title: Bodily pain, social support, depression symptoms and stroke history are independently associated with sleep disturbance among the elderly: a cross-sectional analysis of the Fujiwara-kyo study.
abstract: OBJECTIVE
  To investigate independent effects of various factors associated with sleep disturbance among community-dwelling elderly individuals.
  
  
  METHODS
  We analyzed data obtained from 3732 individuals aged ≥65 years who responded to a self-administered questionnaire and participated in a structured interview which assessed the Pittsburgh Sleep Quality Index (PSQI), subjective bodily pain, the Jichi Medical School Social Support Scale, the Geriatric Depression Scale (GDS-15), health status, and demographic characteristics. Sleep disturbance was defined as a global PSQI score >5.5, which was used as a dependent variable in multiple logistic regression analysis to determine adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) of related factors.
  
  
  RESULTS
  We identified a significant increase in the adjusted ORs for female (OR 1.56, 95 % CI 1.34-1.83), age ≥80 years (1.31, 1.01-1.69), history of stroke (1.44, 1.08-1.92), and a GDS-15 score ≥6 as compared to 0-2 (2.29, 1.86-2.81), with regard to sleep disturbance. Participants with severe or very severe bodily pain had the highest adjusted OR (3.00, 2.15-4.19), and those with very mild bodily pain also had a relatively high OR (1.30, 1.06-1.60), relative to those without subjective bodily pain. In addition, compared with participants with strong social support from spouse or family, those with weak social support had significantly increased adjusted ORs (1.21, 1.01-1.44, 1.44, 1.23-1.70, respectively).
  
  
  CONCLUSIONS
  The present study indicates that sleeping disturbances among the elderly are closely associated with social support from a spouse and family. They are also associated with pain, even at stages in which subjective bodily pain is very mild.
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kishimoto
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Okamoto
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Saeki
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Kimiko
authors.initials: K
authors.lastname: Tomioka
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Obayashi
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Komatsu
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan. knorio@naramed-u.ac.jp.
authors.forename: Norio
authors.initials: N
authors.lastname: Kurumatani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data; D007564:Japan / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology; D012944:Social Support; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology
keywords: Bodily pain; Elderly people; PSQI; Sleep disturbance; Social support