Multi-Trajectories of Sleep Disturbance and Depressive Symptoms and Incident Osteoarthritis: Evidence From the English Longitudinal Study of Ageing.

BACKGROUND

Osteoarthritis (OA) is a leading cause of pain and disability in older adults. Sleep disturbance and depressive symptoms are common and have been linked to multiple chronic conditions, yet how their co-developing longitudinal patterns relate to OA onset remains unclear. We aimed to identify joint trajectories of sleep disturbance and depressive symptoms and examine their associations with incident OA.

METHODS

Data were drawn from the English Longitudinal Study of Ageing (ELSA), a nationally representative prospective cohort of community-dwelling adults aged ≥ 50 years. Sleep disturbance and depressive symptoms (CES-D) assessed across three waves over eight years were modeled using group-based multi-trajectory modeling (GBMTM). OA incidence was defined as new-onset OA between Wave 8 and Wave 9 among participants free of OA at Wave 8. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic factors, health behaviors, body mass index, and comorbidities.

RESULTS

A total of 3604 participants were included. Four joint trajectory groups were identified: persistently good sleep/no depressive symptoms; persistently moderate sleep disturbance/low depressive symptoms; persistently poor sleep/moderate depressive symptoms; and persistently poor sleep/persistently high depressive symptoms. Compared with the persistently good sleep/no depressive symptoms group, the fully adjusted odds of incident OA were higher in the persistently poor sleep/persistently high depressive symptoms group (OR = 2.85, 95% CI 1.90-4.28), the persistently poor sleep/moderate depressive symptoms group (OR = 2.14, 95% CI 1.52-3.02), and the persistently moderate sleep disturbance/low depressive symptoms group (OR = 1.56, 95% CI 1.20-2.03).

CONCLUSION

Long-term co-occurrence of sleep disturbance and depressive symptoms was associated with incident OA in middle-aged and older adults. These patterns may help identify adults at elevated risk, but causal effects and the preventive value of sleep or depression interventions require confirmation.