TY - JOUR
T1 - Objectively measured sleep and physical function
T2 - Associations in low-income older adults with disabilities
AU - Okoye, Safiyyah M.
AU - Szanton, Sarah L.
AU - Perrin, Nancy A.
AU - Nkimbeng, Manka
AU - Schrack, Jennifer A.
AU - Han, Hae Ra
AU - Nyhuis, Casandra
AU - Wanigatunga, Sarah
AU - Spira, Adam P.
N1 - Funding Information:
Support for Dr Okoye was supported by the Robert Wood Johnson Foundation Future of Nursing Scholars program. Support for Dr Nkimbeng was provided by the Robert Wood Johnson Foundation Health Policy Research Scholar program. This work was supported by the National Institutes of Health ( P30 NR014131 ; T32 AG000247 to S.M.O; R01 AG040100 to S.L.S; R01 AG061786 and U01 AG057545 to J.A.S; R01 AG062649 and UL1 TR003098 to H.H; and R01 AG050507 , RF1 AG050745 , U01 AG052445 , and R01 AG049872 to A.P.S). The work described herein does not necessarily represent the official views of the National Institutes of Health or its Institutes.
Publisher Copyright:
© 2021 National Sleep Foundation
PY - 2021/12
Y1 - 2021/12
N2 - Objective: Late-life sleep health has been tied to physical function, but little is known about these associations among socially disadvantaged populations. Design: We determined cross-sectional associations of sleep with physical function in low-income, predominantly Black older adults with disabilities. Participants: One hundred thirty-six older adults (mean age 76.0 years, 83.8% women, 82.4% Black). Measurements: Primary predictors were actigraphic total sleep time (TST), wake after sleep onset (WASO), and subjective sleep complaints. Outcomes were objective physical performance (Short Physical Performance Battery (SPPB)) and participant-reported difficulties in basic and instrumental activities of daily living (ADLs and IADLs). Results: In regression models adjusted for potential confounders, both longer TST and greater WASO were associated with lower SPPB scores and increased IADL difficulty. Participants with a mean TST in the longest (>7.5 hours) vs. intermediate (6.3-7.5 hours) tertile had 27% higher odds of additional IADL difficulty (incident rate ratio = 1.27, 95% confidence interval [CI] 1.03, 1.58). Each additional 10 minutes of WASO was associated with 0.13 point lower SPPB scores (B = −0.13, 95% CI −0.25, −0.01) and increased IADL difficulty (B = 0.02, 95% CI 0.0003, 0.04). Sex moderated the associations of WASO with IADL and ADL difficulties: associations were stronger for males. Subjective sleep complaints were not statistically significantly associated with function. Conclusions: Among disabled, low-income, mostly Black older adults, objective measures of long sleep and greater WASO are associated with poorer physical function. Effect sizes for the associations were modest; however, findings may have important implications given the significant consequences of decreased function on quality of life and caregiving demands.
AB - Objective: Late-life sleep health has been tied to physical function, but little is known about these associations among socially disadvantaged populations. Design: We determined cross-sectional associations of sleep with physical function in low-income, predominantly Black older adults with disabilities. Participants: One hundred thirty-six older adults (mean age 76.0 years, 83.8% women, 82.4% Black). Measurements: Primary predictors were actigraphic total sleep time (TST), wake after sleep onset (WASO), and subjective sleep complaints. Outcomes were objective physical performance (Short Physical Performance Battery (SPPB)) and participant-reported difficulties in basic and instrumental activities of daily living (ADLs and IADLs). Results: In regression models adjusted for potential confounders, both longer TST and greater WASO were associated with lower SPPB scores and increased IADL difficulty. Participants with a mean TST in the longest (>7.5 hours) vs. intermediate (6.3-7.5 hours) tertile had 27% higher odds of additional IADL difficulty (incident rate ratio = 1.27, 95% confidence interval [CI] 1.03, 1.58). Each additional 10 minutes of WASO was associated with 0.13 point lower SPPB scores (B = −0.13, 95% CI −0.25, −0.01) and increased IADL difficulty (B = 0.02, 95% CI 0.0003, 0.04). Sex moderated the associations of WASO with IADL and ADL difficulties: associations were stronger for males. Subjective sleep complaints were not statistically significantly associated with function. Conclusions: Among disabled, low-income, mostly Black older adults, objective measures of long sleep and greater WASO are associated with poorer physical function. Effect sizes for the associations were modest; however, findings may have important implications given the significant consequences of decreased function on quality of life and caregiving demands.
KW - African American
KW - Sleep
KW - actigraphy
KW - disability
KW - older adults
KW - physical performance
UR - http://www.scopus.com/inward/record.url?scp=85120466161&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85120466161&partnerID=8YFLogxK
U2 - 10.1016/j.sleh.2021.09.001
DO - 10.1016/j.sleh.2021.09.001
M3 - Article
C2 - 34602384
AN - SCOPUS:85120466161
SN - 2352-7218
VL - 7
SP - 735
EP - 741
JO - Sleep Health
JF - Sleep Health
IS - 6
ER -