Association between Depression, Lifestyles, Sleep Quality and Sense of Coherence in a Population with Cardiovascular Risk.

Aina Riera-Sampol,Pedro Tauler,Mar Nafría,Miquel Colom,Miquel Bennasar-Veny,Antoni Aguilo

doi:10.3390/nu13020585

Abstract

People with cardiovascular risk have more depression than the general population. Depression and cardiovascular risk have been commonly linked to lower sense of coherence (SOC) values, unhealthy lifestyles, and poor sleep quality. The aim of this study was to analyze the association between depression, health-related lifestyles, sleep quality, and SOC in a population with cardiovascular risk. A cross-sectional study was conducted in 310 participants (aged 35–75 years) with cardiovascular risk. Sociodemographic and anthropometric characteristics, cardiovascular risk, SOC score, depression levels, sleep quality, and lifestyles (physical activity, diet quality (measured as the adherence to the Mediterranean diet), and tobacco and alcohol consumption) were determined. The regression analysis showed significant associations between depression levels and sex (odds ratio (OR): 2.29; 95% CI: 1.29, 4.07), diet (OR: 0.85; 95% CI: 0.73, 0.99), body mass index (BMI) (OR: 1.06; 95% CI: 1.01, 1.12), cardiovascular disease (CVD) (OR: 2.55; 95% CI: 1.18, 5.48), sleep quality (OR: 0.26; 95% CI: 0.15, 0.46), and SOC (OR: 0.96; 95% CI: 0.94, 0.98). Protective effects of male sex, a lower BMI, no CVD, a higher adherence to the Mediterranean diet, a high sleep quality, and a higher SOC were found. In conclusion, among lifestyles determined, only diet was associated with depression levels. SOC and sleep quality were also found as significant predictors for depression levels.

Highlights

Depressive and anxiety disorders are the two main diagnostic categories of common mental disorders
The main finding of the present study was that, in a population with cardiovascular risk, lower depression levels were associated with a higher sense of coherence (SOC), a high sleep quality, being male, a lower body mass index (BMI), absence of cardiovascular disease (CVD), and a higher adherence to the Mediterranean diet
While a proper diet, characterized by a higher adherence to the Mediterranean diet, was associated with lower depression levels, other important lifestyles such as a smoking habit, alcohol consumption, and physical activity levels did not show any association with depression

Summary

Introduction

Depressive and anxiety disorders are the two main diagnostic categories of common mental disorders. In 2015, the global prevalence of depression was estimated to be 4.4%, with higher figures for females (5.1%) than for males (3.6%) and with higher prevalence rates in older adulthood [1]. It has been reported that disordered sleep is strongly associated with depression [3,4,5,6]. Insomnia increases the risk of developing depression and negatively affects the disease’s trajectory, and it is associated with higher suicide rates [5]. Insomnia is considered an important symptom in depression diagnostics [6]. Depression disorders have been linked to lifestyles, and the beneficial roles of a proper diet and physical activity levels and of limited alcohol and tobacco consumption have been reported [7,8,9]. When diet has been analyzed in relation to depression, the Mediterranean diet has been used as one of the main approaches, with some studies reporting its beneficial effect [10,11,12]

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Conclusion