Hsin-Fang Chung1, Nirmala Pandeya1, Annette J Dobson1, Diana Kuh2, Eric J Brunner3, Sybil L Crawford4, Nancy E Avis5, Ellen B Gold6, Ellen S Mitchell7, Nancy F Woods8, Joyce T Bromberger9, Rebecca C Thurston9, Hadine Joffe10, Toyoko Yoshizawa11, Debra Anderson12, Gita D Mishra1. 1. School of Public Health,The University of Queensland,Brisbane,Queensland,Australia. 2. Medical Research Council Unit for Lifelong Health and Ageing at University College London,London,UK. 3. Department of Epidemiology and Public Health,University College London,London,UK. 4. Department of Medicine,University of Massachusetts Medical School,Worcester,MA,USA. 5. Department of Social Sciences and Health Policy,Wake Forest School of Medicine,Medical Center Blvd,Winston-Salem,NC,USA. 6. Department of Public Health Sciences,University of California,Davis,CA,USA. 7. Family and Child Nursing,School of Nursing,University of Washington,Seattle,WA,USA. 8. Biobehavioral Nursing and Health Systems,School of Nursing,University of Washington,Seattle,WA,USA. 9. Departments of Epidemiology and Psychiatry,University of Pittsburgh,Pittsburgh,PA,USA. 10. Connors Center for Women's Health and Department of Psychiatry,Brigham and Women's Hospital and Dana Farber Cancer Institute/Harvard Medical School,Boston,MA,USA. 11. Department of Women's Health Nursing,Tohoku University Graduate School of Medicine,Sendai,Japan. 12. Menzies Health Institute Queensland, Griffith University,Gold Coast,Queensland,Australia.
Abstract
BACKGROUND: Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions. METHODS: A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49-51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation. RESULTS: At baseline, the prevalence of VMS (40%, range 13-62%) and depressed mood (26%, 8-41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27-1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47-2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90-1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38-2.34). CONCLUSIONS: Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.
BACKGROUND: Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions. METHODS: A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49-51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation. RESULTS: At baseline, the prevalence of VMS (40%, range 13-62%) and depressed mood (26%, 8-41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27-1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47-2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90-1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38-2.34). CONCLUSIONS: Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.
Entities:
Keywords:
Depressed mood; hot flushes; menopausal transition; night sweats; sleep difficulties; vasomotor menopausal symptoms
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