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Poor Sleep Quality and Functional Decline in Older Women
Author(s) -
Spira Adam P.,
Covinsky Kenneth,
Rebok George W.,
Punjabi Naresh M.,
Stone Katie L.,
Hillier Teresa A.,
Ensrud Kristine E.,
Yaffe Kristine
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2012.03968.x
Subject(s) - medicine , quartile , actigraphy , odds ratio , confidence interval , grip strength , activities of daily living , odds , prospective cohort study , physical therapy , hand strength , gerontology , logistic regression , circadian rhythm
Objectives To determine whether objectively measured sleep quality predicts 5‐year incident instrumental activity of daily living ( IADL ) impairment and decline in grip strength and gait speed in older women. Design Prospective cohort. Setting Participants' homes, S tudy of O steoporotic F ractures sites. Participants Eight hundred seventeen women with a mean age of 82.4 at baseline. Measurements Participants completed 4.1 ± 0.7 nights of wrist actigraphy at baseline and measures of IADL impairment, grip strength, and gait speed at baseline and 5‐year follow‐up. Results After 5 years of follow‐up, approximately 41% of participants had incident impairment in one or more IADL s. The quartile of women with the shortest total sleep time ( TST ) had 93% greater odds of incident IADL impairment than the longest sleepers (adjusted odds ratio ( AOR ) = 1.93, 95% confidence interval ( CI ) = 1.25–2.97). Similarly, the quartile of women with the lowest sleep efficiency ( SE ) had 65% greater odds of impairment than those with the highest ( AOR = 1.65, 95% CI = 1.06–2.57). Women in the shortest TST quartile had twice the odds of declining grip strength as those with the longest TST ( AOR = 1.97, 95% CI = 1.17–3.32). Finally, women in the quartiles with the most wake after sleep onset ( WASO ) and the lowest SE had approximately 90% greater odds of grip strength decline than those with the least WASO ( AOR = 1.90, 95% CI = 1.11–3.24) and SE ( AOR = 1.92, 95% CI = 1.12–3.29). Conclusion Findings indicate that shorter sleep duration, greater WASO , and lower SE are risk factors for functional or physical decline in older women.