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J Am Geriatr Soc. 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.

Collaborators (151)

Pahor M, Guralnik JM, Leeuwenburgh C, Caudle C, Crump L, Holmes L, Lee J, Lester R, Lu CJ, O'Mara R, Miller ME, Espeland MA, Ambrosius WT, Applegate W, Babcock D, Beavers DP, Byington RP, Cook D, Furberg CD, Griffin J, Harvin LN, Henkin L, Hepler J, Hsu FC, Lovato L, Roberson W, Rushing J, Rushing S, Stowe CL, Walkup MP, Hire D, Rejeski W, Katula JA, Brubaker PH, Mihalko SL, Jennings JM, Hadley EC, Romashkan S, Bonds DE, Patel KV, McDermott MM, Spring B, Hauser J, Kerwin D, Domanchuk K, Graff R, Rego A, Church TS, Blair SN, Myers VH, Monce R, Britt NE, Harris MN, McGucken AP, Rodarte R, Millet HK, Tudor-Locke C, Butitta BP, Donatto SG, Cocreham SH, King AC, Castro CM, Haskell WL, Stafford RS, Pruitt LA, Berra K, Yank V, Fielding RA, Nelson ME, Folta SC, Phillips EM, Liu CK, McDavitt EC, Reid KF, Kim WS, Beard VE, Manini TM, Anton SD, Nayfield S, Buford TW, Marsiske M, Sandesara BD, Knaggs JD, Lorow MS, Marena WC, Korytov I, Morris HL, Fitch M, Singletary FF, Causer J, Radcliff KA, Newman AB, Studenski SA, Goodpaster BH, Glynn NW, Lopez O, Nadkarni NK, Williams K, Newman MA, Grove G, Bonk JT, Rush J, Kost P, Ives DG, Kritchevsky SB, Marsh AP, Brinkley TE, Demons JS, Sink KM, Kennedy K, Shertzer-Skinner R, Wrights A, Fries R, Barr D, Gill TM, Axtell RS, Kashaf SS, de Rekeneire N, McGloin JM, Wu KC, Iannone LP, Mautner R, Shepard DM, Fennelly B, Barnett TS, Halpin SN, Brennan MJ, Bugaj JA, Zenoni MA, Mignosa BM, Williamson J, Sink KM, Hendrie HC, Rapp SR, Verghese J, Woolard N, Espeland M, Jennings J, Pepine CJ, Ariet M, Handberg E, Deluca D, Hill J, Szady A, Chupp GL, Flynn GM, Gill TM, Hankinson JL, VazFragoso CA, Groessl EJ, Kaplan RM.

Author information

1
Clinical Epidemiology Research Center, Veterans Affairs Connecticut, West Haven, Connecticut; Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.

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

PMID:
24889836
PMCID:
PMC4057978
DOI:
10.1111/jgs.12845
[Indexed for MEDLINE]
Free PMC Article

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