The association between subjectively impaired sleep and symptoms of depression and anxiety in a frail elderly population.

Abstract

Most previous studies showed an association between sleep impairment in the elderly and symptoms of depression and anxiety. Majority of these studies were conducted in "strong", community-dwelling elderly. To assess the association between subjective sleep impairment and its affective disturbances among frail elderly patients. The retrospective study included patients 65years old and above. Data included socio-demographic characteristics, the mini-mental state examination, the short anxiety screening test, the 15-item Geriatric Depression Scale, and the Patient Health Questionnaire. The patients were asked about sleep complaints. The study population consisted of 496 patients. The mean age was 83.7 ± 6.2 years, and only 7 (1.4%) did not report any sleep disturbance. After adjustment, depression symptoms were associated only with decreased overall sleep satisfaction (OR 2.62, 95% CI 1.18-5.81), while anxiety symptoms were associated with decreased overall sleep satisfaction (OR 3.17, 96% CI 1.71-5.88), difficulty falling asleep (OR 3.58, 95% CI 1.96-6.52), waking up during the night (OR 3.16, 95% CI 1.63-6.1), morning weakness (OR 2.68, 95% CI 1.44-5.0) and daytime drowsiness (OR 2.39, 95% CI 1.21-4.69). Sleep impairment is very prevalent among frail elderly and associated much more with anxiety than with depression. The findings of the present study provide further evidence for the importance in taking a detailed history of sleep habits during the course of the geriatric assessment in frail elderly patients.