The associations of trouble sleeping, biological age acceleration with depressive symptoms: Evidence from three cohorts.
OBJECTIVE This study investigates the relationship between trouble sleeping, biological age (BA) acceleration, and depressive symptoms, and their combined association with depressive symptoms. METHODS Data were utilized from three cohorts: NHANES, CHARLS, and HRS. Depressive symptoms were assessed using PHQ-9 or CES-D. BA acceleration was calculated as the residual difference between BA and chronological age. In the cross-sectional analysis, logistic regression models were used to examine the associations of BA acceleration and trouble sleeping with depressive symptoms. RESULTS Trouble sleeping exhibited an association with higher odds of depressive symptoms (NHANES: OR = 4.714; CHARLS: OR = 6.643; HRS: OR = 1.842, all P < 0.001). BA acceleration was positively associated with depressive symptoms in NHANES (OR = 1.036, P < 0.001) and HRS (OR = 1.011, P = 0.007), but negatively in CHARLS (OR = 0.960, P = 0.039). Individuals with "accelerated aging & trouble sleeping" had the highest odds of depressive symptoms among different groups compared to those with "non-accelerated aging & no trouble sleeping" in NHANES (OR = 5.762, P < 0.001) and HRS (OR = 2.089, P < 0.001). In CHARLS, the highest odds were observed in the "non-accelerated aging & trouble sleeping" group (OR = 6.405, P < 0.001), while the "accelerated aging & no trouble sleeping" group showed no significant association (OR = 0.889, P = 0.126). CONCLUSIONS In NHANES and HRS, the combined association of BA acceleration and trouble sleeping was associated with the highest odds of depressive symptoms. In CHARLS, however, there was an inverse association between BA acceleration and depressive symptoms, and a lack of higher odds of depressive symptoms in the combined association. These findings reveal cross-national differences between U.S. and Chinese populations.