Sleep quality in residents of assisted living facilities: effect on quality of life, functional status, and depression.
OBJECTIVE
To describe sleep patterns in older adults living in assisted living facilities (ALFs) and to explore the relationship between sleep disturbance and quality of life, functional status, and depression over 6 months of follow-up.


METHODS
Prospective, observational cohort study.


METHODS
Eighteen ALFs in the Los Angeles area.


METHODS
One hundred twenty-one ALF residents aged 65 and older (mean age 85.3, 86% female, 88% non-Hispanic white).


METHODS
Data were collected at baseline and 3 and 6 months after enrollment. Data collected were demographics, physical and cognitive functioning, depression, quality of life, comorbidities, medications, and subjective (i.e., questionnaires) and objective (i.e., 3 days and nights of wrist actigraphy) measures of sleep.


RESULTS
Sixty-five percent of participants reported clinically significant sleep disturbance on the Pittsburgh Sleep Quality Index, and objective wrist actigraphy confirmed poor sleep quality. In regression analyses including sleep variables and other predictors, more self-reported sleep disturbance at baseline was associated with worse health-related quality of life (Medical Outcomes Study 12-item Short Form Survey Mental Component Summary score) and worse depressive symptoms five-item Geriatric Depression Scale at follow-up. Worse nighttime sleep (according to actigraphy) at baseline was associated with worse activities of daily living functioning and more depressive symptoms at follow-up.


CONCLUSIONS
Sleep disturbance is common in older ALF residents, and poor sleep is associated with declining functional status and quality of life and greater depression over 6 months of follow-up. Studies are needed to determine whether improving sleep in ALF residents will result in improvements in these outcomes. Well-established treatments should be adapted for use in ALFs and systematically evaluated in future research.
Martin
Jennifer L
JL
David Geffen School of Medicine and Cousin's Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California, USA. Jennifer.martin@va.gov
Fiorentino
Lavinia
L
Jouldjian
Stella
S
Josephson
Karen R
KR
Alessi
Cathy A
CA
D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D003071:Cognition; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012890:Sleep / Q000502:physiology*