Low peak expiratory flow plus sleep disturbance and later depressive symptoms in four ageing cohorts
In four ageing cohorts of 49,201 people aged 50 to 100, having both low peak expiratory flow and sleep disturbance was linked to a higher rate of new elevated depressive symptoms than either factor alone, and the combined burden appeared additive rather than synergistic. [1]
Automatic summary · not editorially reviewed
The key findings
The study analysed 49,201 at-risk participants aged 50 to 100 from four ageing cohorts in the US, England, China and 16 European countries. [1]
The joint-exposure group had a pooled adjusted rate ratio of 1.40 for incident elevated depressive symptoms, versus 1.14 for low peak expiratory flow only and 1.27 for sleep disturbance only. [1]
No interaction was found on either scale, and the authors describe the combined burden as additive rather than synergistic. [1]
The source at a glance
- Study type / format
- Four-cohort longitudinal observational study (abstract)
- Population / context
- 49,201 at-risk participants aged 50 to 100 in four ageing cohorts
- Summary based on
- Study abstract
- Original publication
- September 10, 2026
Four cohorts, 49,201 people aged 50 to 100
The study combined four ageing cohorts: the Health and Retirement Study in the US, the English Longitudinal Study of Ageing, the China Health and Retirement Longitudinal Study and the Survey of Health, Ageing and Retirement in Europe across 16 countries. It included 49,201 at-risk participants aged 50 to 100. Low peak expiratory flow was defined as the lowest quartile within sex and age bands, and sleep disturbance was measured with each cohort's established measure. The outcome was incident elevated depressive symptoms, modelled with Poisson generalized estimating equations and random-effects meta-analysis.
Supporting source [1]
Joint exposure linked to more new depressive symptoms
The group with both exposures had a higher adjusted rate of incident elevated depressive symptoms in every cohort (pooled adjusted rate ratio 1.40, 95% confidence interval 1.28 to 1.52), corresponding to 7 to 25 additional events per 1000 person-years. The associations for each component alone were smaller: low peak expiratory flow only 1.14 and sleep disturbance only 1.27. No interaction was found on either scale, with consistent results across cohorts. Findings held in several sensitivity analyses and were replicated in one cohort using other lung-function measures.
Supporting source [1]
Additive risk marker, not a synergistic phenotype
The authors conclude that co-occurring low peak expiratory flow and sleep disturbance mark a consistent, additive burden of incident depressive symptoms in later life. They state that combined assessment should be read as simple risk addition, not as a synergistic high-risk phenotype. This is an observational, longitudinal association; it does not show that either exposure causes depressive symptoms. The abstract reports the design, cohorts and outcome but not full details of follow-up or measurement, and the full text was not reviewed.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. This is an observational longitudinal association, not evidence of causation. Details of follow-up and measurement are not fully reported in the abstract.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Li H, Tan H. · europepmc.org · September 10, 2026