Cardiometabolic disease, depressive symptoms, and sleep disorders in middle-aged adults with functional disabilities: NHANES 2007-2014.

PURPOSE: This study examined whether depressive symptoms and sleep disorders modified the association between functional disabilities and cardiometabolic disease profiles in middle-aged adults (40-64 years).

METHODS: Participants came from the 2007-2014 NHANES. Information regarding cardiometabolic diseases, demographics, depressive symptoms, and sleep disorders were obtained. Logistic regression analyses were performed with group as the exposure and cardiometabolic diseases as the response.

RESULTS: Adults with moderate (n = 550) and severe (n = 556) functional disabilities had a higher prevalence of cardiometabolic diseases, depressive symptoms, and sleep disorders compared to adults without functional disabilities (n = 3765; p < 0.05). After adjusting for demographics, the odds of cardiovascular disease and diabetes were higher in adults with severe functional disabilities (OR: 1.47 and 1.76, p < 0.05), but not in adults with moderate functional disabilities (OR: 1.21 and 1.22, p > 0.05). With further adjustment for depressive symptoms and sleep disorders, the odds of cardiovascular disease (OR: 1.47) and diabetes (OR: 1.76) remained increased (p < 0.05) in adults with severe functional disabilities.

CONCLUSIONS: By middle-age, adults with functional disabilities have an elevated prevalence of cardiometabolic diseases, depressive symptoms, and sleep disorders compared to adults without functional disabilities. The elevated cardiometabolic disease profiles are present in adults with severe functional disabilities even after adjusting depressive symptoms and sleep disorders. IMPLICATIONS FOR REHABILITATION In the elderly population, cardiometabolic diseases, depression, and sleep disorders are prevalent conditions and are often co-morbid. In a nationally representative sample of middle-aged adults, study findings found that those with severe functional disabilities had an elevated cardiometabolic disease prevalence compared to adults without functional disabilities, even after accounting for the higher prevalence of depressive symptoms and sleep disorders. Earlier screening for cardiometabolic diseases, depression, and sleep disorders in adults with functional disabilities, or those who are at risk for developing functional disabilities, are warranted. Interventions pertaining to physical, pharmacological, or care coordination focused on improving cardiometabolic disease profiles among adults with functional disabilities are needed.