Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 26;19(9):e0311024.
doi: 10.1371/journal.pone.0311024. eCollection 2024.

Association of dysphagia and loneliness and their interaction with sleep quality among older adults in nursing homes: A cross-sectional study

Affiliations

Association of dysphagia and loneliness and their interaction with sleep quality among older adults in nursing homes: A cross-sectional study

Bihan Wen et al. PLoS One. .

Abstract

Objective: Poor sleep quality is a risk factor for many adverse health outcomes and has become a widespread and serious public health problem, especially among older adults. This study aimed to explore the association between dysphagia, loneliness, and their interaction with sleep quality among older Chinese adults living in nursing homes.

Methods: This cross-sectional study used multistage cluster random sampling to select 56 nursing homes in Hunan Province, China. Data on sociodemographic characteristics, health-related status, lifestyle, and behavioral and social psychological factors were collected. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. The 30 mL Water Swallowing Test and Eating Assessment Tool-10 items were used to screen for dysphagia, and the 14th item of the Center for Epidemiologic Studies Depression Scale was used to measure loneliness. Binary logistic regression models were used to analyze the relationship between poor sleep quality, dysphagia, and loneliness. The interaction between these variables was evaluated using multiplicative and additive interaction models.

Results: This study included 3,356 older adults aged 60 and above. The mean Pittsburgh Sleep Quality Index score was 6.31 ± 3.11, and the incidence of poor sleep quality was 30.8%. A total of 642 (19.1%) older adults had dysphagia, and 1,358 (40.5%) experienced loneliness. After adjusting for all covariates, dysphagia and loneliness were associated with an increased risk of poor sleep quality. The interaction analysis demonstrated that the risk of poor sleep quality among older adults with dysphagia and loneliness was 3.476 times higher than that in those without dysphagia and loneliness. Dysphagia and loneliness had an additive interaction effect on poor sleep quality in older adults living in nursing homes.

Conclusions: Poor sleep quality can be effectively prevented by focusing on older adults in nursing homes experiencing dysphagia, loneliness, or both and implementing targeted health interventions.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Average response plot for interactions.
OR, odds ratio.

Similar articles

Cited by

References

    1. Bao Y.P., Han Y., Ma J., et al.., Cooccurrence and bidirectional prediction of sleep disturbances and depression in older adults: Meta-analysis and systematic review. Neurosci Biobehav Rev, 2017. 75: p. 257–273. doi: 10.1016/j.neubiorev.2017.01.032 - DOI - PubMed
    1. Lorber M., Kmetec S., Davey A., et al.., Associations between Sleep Quality, Frailty, and Quality of Life among Older Adults in Community and Nursing Home Settings. Int J Environ Res Public Health, 2023. 20(6). doi: 10.3390/ijerph20064937 - DOI - PMC - PubMed
    1. Neikrug A.B. and Ancoli-Israel S., Sleep disturbances in nursing homes. J Nutr Health Aging, 2010. 14(3): p. 207–11. doi: 10.1007/s12603-010-0051-8 - DOI - PubMed
    1. Malagelada J.R., Bazzoli F., Boeckxstaens G., et al.., World gastroenterology organisation global guidelines: dysphagia—global guidelines and cascades update September 2014. J Clin Gastroenterol, 2015. 49(5): p. 370–8. doi: 10.1097/MCG.0000000000000307 - DOI - PubMed
    1. Madhavan A., LaGorio L.A., Crary M.A., et al.., Prevalence of and Risk Factors for Dysphagia in the Community Dwelling Elderly: A Systematic Review. J Nutr Health Aging, 2016. 20(8): p. 806–815. - PubMed