OBJECTIVES: To explore the unique impact of poor sleep and symptoms of depression on sleep quality for up to 1 year after inpatient post-acute rehabilitation among older adults. DESIGN: Prospective longitudinal cohort study. SETTING: Two inpatient post-acute rehabilitation facilities. PARTICIPANTS: A total of 245 individuals older than 65 years (mean age = 80 years, 38% women). INTERVENTIONS: None. MEASUREMENTS: Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) during the post-acute care stay twice to evaluate pre-illness sleep quality and sleep quality during the post-acute care stay, and again at 3-, 6-, 9-, and 12-month follow-up. Demographics, symptoms of depression, cognitive functioning, and comorbidities were also assessed. RESULTS: Across time points, sleep was significantly disturbed for many individuals. Nested regression models predicting PSQI total score at 3, 6, 9, and 12 months showed that variables entered in Block 1 (age, gender, cognitive functioning, and comorbidities) were significant predictors of poor sleep at 6-month follow-up but not at 3-, 9-, or 12-month follow-up. Depression (Block 2) and pre-illness PSQI total score (Block 3) were significant predictors of PSQI total score at all follow-up time points. PSQI total score during post-acute care (Block 4) explained a significant proportion of variance only at the 3-month follow-up. CONCLUSIONS: This study confirms that chronic poor sleep is common among older adults during post-acute rehabilitation and resolution of sleep disturbance after acute health events may be a lengthy process. Our findings expand understanding of the role of depressive symptoms and preexisting sleep complaints in predicting poor sleep over time among these vulnerable older adults.
OBJECTIVES: To explore the unique impact of poor sleep and symptoms of depression on sleep quality for up to 1 year after inpatient post-acute rehabilitation among older adults. DESIGN: Prospective longitudinal cohort study. SETTING: Two inpatient post-acute rehabilitation facilities. PARTICIPANTS: A total of 245 individuals older than 65 years (mean age = 80 years, 38% women). INTERVENTIONS: None. MEASUREMENTS: Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) during the post-acute care stay twice to evaluate pre-illness sleep quality and sleep quality during the post-acute care stay, and again at 3-, 6-, 9-, and 12-month follow-up. Demographics, symptoms of depression, cognitive functioning, and comorbidities were also assessed. RESULTS: Across time points, sleep was significantly disturbed for many individuals. Nested regression models predicting PSQI total score at 3, 6, 9, and 12 months showed that variables entered in Block 1 (age, gender, cognitive functioning, and comorbidities) were significant predictors of poor sleep at 6-month follow-up but not at 3-, 9-, or 12-month follow-up. Depression (Block 2) and pre-illness PSQI total score (Block 3) were significant predictors of PSQI total score at all follow-up time points. PSQI total score during post-acute care (Block 4) explained a significant proportion of variance only at the 3-month follow-up. CONCLUSIONS: This study confirms that chronic poor sleep is common among older adults during post-acute rehabilitation and resolution of sleep disturbance after acute health events may be a lengthy process. Our findings expand understanding of the role of depressive symptoms and preexisting sleep complaints in predicting poor sleep over time among these vulnerable older adults.
Authors: M D Miller; C F Paradis; P R Houck; S Mazumdar; J A Stack; A H Rifai; B Mulsant; C F Reynolds Journal: Psychiatry Res Date: 1992-03 Impact factor: 3.222
Authors: A M Kramer; J F Steiner; R E Schlenker; T B Eilertsen; C A Hrincevich; D A Tropea; L A Ahmad; D G Eckhoff Journal: JAMA Date: 1997-02-05 Impact factor: 56.272
Authors: S I Barbar; P L Enright; P Boyle; D Foley; D S Sharp; H Petrovitch; S F Quan Journal: J Gerontol A Biol Sci Med Sci Date: 2000-07 Impact factor: 6.053
Authors: Sara Morghen; Giuseppe Bellelli; Sara Manuele; Fabio Guerini; Giovanni B Frisoni; Marco Trabucchi Journal: Int J Geriatr Psychiatry Date: 2010-11-09 Impact factor: 3.485