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. 2014 Jun;62(6):1064-72.
doi: 10.1111/jgs.12845. Epub 2014 Jun 2.

Sleep-wake disturbances in sedentary community-dwelling elderly adults with functional limitations

Carlos A Vaz Fragoso  1 , Michael E Miller, Roger A Fielding, Abby C King, Stephen B Kritchevsky, Mary M McDermott, Valerie Myers, Anne B Newman, Marco Pahor, Thomas M Gill; Lifestyle Interventions and Independence in Elder Study Group
Collaborators, Affiliations

Sleep-wake disturbances in sedentary community-dwelling elderly adults with functional limitations

Carlos A Vaz Fragoso et al. J Am Geriatr Soc. 2014 Jun.

Abstract

Objectives: To evaluate sleep-wake disturbances in sedentary community-dwelling elderly adults with functional limitations.

Design: Cross-sectional.

Setting: Lifestyle Interventions and Independence in Elder (LIFE) Study.

Participants: Community-dwelling persons (mean age 78.9) who spent fewer than 20 min/wk in the previous month engaged in regular physical activity and fewer than 125 min/wk of moderate physical activity, and had a Short Physical Performance Battery (SPPB) score of <10 (N = 1,635).

Measurements: Mobility was evaluated according to 400-m walk time (slow gait speed defined as <0.8 m/s) and SPPB score (≤ 7 defined moderate to severe mobility impairment). Physical inactivity was defined according to sedentary time, as a percentage of accelerometry wear time with activity of <100 counts/min; participants in the top quartile of sedentary time were classified as having a high sedentary time. Sleep-wake disturbances were evaluated using the Insomnia Severity Index (ISI) (range 0-28; ≥ 8 defined insomnia), Epworth Sleepiness Scale (ESS) (range 0-24; ≥ 10 defined daytime drowsiness), Pittsburgh Sleep Quality Index (PSQI) (range 0-21; >5 defined poor sleep quality), and Berlin Questionnaire (high risk of sleep apnea).

Results: Prevalence rates were 43.5% for slow gait speed and 44.7% for moderate to severe mobility impairment, with 77.0% of accelerometry wear time spent as sedentary time. Prevalence rates were 33.0% for insomnia, 18.1% for daytime drowsiness, 47.8% for poor sleep quality, and 32.9% for high risk of sleep apnea. Participants with insomnia had a mean ISI score of 12.1, those with daytime drowsiness had a mean ESS score of 12.5, and those with poor sleep quality had a mean PSQI score of 9.2. In adjusted models, measures of mobility and physical inactivity were generally not associated with sleep-wake disturbances, using continuous or categorical variables.

Conclusion: In a large sample of sedentary community-dwelling elderly adults with functional limitations, sleep-wake disturbances were prevalent but only mildly severe and were generally not associated with mobility impairment or physical inactivity.

Trial registration: ClinicalTrials.gov NCT01072500.

Keywords: mobility impairment; physical inactivity; sleep-wake disturbances.

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Conflict of interest statement

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

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