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The following is a summary of “Depression, sleep and pain affect instrumental activities of daily living through cognitive functioning in adults with sickle cell disease: A report from the Sickle Cell Disease Implementation Consortium,” published in the November 2024 issue of Hematology by Longoria et al. 

Researchers conducted a retrospective study to examine the impact of depression, disrupted sleep, and pain on daily living in adults with sickle cell disease.  

They tested the link between comorbidities (depression, disrupted sleep, and pain) and attention/executive functioning, processing speed, and instrumental activities of daily living (IADLs). They also assessed if cognitive symptoms mediate this relationship. Participants (n = 2,417) completed patient-reported outcomes, with a mean age of 28 years and 73% having HbSS/Sβ⁰  genotypes. 

The results showed that depression, pain frequency, and disrupted sleep were linked to processing speed and attention/executive functioning (all P < 0.01), controlling for stroke and demographics. IADLs were associated with depression, pain, sleep, attention/executive functioning, income (<$25,000) (all P < 0.001), and genotype (P = 0.0025). Mediation models showed significant indirect effects of attention/executive functioning and processing speed (both P < 0.001) on the relationship between comorbidities and IADLs. Attention/executive functioning explained 17.5% of the relationship between depression and IADLs, while processing speed explained 10% for sleep and 8% for depression. 

They concluded that prioritizing the management of comorbidities helped mitigate cognitive symptoms and improve complex daily living skills. 

Source: onlinelibrary.wiley.com/doi/10.1111/bjh.19881