title: Functional outcomes of excessive daytime sleepiness in older adults.
abstract: OBJECTIVE
  To describe the effect of self-reported excessive daytime sleepiness (EDS) on functional outcomes.
  
  
  METHODS
  Case-control study designed to examine differences in functional status between cases (with daytime sleepiness) and controls (no daytime sleepiness) with regard to demographic factors, general health, sleep history, and medications.
  
  
  METHODS
  Retirement communities in southeastern Pennsylvania, Delaware, and New Jersey.
  
  
  METHODS
  Seventy-six nondepressed, nondemented adults, aged 65 and older, were cases (had daytime sleepiness) and 38 were controls (had no daytime sleepiness).
  
  
  METHODS
  Standardized questionnaires to assess disease-specific functional status (Functional Outcomes of Sleepiness Questionnaire (FOSQ) and Epworth Sleepiness Scale (ESS)), depression (Geriatric Depression Scale-Short Form and the Center for Epidemiologic Studies-Depression Scale), dementia (Short Blessed Test), demographic factors, current medical history, and sleep complaints.
  
  
  RESULTS
  There was a significant difference in functional status between sleepy cases and nonsleepy controls. Sleepiness had a moderate to large negative effect (effect size range from 0.59 to 0.83, P <.005) on the following functional domains of the FOSQ: social outcome, general productivity, vigilance, activity level, and global assessment of functional status. Correlation between ESS and FOSQ subscales were -0.31 to -0.67, P <.05. Examination of cases with daytime sleepiness revealed increased functional impairment in individuals with more than three medical conditions or those taking more than four medications (P <.001 and P =.03, respectively).
  
  
  CONCLUSIONS
  Daytime sleepiness is associated with functional impairments in a broad range of activities. The decrease in daily functioning noted in the sleepy subjects has implications for deconditioning and related comorbidity. These findings suggest that exploration of daytime sleepiness should be part of the ongoing assessment of the elderly, particularly those with multiple medical conditions.
authors.affiliation: Division of Geriatric Medicine, School of Medicine, University of Pennsylvania, Philadelphia, USA. ngoonera@mail.med.upenn.edu
authors.forename: Nalaka S
authors.initials: NS
authors.lastname: Gooneratne
authors.forename: Terri E
authors.initials: TE
authors.lastname: Weaver
authors.forename: Jacqueline R
authors.initials: JR
authors.lastname: Cater
authors.forename: Frances M
authors.initials: FM
authors.lastname: Pack
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Arner
authors.forename: Andra S
authors.initials: AS
authors.lastname: Greenberg
authors.forename: Allan I
authors.initials: AI
authors.lastname: Pack
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology