title: Factors associated with insomnia in older people with a mild to moderate degree of poor cognitive ability in Thailand.
abstract: OBJECTIVE
  To examine the prevalence and risk factors of insomnia among older adults with a mild to moderate degree of poor cognitive ability.
  
  
  METHODS
  A total of 18,634 people aged 60 years old or more who had been included in a multistage National Health Examination survey III (NHES III), 4138 of whom had a mild to moderate degree of poor cognitive ability, were identified. Prevalence and associated factors of self-reported insomnia and daytime tiredness due to inadequate sleep (DTIS) were analyzed.
  
  
  RESULTS
  The prevalence of older people with a mild to moderate degree of poor cognitive ability was 22.2%. The prevalence of insomnia and DTIS among older people with poor cognitive ability was 63.7% and 53.2%, respectively. The independent factors associated with insomnia within this particular group were: female sex, aged of 80 years or more, no formal education, financially poor, poor self-care, joint pain, feeling depressed, and poor self-perceived health. The odds of insomnia increased with increased severity of self-perceived health. Interestingly, nearly all independent factors associated with insomnia were also significantly associated with DTIS, and with both conditions combined.
  
  
  CONCLUSIONS
  Modifiable risk factors, such as depressive symptom, poor health status and joint pain, should be managed to primarily prevent the occurrence of insomnia in older people with poor cognitive ability.
authors.affiliation: Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Prasert
authors.initials: P
authors.lastname: Assantachai
authors.forename: Wichai
authors.initials: W
authors.lastname: Aekplakorn
authors.forename: Junya
authors.initials: J
authors.lastname: Pattara-Archachai
authors.forename: Yawarat
authors.initials: Y
authors.lastname: Porapakkham
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology