Association Between Sleep and Physical Function in Older Veterans in an Adult Day Healthcare Program

作者：Song Yeonsu; Dzierzewski Joseph M; Fung Constance H; Rodriguez Juan C; Jouldjian Stella; Mitchell Michael N; Josephson Karen R; Alessi Cathy A; Martin Jennifer L^*

来源：Journal of the American Geriatrics Society, 2015, 63(8): 1622-1627.

DOI：10.1111/jgs.13527

• adult day health care
• elderly adults
• physical function
• sleep
• veterans

ObjectivesTo examine whether sleep disturbance is associated with poor physical function in older veterans in an adult day healthcare (ADHC) program.
DesignCross-sectional.
SettingOne ADHC program in a Veterans Affairs Ambulatory Care Center.
ParticipantsOlder veterans (N=50) enrolled in a randomized controlled trial of a sleep intervention program who had complete baseline data.
MeasurementsInformation on participant characteristics (e.g., age, depression, relationship to caregiver, pain, comorbidity) was collected using appropriate questionnaires. Physical function was measured using activity of daily living (ADL) and instrumental ADL (IADL) total scores from the Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire. Sleep was assessed subjectively (Pittsburgh Sleep Quality Index, Insomnia Severity Index) and objectively (wrist actigraphy).
ResultsParticipants required substantial assistance with ADLs and IADLs. A regression model showed that participant characteristics (marital status, use of sleep medication, comorbidity, posttraumatic stress disorder) and living arrangement (living with a spouse or others) were significantly associated with poor physical function. Poorer objective sleep (total sleep time, total numbers of awakenings, total wake time) was significantly associated with poor physical function, accounting for a significant proportion of the variance other than participant characteristics.
ConclusionObjective measures of nighttime sleep disturbance were associated with poor physical function in older veterans in an ADHC program. Further research is needed to determine whether interventions to improve sleep will delay functional decline in this vulnerable population.

• 出版日期2015-8