Abstract
BackgroundPatients with affective disorders of different ages have been found to present weight changes and different circadian activity patterns. This study assessed the effects of age, Body Mass Index (BMI) and depression severity on the activity-rest cycle in persons with affective disorders using a novel multifactorial 24-h analysis method.MethodsTwo hundred and thirty-six participants aged between 14 and 85 years underwent 5 to 22 days of actigraphy monitoring (mean duration = 14 days). BMI was also recorded and symptom severity was assessed with the Hamilton Depression Rating Scale (HDRS). Participants were divided into two groups: healthy controls (n = 68) and participants with a lifetime diagnosis of affective disorders (n = 168). First, the multiple regression method was employed to formulate the circadian activity pattern in term of the factors age, BMI and HDRS. For each group, the functional linear analysis method was applied to assess the relative effects of the factors. Finally, Wald-tests were used to assess the contribution of each factor on the circadian activity pattern.ResultsIn the affective disorders group, higher BMI was associated with higher activity levels from 3 am until 5.30 am and with lower activity levels from 10 am until 10.30 pm. Older age was associated with less activity across the day, evening, and night - from 11 am until 5.30 am. Higher HDRS scores were associated with higher activity around 1:30 am. In healthy controls, the effects of BMI and age on activity patterns were less pronounced and affected a narrower portion of the 24-h period.ConclusionThese findings suggest that older age and higher BMI are linked to lower daytime activity levels. Higher BMI and worse symptom severity were also associated with nocturnal activity patterns suggestive of sleep disturbances. The influence of age and BMI on 24-h activity profiles appear to be especially pronounced in people with affective disorders.
Highlights
Patients with affective disorders of different ages have been found to present weight changes and different circadian activity patterns
The current study aimed to examine 24-h activity patterns in persons with a lifetime history of affective disorders in relation to body mass index (BMI), age and depression symptom severity using functional linear modeling (FLM)
In this study, the impact of BMI, age, and depression symptom severity on the activity patterns of 168 persons with a lifetime history of affective disorders and 68 healthy control participants was analyzed using an adapted FLM technique allowing the examination of multiple factors across all the 24-h cycle
Summary
Patients with affective disorders of different ages have been found to present weight changes and different circadian activity patterns. This study assessed the effects of age, Body Mass Index (BMI) and depression severity on the activity-rest cycle in persons with affective disorders using a novel multifactorial 24-h analysis method. Metabolic changes, such as weight gain, hypertension or diabetes, are highly prevalent in affective disorders. Body weight, which is closely related to sedentary lifestyle and sleep abnormalities, is probably one of the most prominent and readily modifiable components of these metabolic complications and there is increasing evidence for related metabolic pathophysiology in obesity and affective disorders [3,4,5]. Medications commonly used to treat affective disorders may contribute to weight gain [11]
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