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Objectively Measured Sleep Quality and Nursing Home Placement in Older Women
Author(s) -
Spira Adam P.,
Covinsky Kenneth,
Rebok George W.,
Stone Katie L.,
Redline Susan,
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.1532-5415.2012.04044.x
Subject(s) - medicine , odds ratio , actigraphy , confidence interval , odds , sleep (system call) , quartile , residence , nursing homes , prospective cohort study , gerontology , physical therapy , demography , logistic regression , nursing , circadian rhythm , sociology , computer science , operating system
Objectives To determine the association between objectively measured sleep and subsequent placement in a nursing home or a personal care home. Design Prospective cohort. Setting Participants' homes and sites of the Study of Osteoporotic Fractures. Participants One thousand six hundred sixty‐four community‐dwelling women with a mean age of 83 ± 4. Measurements At baseline, participants completed an average of 4 nights of wrist actigraphy; they provided data on place of residence at baseline and at follow‐up, 5 years later. Results At baseline, participants had a mean total sleep time of 408 ± 72 minutes, mean wake after sleep onset of 71 ± 43 minutes, and mean sleep efficiency of 79 ± 11%. At follow‐up, 71 (4%) were residing in a nursing home, and 127 (8%) were in a personal care home. Women with the most wake after sleep onset (by quartile) had more than twice the odds as those with the least of placement in a nursing home (adjusted odds ratio ( AOR ) = 2.94, 95% confidence interval ( CI ) = 1.34–6.44) or a personal care home ( AOR = 2.33, 95% CI = 1.26–4.30). Similarly, women with the lowest sleep efficiency had more than three times the odds as those with the highest of nursing home placement ( AOR = 3.25, 95% CI = 1.35, 7.82) and more than twice the odds of placement in a personal care home ( AOR = 2.38, 95% CI = 1.33, 4.24). There was no association between sleep duration and placement. Conclusion In very old community‐dwelling women, greater wake after sleep onset and lower sleep efficiency are risk factors for placement in a nursing home or personal care home. Sleep duration alone does not appear to increase the risk of placement in these long‐term care settings.