title: Sleep quality in residents of assisted living facilities: effect on quality of life, functional status, and depression.
abstract: 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.
authors: 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
authors: Jennifer L
authors: JL
authors: Martin
authors: Lavinia
authors: L
authors: Fiorentino
authors: Stella
authors: S
authors: Jouldjian
authors: Karen R
authors: KR
authors: Josephson
authors: Cathy A
authors: CA
authors: Alessi
mesh_terms: 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*