Abstract
Japan’s aging population rate is increasing and healthy life expectancy has decreases by 10 years shorter than average life expectancy. The aim of this study is to determine the relationship among chronic disease, sleep quality, health-related quality of life (HRQOL), and activities of daily living in people over 55 years old who live in the community. Subjects were 161 persons aged 57 to 90 years who were treated with chronic disease in the outpatient department of the A hospital. Exclusion criteria included patients with dementia, cancer and severe heart disease. The survey evaluation questionnaires included the Pittsburgh Sleep Quality Index (PSQI), HRQOL by Short-Form 8 Health Survey (SF-8), and activities of daily living. Variables associated with quality of sleep, HRQOL in univariate analysis with p < 0.05 were entered into multivariate analysis using logistic regression with a stepwise forward selection procedure to determine independent variables and their association with major causes. The logistic regression analysis was done using SPSS software and the post-hoc power of the study was estimated using G*power. The level of significance was set at p < 0.05. The risk factor of poor sleep quality was because of history of cancer [odds ratio (OR): 3.53, 95% confidence interval (CI): 1.06 - 11.77], and insomnia (OR: 3.25, 95% CI: 1.55 - 6.79). The risk factors of poor physical HRQOL were motor disease (OR: 2.62, 95% CI: 1.36 - 5.07), respiratory disease (OR: 3.24, 95% CI: 1.27 - 8.26) and having pain (OR: 11.71, 95% CI: 5.35 - 25.66). In addition, anemia was found to be a risk factor of poor mental HRQOL (OR: 4.87, 95% CI: 1.11 - 21.33). The feeling-for-their-body-age (OR: 0.30, 95% CI: 0.15-0.59) was as “younger than actual age” and advanced the risk factor of poor sleep quality. In addition, feeling-for-their-age (OR: 0.44, 95% CI: 0.21 - 0.92) resulted in reduced risk factor of poor physical HRQOL. The risk factor of poor sleep quality was due to a patient with history of cancer. The factor for good sleep quality and the good factor for physical HRQOL were indications of feeling younger than the actual age.
Highlights
Japan’s aging population rate is increasing [1], and average healthy life expectancy, and male healthy life expectancy are 9.13 years shorter than the average life expectancy; female healthy life expectancy is 12.68 years shorter than average life expectancy [2]
The aim of this study is to determine the relationship among chronic disease, sleep quality, health-related quality of life (HRQOL), and activities of daily living in people over 55 years old who live in the community
The risk factor of poor sleep quality was because of history of cancer [odds ratio (OR): 3.53, 95% confidence interval (CI): 1.06 - 11.77], and insomnia (OR: 3.25, 95% CI: 1.55 - 6.79)
Summary
Japan’s aging population rate is increasing [1], and average healthy life expectancy, and male healthy life expectancy are 9.13 years shorter than the average life expectancy; female healthy life expectancy is 12.68 years shorter than average life expectancy [2]. The sleep quality decreases with age [7] and the following changes occur. That is increase in daytime drowsiness, decrease in sleeping time, difficulty in getting to sleep, nocturnal awakening, sleep fragmentation, decrease in deep sleeps at stage 3 and 4 of non-REM sleep and the acceleration of circadian rhythm of becoming sleepy in the early evening and awakening in the early morning [8] [9]. The symptoms of lack of sleep and insomnia are related to the decrease in operating efficiency [11], the increases in the risks of mental disorders including depression [12], risk of death [13] [14], risk of falling [15] and a decrease in cognitive function [8] [16]. It is determined that short-duration sleep and waking-up in the early morning are related to a strong sense of fatigue [17]
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