title: Association between insomnia symptoms and functional status in U.S. older adults.
abstract: OBJECTIVE
  We studied the association between insomnia symptoms and late-life functioning, including physical capacity, limitations in household activities, and participation in valued activities.
  
  
  METHODS
  Participants were 6,050 adults independent in self-care activities from a representative sample of older Medicare beneficiaries. They completed objective measures of physical capacity and self-report measures of insomnia symptoms, help and difficulty with household activities, and participation in valued activities.
  
  
  RESULTS
  After adjustment, insomnia symptoms were associated with a greater odds of receiving help or having difficulty with selected household activities (laundry, shopping), greater odds of help or difficulty with ≥ 1 household activity [1 symptom vs. 0, odds ratio (OR)=1.27, p < .05; 2 symptoms vs. 0, OR = 1.35, p < .01), and of restricted participation in specific valued activities (attending religious services, going out for enjoyment) and in ≥ 1 valued activity (1 symptom vs. 0, OR = 1.29, p < .05; 2 symptoms vs. 0, OR = 1.50, p < .01). There was no independent association between insomnia symptoms and physical capacity.
  
  
  CONCLUSIONS
  Among older adults, insomnia symptoms are associated with a greater odds of limitation in household activities and of restricted participation in valued activities. Insomnia interventions may improve functioning and quality of life among elders.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland. aspira@jhsph.edu.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Spira
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Kaufmann
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Judith D
authors.initials: JD
authors.lastname: Kasper
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
authors.forename: Maurice M
authors.initials: MM
authors.lastname: Ohayon
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: George W
authors.initials: GW
authors.lastname: Rebok
authors.affiliation: Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennysylvania.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Skidmore
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: Parisi
authors.affiliation: Department of Psychiatry, University of Pittsburgh Medical Center and Graduate School of Public Health, Pittsburgh, Pennysylvania.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D008297:Male; D009043:Motor Activity; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D057185:Sedentary Behavior; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: Function; Insomnia; Sleep; Valued activities.