Song Yeonsu, Dzierzewski Joseph M, Fung Constance H, Rodriguez Juan C, Jouldjian Stella, Mitchell Michael N, Josephson Karen R, Alessi Cathy A, Martin Jennifer L
Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
J Am Geriatr Soc. 2015 Aug;63(8):1622-7. doi: 10.1111/jgs.13527. Epub 2015 Jul 22.
To examine whether sleep disturbance is associated with poor physical function in older veterans in an adult day healthcare (ADHC) program.
Cross-sectional.
One ADHC program in a Veterans Affairs Ambulatory Care Center.
Older veterans (N = 50) enrolled in a randomized controlled trial of a sleep intervention program who had complete baseline data.
Information on participant characteristics (e.g., age, depression, relationship to caregiver, pain, comorbidity) was collected using appropriate questionnaires. Physical function was measured using activity of daily living (ADL) and instrumental ADL (IADL) total scores from the Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire. Sleep was assessed subjectively (Pittsburgh Sleep Quality Index, Insomnia Severity Index) and objectively (wrist actigraphy).
Participants required substantial assistance with ADLs and IADLs. A regression model showed that participant characteristics (marital status, use of sleep medication, comorbidity, posttraumatic stress disorder) and living arrangement (living with a spouse or others) were significantly associated with poor physical function. Poorer objective sleep (total sleep time, total numbers of awakenings, total wake time) was significantly associated with poor physical function, accounting for a significant proportion of the variance other than participant characteristics.
Objective measures of nighttime sleep disturbance were associated with poor physical function in older veterans in an ADHC program. Further research is needed to determine whether interventions to improve sleep will delay functional decline in this vulnerable population.
探讨在成人日间保健（ADHC）项目中，睡眠障碍是否与老年退伍军人身体功能不佳相关。
横断面研究。
一家退伍军人事务门诊护理中心的一个ADHC项目。
参与一项睡眠干预项目随机对照试验且有完整基线数据的老年退伍军人（N = 50）。
使用适当问卷收集参与者特征信息（如年龄、抑郁、与照料者的关系、疼痛、合并症）。身体功能通过美国老年人资源与服务多维功能评估问卷中的日常生活活动（ADL）和工具性ADL（IADL）总分来测量。睡眠通过主观评估（匹兹堡睡眠质量指数、失眠严重程度指数）和客观评估（手腕活动记录仪）进行评估。
参与者在ADL和IADL方面需要大量帮助。回归模型显示，参与者特征（婚姻状况、睡眠药物使用、合并症、创伤后应激障碍）和生活安排（与配偶或他人同住）与身体功能不佳显著相关。较差的客观睡眠（总睡眠时间、总觉醒次数、总清醒时间）与身体功能不佳显著相关，在参与者特征之外的变异中占很大比例。
在ADHC项目中，夜间睡眠障碍的客观测量指标与老年退伍军人身体功能不佳相关。需要进一步研究以确定改善睡眠的干预措施是否会延缓这一脆弱人群的功能衰退。
