Circadian Rest–Activity Rhythms Predict Future Increases in Depressive Symptoms Among Community-Dwelling Older Men
Open accessAbstract
Objective Circadian rest-activity rhythms (CARs) have been cross-sectionally associated with depressive symptoms, although no longitudinal research has examined whether CARs are a risk factor for developing depressive symptoms.Methods We examined associations of CARs (measured with actigraphy over a mean of 4.8 days) with depressive symptoms (measured with the Geriatric Depression Scale) among 2,892 community-dwelling older men (mean age: 76.2 ± 5.5 years) from the MrOS Sleep Study who were without cognitive impairment. Among 2,124 men with minimal (0-2) symptoms at baseline, we assessed associations between CAR parameters and increases to mild (3-5) or clinically significant (≥6) symptoms after an average of 1.2 (±0.32) years.Results Cross-sectional associations between rhythm height parameters were independent of chronic diseases, lifestyle, sleep, and self-reported physical activity covariates. For example, men in the lowest mesor quartile had twice the adjusted odds (adjusted odds ratio [AOR]: 2.04, 95% confidence interval [CI]: 1.36-3.04, p = 0.0005) of having prevalent clinically significant symptoms (compared to minimal). Longitudinally, low CAR robustness (being in the lowest quartile of the pseudo-F statistic) was independently associated with increasing odds of developing symptoms (i.e., AOR for having clinically significant depressive symptoms at follow-up = 2.58, 95% CI: 1.11-5.99, p = 0.03).Conclusion CAR disturbances are indicative of depressive symptomology. Low CAR robustness may independently contribute to the risk of worsening depression symptomology.
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Among cosinor-based metrics, lower pseudo-F statistic values and later acrophase, both based on steps and heart rate, were associated with more severe symptoms, but these correlations became nonsignificant after FDR correction and in multiple regression analysis.
“our data indicated lower pseudo-F statistic values and later acrophase, both based on steps and heart rate, in participants with more severe symptoms, which is consistent with existing evidence [22,23,25,26,29,30], yet these correlations became nonsignificant after the FDR correction and in multiple regression analysis.”
From Digital Biomarkers for Depression Screening With Wearable Devices: Cross-sectional Study With Machine Learning Modeling (2021) · cites this paper as [26]
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Self-citationStone, K. L., & Li, V. (2019) · Oxford University Press eBooks · doi:10.1093/oso/9780190930448.003.0006 · Cited by 2 · see citing works
Self-citationCavaillès, C., Stone, K. L., Leng, Y., & Yaffe, K. S. (2025) · SLEEP · doi:10.1093/sleep/zsaf219 · Cited by 1 · see citing works
Self-citationPoon, C.-Y., Ho, F. Y., Lo, H. K.-Y., Yeung, W.-F., Chung, K., Chan, C. S., & Harvey, A. G. (2026) · Psychological Medicine · doi:10.1017/s0033291726103481 · Cited by 1 · see citing works
Polidori, M. C., & Meyer, A. M. (2018) · Springer eBooks · doi:10.1007/978-3-662-57358-7_8 · Cited by 1 · see citing works
Qin, S., Ong, J. L., Chia, J., Low, A., Lee, C., Koek, D., Cheong, K., & Chee, M. W. L. (2024) · Sleep Health · doi:10.1016/j.sleh.2024.10.005 · Cited by 1 · see citing works
Circadian Sleep-Wake Activity Patterns During Aging
Stone, K. L., & Tranah, G. J. (2017) · Healthy ageing and longevity · doi:10.1007/978-3-319-64543-8_13 · Cited by 1 · see citing works
Self-citationSmagula, S. F. (2014) · D-Scholarship@Pitt (University of Pittsburgh)
Self-citationWhat's in a delayed bathyphase?
Smagula, S. F. (2015) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2015.05.016
Self-citationGraves, J. (2018) · D-Scholarship@Pitt (University of Pittsburgh)
Depression in Osteoarthritis and Melatonin or Light Therapy
Marks, R. (2021) · Open Journal of Geriatrics · doi:10.22259/2639-359x.0401003
Lin, Y., Lin, C., Chuang, H., Chang, H., Chen, I., & Chen, T. (2024) · doi:10.2196/preprints.60798
Lee, H., Kang, S., & Lee, S. H. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5216287
Epidemiology of Sleep and Circadian Health
Xiao, Q., & Stone, K. L. (2025) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197602751.013.12
Self-citationStahl, S. T., Rodakowski, J. L., Patira, R., & Smagula, S. F. (2025) · doi:10.2196/preprints.88773
Self-citationLee, H., Kang, S., & Lee, S. H. (2026) · Journal of Medical Internet Research · doi:10.2196/76432
Actigraphy-derived rest-activity rhythm profiles in major depressive disorder: A cluster analysisPreprint
Poon, C.-Y., Smagula, S. F., & Ho, F. Y. (2026) · Research Square · doi:10.21203/rs.3.rs-8647960/v1
Self-citationStahl, S. T., Rodakowski, J. L., Patira, R., & Smagula, S. F. (2026) · JMIR Formative Research · doi:10.2196/88773
Self-citationZhang, W., Zhao, J., Guo, C., Hu, S., Zhang, X., Liu, X., Shen, H., Zhang, X., Cao, F., & Cui, N. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122437
- Authors
- Smagula, S. F., Ancoli-Israel, S., Blackwell, T., Boudreau, R., Stefanick, M. L., Paudel, M. L., Stone, K. L., & Cauley, J. A.
- Affiliations
- University of Pittsburgh (US)
- California Pacific Medical Center (US)
- Stanford University (US)
- University of Minnesota (US)
- Corresponding author
- Cauley, Jane A.
- ORCID
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 23
- Issue
- 5
- Pages
- 495-505
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC4277502
- OpenAlex
- W2112892129
- Cited by
- 63
- References
- 45
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 10 · 2023: 5 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 1
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- National Center for Advancing Translational Sciences
- NIH Roadmap for Medical Research (U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, UL1 TR000128)
- National Heart, Lung, and Blood Institute (R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, R01 HL070839)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- circadian rest-activity rhythm, depressive symptoms, older men, actigraphy, mesor, risk factors for depression, community-dwelling older adults
- MeSH terms
- Aged, Aged, 80 and over, Aging, Depression, Follow-Up Studies, Humans, Life Style, Male, Motor Activity, Psychiatric Status Rating Scales, Risk Factors, Sleep, United States, Geriatric Assessment, Comorbidity, Chronobiology Disorders, Actigraphy, Independent Living
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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