engleski

Predictors of sleep quality in older adults in Zagreb

The changes in sleep-wake process over the lifespan are well established. Epidemiological data show that 50-65% of older adults report impaired sleep quality (SQ). This impairment can rather be attributed to health status and various psychosocial factors than to the aging process per se. The results of our previous study showed the expectedly impaired SQ in nursing home residents, best predicted by self-perceived health and functional ability. The aims of the current study were to examine SQ of older adults living in different arrangements and to examine factors contributing to their SQ. Participants were 334 older adults (73% females) from Zagreb. Half were the NH residents and half OH residents. Their dominant age was 78 years, varying between 69 and 100 years. All were ambulatory, without diagnosis of dementia. Trained interviewers collected data individually, through structured interviews in nursing homes and in gerontology centre. Questionnaire comprised of general questions, questions to assess self-perceived health and standardized scales to measure social participation, functional ability, life satisfaction, and SQ. SQ was assessed by the Pittsburgh Sleep Quality Index (PSQI). Our results showed PSQI score greater than 5, indicating poor SQ in 60% of older adults. In NH residents the percentage was higher than in OH residents (71% vs. 50%, p < .001). Selected set of predictors explained small but significant proportion of variance in PSQI score and 7 domains. Predictors explained the highest proportion of variance in the use of sleep medication (22.6%) and subjective SQ (21%). Expectedly, women had poorer total PSQI, longer sleep latency and used more sleep medication than men. Older age significantly predicted only the use of sleep medication, as was expected within this age range. Living in NH predicted worse PSQI, shorter sleep duration, less sleep efficiency, more use of sleep medication and poorer daytime functioning. Greater life satisfaction predicted better total PSQI, higher subjective SQ, longer sleep duration, shorter sleep latency, less sleep disturbances and less use of sleep medication. Poorer self-perceived health predicted poorer PSQI, worse subjective SQ, more sleep disturbances and more use of sleep medication while better functional ability predicted shorter sleep latency and better daytime functioning. Separate predictors’ analyses of NH and OH older adults are called for to enable tailoring preventive strategies according to specific needs. Contribution of psychosocial factors in SQ prediction in older age points to the necessity of investment in sleep hygiene education and psychosocial support, especially to NH residents.

sleep ; PSQI ; functional ability ; life satisfaction ; older adults ; self-perceived health

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