Nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension: findings from a national survey

ObjectivesCognitive impairment is a major health concern in older adults with hypertension, and both depression and abnormal sleep duration are recognized as potential contributing factors. This study aimed to explore the nonlinear association of depression and sleep duration with cognitive impairme...

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Main Authors: Hui-Ying Fan, He-Li Sun, Yuan Feng, Qinge Zhang, Hua-Qing Xing, Qian-Hua Huang, Zhaohui Su, Teris Cheung, Chee H. Ng, Yu-Tao Xiang, Gang Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Aging Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnagi.2025.1579560/full
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author Hui-Ying Fan
Hui-Ying Fan
Hui-Ying Fan
He-Li Sun
He-Li Sun
Yuan Feng
Qinge Zhang
Hua-Qing Xing
Hua-Qing Xing
Qian-Hua Huang
Qian-Hua Huang
Zhaohui Su
Teris Cheung
Chee H. Ng
Yu-Tao Xiang
Yu-Tao Xiang
Gang Wang
author_facet Hui-Ying Fan
Hui-Ying Fan
Hui-Ying Fan
He-Li Sun
He-Li Sun
Yuan Feng
Qinge Zhang
Hua-Qing Xing
Hua-Qing Xing
Qian-Hua Huang
Qian-Hua Huang
Zhaohui Su
Teris Cheung
Chee H. Ng
Yu-Tao Xiang
Yu-Tao Xiang
Gang Wang
author_sort Hui-Ying Fan
collection DOAJ
description ObjectivesCognitive impairment is a major health concern in older adults with hypertension, and both depression and abnormal sleep duration are recognized as potential contributing factors. This study aimed to explore the nonlinear association of depression and sleep duration with cognitive impairment among older adults with hypertension.MethodsThis cross-sectional study was based on the 2017–2018 wave of Chinese Longitudinal Healthy Longevity Survey. Depression and cognitive function were measured using the 10-item Center for Epidemiological Studies Short Depression Scale and Mini Mental State Examination, respectively. Univariate, binary logistic regression, and restricted cubic spline regression analyses were used to examine the associations between depression, sleep duration and cognitive impairment.ResultsA total of 3,989 older adults with hypertension were included. The prevalence of depression and cognitive impairment were 28.1% (95%CI = 26.7–29.5%) and 10.1% (95%CI = 9.2–11.1%), respectively. After adjusting for confounding factors, a significant linear association (nonlinear p = 0.814) between depression and cognitive impairment risk was found, while a U-shaped nonlinear association was identified between sleep duration and cognitive impairment risk (p = 0.040). Both shorter (<6.6 h) and longer (>7.7 h) sleep duration per day were associated with higher cognitive impairment risk, with an inflection point at 7.3 h. The effect of sleep duration on cognitive impairment risk was more significant for participants with a higher (≥ 6 years) education level.ConclusionThis study highlights the importance of managing depression and optimizing sleep duration in addressing the risk of cognitive decline in older adults with hypertension.
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spelling doaj-art-161833db71c7449193fb5cd928f13c9c2025-08-20T02:39:25ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652025-07-011710.3389/fnagi.2025.15795601579560Nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension: findings from a national surveyHui-Ying Fan0Hui-Ying Fan1Hui-Ying Fan2He-Li Sun3He-Li Sun4Yuan Feng5Qinge Zhang6Hua-Qing Xing7Hua-Qing Xing8Qian-Hua Huang9Qian-Hua Huang10Zhaohui Su11Teris Cheung12Chee H. Ng13Yu-Tao Xiang14Yu-Tao Xiang15Gang Wang16International Nursing School, Hainan Medical University, Haikou, Hainan, ChinaUnit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaCentre for Cognitive and Brain Sciences, University of Macau, Macao SAR, ChinaUnit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaCentre for Cognitive and Brain Sciences, University of Macau, Macao SAR, ChinaBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, ChinaUnit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaCentre for Cognitive and Brain Sciences, University of Macau, Macao SAR, ChinaUnit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaCentre for Cognitive and Brain Sciences, University of Macau, Macao SAR, ChinaSchool of Public Health, Southeast University, Nanjing, ChinaSchool of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, ChinaDepartment of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, AustraliaUnit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaCentre for Cognitive and Brain Sciences, University of Macau, Macao SAR, ChinaBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, ChinaObjectivesCognitive impairment is a major health concern in older adults with hypertension, and both depression and abnormal sleep duration are recognized as potential contributing factors. This study aimed to explore the nonlinear association of depression and sleep duration with cognitive impairment among older adults with hypertension.MethodsThis cross-sectional study was based on the 2017–2018 wave of Chinese Longitudinal Healthy Longevity Survey. Depression and cognitive function were measured using the 10-item Center for Epidemiological Studies Short Depression Scale and Mini Mental State Examination, respectively. Univariate, binary logistic regression, and restricted cubic spline regression analyses were used to examine the associations between depression, sleep duration and cognitive impairment.ResultsA total of 3,989 older adults with hypertension were included. The prevalence of depression and cognitive impairment were 28.1% (95%CI = 26.7–29.5%) and 10.1% (95%CI = 9.2–11.1%), respectively. After adjusting for confounding factors, a significant linear association (nonlinear p = 0.814) between depression and cognitive impairment risk was found, while a U-shaped nonlinear association was identified between sleep duration and cognitive impairment risk (p = 0.040). Both shorter (<6.6 h) and longer (>7.7 h) sleep duration per day were associated with higher cognitive impairment risk, with an inflection point at 7.3 h. The effect of sleep duration on cognitive impairment risk was more significant for participants with a higher (≥ 6 years) education level.ConclusionThis study highlights the importance of managing depression and optimizing sleep duration in addressing the risk of cognitive decline in older adults with hypertension.https://www.frontiersin.org/articles/10.3389/fnagi.2025.1579560/fullolder adultshypertensioncognitive impairmentdepressionsleep duration
spellingShingle Hui-Ying Fan
Hui-Ying Fan
Hui-Ying Fan
He-Li Sun
He-Li Sun
Yuan Feng
Qinge Zhang
Hua-Qing Xing
Hua-Qing Xing
Qian-Hua Huang
Qian-Hua Huang
Zhaohui Su
Teris Cheung
Chee H. Ng
Yu-Tao Xiang
Yu-Tao Xiang
Gang Wang
Nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension: findings from a national survey
Frontiers in Aging Neuroscience
older adults
hypertension
cognitive impairment
depression
sleep duration
title Nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension: findings from a national survey
title_full Nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension: findings from a national survey
title_fullStr Nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension: findings from a national survey
title_full_unstemmed Nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension: findings from a national survey
title_short Nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension: findings from a national survey
title_sort nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension findings from a national survey
topic older adults
hypertension
cognitive impairment
depression
sleep duration
url https://www.frontiersin.org/articles/10.3389/fnagi.2025.1579560/full
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