title: Association Between Sleep and Physical Function in Older Veterans in an Adult Day Healthcare Program.
abstract: OBJECTIVE
  To examine whether sleep disturbance is associated with poor physical function in older veterans in an adult day healthcare (ADHC) program.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  One ADHC program in a Veterans Affairs Ambulatory Care Center.
  
  
  METHODS
  Older veterans (N = 50) enrolled in a randomized controlled trial of a sleep intervention program who had complete baseline data.
  
  
  METHODS
  Information on participant characteristics (e.g., age, depression, relationship to caregiver, pain, comorbidity) was collected using appropriate questionnaires. Physical function was measured using activity of daily living (ADL) and instrumental ADL (IADL) total scores from the Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire. Sleep was assessed subjectively (Pittsburgh Sleep Quality Index, Insomnia Severity Index) and objectively (wrist actigraphy).
  
  
  RESULTS
  Participants required substantial assistance with ADLs and IADLs. A regression model showed that participant characteristics (marital status, use of sleep medication, comorbidity, posttraumatic stress disorder) and living arrangement (living with a spouse or others) were significantly associated with poor physical function. Poorer objective sleep (total sleep time, total numbers of awakenings, total wake time) was significantly associated with poor physical function, accounting for a significant proportion of the variance other than participant characteristics.
  
  
  CONCLUSIONS
  Objective measures of nighttime sleep disturbance were associated with poor physical function in older veterans in an ADHC program. Further research is needed to determine whether interventions to improve sleep will delay functional decline in this vulnerable population.
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Yeonsu
authors.initials: Y
authors.lastname: Song
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Dzierzewski
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors.forename: Constance H
authors.initials: CH
authors.lastname: Fung
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.|Department of Medicine, Pontificia Universidad Catolica, Santiago, Chile.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Rodriguez
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Stella
authors.initials: S
authors.lastname: Jouldjian
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Mitchell
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Karen R
authors.initials: KR
authors.lastname: Josephson
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Alessi
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Martin
mesh_terms: D056044:Actigraphy; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003430:Cross-Sectional Studies; D003631:Day Care, Medical / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D015397:Program Evaluation; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans
keywords: adult day health care; elderly adults; physical function; sleep; veterans