24-HOUR ACTIVITY RHYTHM AND SLEEP DISTURBANCES IN DEPRESSION AND ANXIETY: A POPULATION-BASED STUDY OF MIDDLE-AGED AND OLDER XXXX .

@entity1 @entity308 @entity148 @entity146
BACKGROUND: Disturbed circadian rhythms have been associated with @entity308 and @entity148 , but it is unclear if disturbances in the 24-hr activity rhythm and sleep are independently and specifically related to these disorders. METHODS: In 1,714 middle-aged and elderly @entity1 of the Rotterdam Study, we collected actigraphy recordings of at least 96 hr (138    14 hr, mean    standard deviation). Activity rhythms were quantified calculating the fragmentation of the rhythm, stability of the rhythm over days, and timing of the rhythm. Total sleep time, sleep onset latency, and wake after sleep onset were also estimated with actigraphy. @entity308 symptoms were assessed with the Center for Epidemiologic Studies @entity308 scale, @entity1 with clinically relevant @entity308 were interviewed to diagnose @entity308 . @entity148 were determined with the Munich version of the Composite International Diagnostic Interview. RESULTS: More fragmented rhythms were associated with clinically relevant @entity308 (odds ratio (OR): 1.27, 95% confidence interval (CI): 1.04;1.54) and @entity148 (OR: 1.39, 95% CI: 1.14;1.70) after covariate adjustment. Less stable rhythms, longer sleep onset latency, and more wake after sleep onset were related to clinically relevant @entity308 or @entity148 only if not adjusted for covariates and other activity rhythm and sleep indicators. CONCLUSIONS: Our study in middle-aged and elderly @entity1 suggests that fragmentation of the 24-hr activity rhythm is associated with @entity308 and @entity148 . Moreover, this association also largely accounts for the effect of disturbed sleep on these @entity146 .
