title: Poor self-reported sleep quality predicts mortality within one year of inpatient post-acute rehabilitation among older adults.
abstract: OBJECTIVE
  To evaluate the association between self-reported sleep quality among older adults during inpatient post-acute rehabilitation and one-year survival.
  
  
  METHODS
  Prospective, observational cohort study.
  
  
  METHODS
  Two inpatient post-acute rehabilitation sites (one community and one Veterans Administration).
  
  
  METHODS
  Older patients (aged ≥ 65 years, n = 245) admitted for inpatient post-acute rehabilitation.
  
  
  METHODS
  None.
  
  
  RESULTS
  Within one year of post-acute rehabilitation, 57 participants (23%) were deceased. Cox proportional hazards models showed that worse Pittsburgh Sleep Quality Index (PSQI) total scores during the post-acute care stay were associated with increased mortality risk when controlling for amount of rehabilitation therapy received, comorbidities, and cognitive functioning (Hazard ratio [95% CI] = 1.11 [1.02-1.20]). Actigraphically estimated sleep was unrelated to mortality risk.
  
  
  CONCLUSIONS
  Poorer self-reported sleep quality, but not objectively estimated sleep parameters, during post-acute rehabilitation was associated with shorter survival among older adults. This suggests self-reported poor sleep may be an important and potentially modifiable risk factor for negative outcomes in these vulnerable older adults. Studies of interventions to improve sleep quality during inpatient rehabilitation should therefore be undertaken, and the long-term health benefits of improved sleep should be explored.
authors: David Geffen School of Medicine, University of California, Los Angeles, USA.
authors: Jennifer L
authors: JL
authors: Martin
authors: Lavinia
authors: L
authors: Fiorentino
authors: Stella
authors: S
authors: Jouldjian
authors: Michael
authors: M
authors: Mitchell
authors: Karen R
authors: KR
authors: Josephson
authors: Cathy A
authors: CA
authors: Alessi
mesh_terms: D056044:Actigraphy; D000208:Acute Disease / Q000401:mortality / Q000534:rehabilitation*; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000401:mortality*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome