minimal symptoms (36%) and (2) depression symptoms (64%). After multiple comparison correction, the group of dCGs with depression symptoms was less active from 8 to 10 AM (Cohen's d ≤ -0.9). These morning activity levels predicted the degree of symptom change on the PHQ-9 6 months later (per SD unit β = -0.8, 95% confidence interval: -1.6, -0.1, p = 0.03) independent of self-reported activity restriction and other key factors.

CONCLUSIONS: These novel findings suggest that morning activity may protect dCGs from depression symptoms. Future studies should test whether helping dCGs get active in the morning influences the other features of depression in this population (i.e. insomnia, intrusive thoughts, and perceived activity restriction).

Keywords: Dementia caregiving; activity restriction; depression symptoms; physical activity; sleep

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