ABSTRACT NUMBER: ESOC2026A458 ASSOCIATION OF DEPRESSION TRAJECTORIES AND SLEEP TRAJECTORIES WITH STROKE IN THE MIDDLE-AGED AND OLDER CHINESE POPULATION: A CHARLS-BASED COHORT STUDY

Abstract Background and aims Cerebrovascular diseases are major global contributors to death and disability. Prior studies have focused on static mental and behavioral factors' impact on cerebrovascular diseases, ignoring their dynamic nature and interactions.This study sought to establish trajectory models for depression and sleep, and assess their independent and combined effects on the risk of stroke. Methods The analysis included Chinese residents aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2020. Trajectories of depression and sleep duration over a 5-year follow-up period were constructed employing group-based trajectory modeling. Cox regression were utilized to explore the independent and combined effects of different trajectories on the risk of stroke, as well as the differences in effects across trajectories. Results In total, 8,680 participants were included. Three trajectories of Center for Epidemiological Studies Depression (CES-D) were identified, including low-stable (21.95%), medium-stable (48.27%), and high-stable trajectories (29.78%). Sleep trajectories were determined including persistent short sleep duration (30.1%), medium sleep duration (42.8%), and prolonged sleep duration (27.1%). Persistent severe depression (HR=2.106, 95% CI: 1.708, 2.598) and persistent short sleep duration (HR=1.324, 95% CI: 1.114, 1.574) were independently associated with the risk of stroke, respectively. Participants with prolonged sleep duration combined with persistent severe depression demonstrated a higher risk of new-onset stroke (HR=3.322, 95% CI: 2.370, 4.656) than those with normal sleep duration or mild depression. Conclusions Persistent depression and abnormal sleep duration are closely associated with increased risks of cerebrovascular diseases, potentially exhibiting a synergistic effect. Conflict of interest Yujie Chen & Muke Zhou: nothing to disclose