Does poor sleep quality and excessive daytime sleepiness influence fear of falling among older adults? A cross-sectional study

Poor sleep health predicts the onset of a fear of falling among community-dwelling older adults

INTRODUCTION

A greater fear of falling predicts disability, falls, and mortality among older adults. Although poor sleep has been identified as a relevant risk factor for fear of falling among older adults, evidence is primarily shown in cross-sectional studies using isolated sleep characteristics. Less is known about whether prior fall experiences change the sleep health-fear of falling link among older adults. We investigated the longitudinal relationship between sleep health and the incidence of fear of falling among community-dwelling older adults and how the association differed between those with or without prior fall experiences.

METHODS

Data were from individuals who completed the sleep module in the National Health and Aging Trends Study (2013-2014; n = 686). Fear of falling was assessed with a single item. Multidimensional sleep health was measured with self-reported sleep items based on the SATED model (ie, sleep satisfaction, daytime alertness, timing, efficiency, and duration). Covariates included sociodemographics, assistive device usage, health, risky behavior, and sleep medications. Multiple logistic regression was used to analyze the data.

RESULTS

Poor sleep health was associated with the onset of fear of falling at 1-year follow-up (odds ratios=1.20, 95% confidence interval=1.02-1.41). Moreover, poor sleep health increased the odds of having fear of falling among individuals without prior falls experiences and elevated the already heightened risks of developing fear of falling among those who fell at baseline.

CONCLUSIONS

Given that fear of falling and experiencing a fall each increase the risk of the other occurring in the future, improving sleep health may prevent older adults from stepping into the vicious cycle of fear of falling and falls.

Sleep Quality Predicts Functional Disability in Older Adults with Low Back Pain: A Longitudinal Study

Low back pain (LBP) and sleep quality are two very prevalent complaints in the older population. However, little is known about the prognostic relationship between sleep quality and disability in older adults with LBP. The aim of this study was to examine the association between sleep quality and disability in older adults with LBP. This was a longitudinal study over a 6-month period. Older adults with LBP in the last 12 weeks and who had preserved cognitive functions were recruited. The questionnaires used were the Pittsburgh Sleep Quality Index and the Roland Morris Disability Questionnaire. At baseline, we collected information on demographic/anthropometric variables, cognitive status, depression, daytime sleepiness, and comorbidities. Linear regression adjusted for potential covariates were performed. Poor sleep at baseline predicted higher disability after 6 months [β = 0.30 (CI95%:0.07 to 0.55)]. Our results support the existence of an important relationship between sleep and disability in older adults with LBP.