0850 Association of Actigraphy-Assessed Sleep Parameters and Physical Functioning following Acute Hospitalization in Older Adults

Abstract

Abstract Introduction Three out of 10 older adults are admitted for acute care in U.S. hospitals where they are at risk for a rapid decline in physical function due to deconditioning. Identifying factors, such as sleep continuity, that may be related to recovery of physical functioning is a key step in facilitating independence following hospital discharge. Thus, this study aimed to examine the association between actigraphy-assessed sleep parameters and physical functioning after an acute hospitalization in community dwelling older adults. Methods Participants (n=24; age 68.9±5.5y, 71% female, 96% white), were recruited during an acute hospitalization. Participants completed physical performance testing using the Short Physical Performance Battery (SPPB) during acute hospitalization (baseline) and at 4-weeks post-discharge (follow-up). At the time of discharge, participants were given Philips Actiwatch-2® device to record sleep continuity for four weeks following hospital discharge. Actigraphy parameters included total sleep time (TST), sleep efficiency (SE), sleep onset latency (SOL) and wake after sleep onset (WASO). We conducted multivariate regression analyses using Poisson distribution to determine whether actigraphy-derived sleep parameters predicted of physical function. Results Increase in actigraphy-derived SE was associated with greater SPPB Balance (0.05±0.02, p=0.04) at the 4-week follow-up assessment. Increased TST was associated with improvements in SPPB total score (0.004±0.002, p=0.05) change score from baseline to 4-week follow-up. SE (0.11±0.04, p=0.01) and TST (0.004±0.002, p=0.005) were positively associated, whereas WASO (0.03±0.01, p=0.05) and SOL (0.15±0.07, p=0.03) were inversely associated with improvement in SPPB Balance change score from baseline to 4-week follow-up. Conclusion Together, these results demonstrated that improvements in actigraphy-derived sleep parameters (increased sleep efficiency and total sleep time; and decreased wake after sleep onset and sleep onset latency) were associated with improvements in physical functioning from hospital to 4-week follow up. Improving sleep during hospitalization may reduce hospital deconditioning and improve functional recovery. Support (if any) This work is supported by NIH Grant #s R01NR018342 (PI: Nowakowski), P30AG024832, UTMB Pepper OAIC, (PI: Volpi), UL1TR001439, (UTMB ITS); and the National Dairy Council (1229, PI: Volpi) Additional support was provided by the Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413).