Recognizing elderly women with sleep problems and falls from information on comorbidites and medications in a continuous use
DOI:
https://doi.org/10.14738/assrj.69.7051Abstract
Geriatric syndromes represent new, comprehensive concepts, which can help identifying vulnerable elderly people with multimorbidity. There is also a problem in using the result in a general practice working environment. We suggest fast audit as a method for conducting research on a small scale. The aim of this study was to find out the specific characteristics that can be used for a fast recognition of elderly women who have sleep problems and are susceptible to falls. We conducted a survey on a sample of 105 elderly women (age range 60-80 years, average 68.7±5.1 SD), in a general practice setting, in the town of Osijek, eastern Croatia. The sleep disturbance was identified using the standard Pittsburgh Sleep Quality Index, while information on falls were taken from electronic health records (eHRs) and patient interviews. We used a multi-item questionnaire for socio-demographic characteristics and lifestyle habits. EHRs were used to diagnose problems associated with sleep disturbances and falls, as well as for the use of medication that affect mental functions. We found out that 74.2% of examined women had sleep problems, and 25.7% of them experienced falls in the past two years. Diagnoses that distinguished women with and those without sleep problems included dyspepsia and urinary tract infections (50% vs. 23.1%). Women with sleep problems, compared to those without them, more commonly used two or more medications, usually antidepressants, analgesics and anxiolytics. Lower back pain and osteoporosis were used as screening tools for women susceptible to falls, compared to women without reports of falling. (81.5% vs 61.5% and 22.2% vs. 5.1%). Women with falls had a higher degree of overlapping with sleep disorders (81.5%). Anxiolytics application could be a link between sleep disorders and falls (the overlapping ratio 68%).
References
Berg,W.P. (1997). Circumstances and consequences of falls in independent community-dwelling older adults. Age Ageing, 26(4), 261-268.
Buffa, R., Floris, G.U., Putzu, P. F., Marini, E. (2011). Body composition variations in ageing. Coll Antropol, 35, 25965.
Buxton, O.M., Cain, S.W., O`Connor, S.P., Porter, J.H., Duffy, J.F., Wamg, W., et al. (2012). Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption. Science translation medicine, 4, 129ra43.
Cappucio, F.P., Cooper, D., Delia, L., Strazzullo, P., Miller, M.A. (2011). Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analsis of prospective studies. Eur Heart J, 32, 1484-1492.
Cappucio, F.P., D`Elia L., Strazzullo, P., Miller, M.A. (2010). Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep, 33, 585-592.
Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F., et al. (2010). Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age and ageing, 39, 412-423.
Itani, O., Jike, M., Watanabe, N., Kaneita, Y. (2016). Short sleep duration and health outcomes: a systematic review, meta-analysis and meta-regression. Sleep Medicine, http://dx.doi.org/doi/10.1016/j.sleep.2016.08.006
Kaplan, G.A., Seeman, T.E., Cohen, R.D., Knudsen, L.P., Guralnik, J. (1987). Mortality among the elderly in the Alameda County Study: behavioural and demographic risk factors. Am J Public Health, 77, 307-312.
Koyanagi, A., Garin, N., Olaya, B., Ayuso-Mateos, J.L., Chatterji, S., Leonardi, M., et al. (2014). Chronic conditions and sleep problems among adults aged 50 years or over in nine countries: a multi-country study. PLOS ONE, published online 5 December 2014. http://doi.org/10.1371/journal-pone.0114742
Laird, R.D. (2001). Fall history is an independent predictor of adverse health outcomes and utilization in the elderly. Am J Manag Care, 7(12), 1133-1138.
Leipzig, R.M., Cumming, R.G., Tinetti, M.E. (1999). Drugs and falls in older people: a systematic review and metaanalysis: I. Psychotropic drugs. J Am Geriatr Soc, 47(1), 30-39.
Liu-Ambrose, T. (2009). Dual-task gait performance among community-dwelling senior women: the role of balance confidence and executive functions. J Gerontol A Biol Sci Med Sci, 64(9), 975-982.
Lord, S.R., Smith, S.T., Menant, J.C. (2010). Vision and falls in older people: risk factors and intervention strategies. Clin Geriatr Med, 26(4), 569-581.
Masud, T., Morris R.O. (2001). Epidemiology of falls. Age Ageing, 30(4), 3-7.
Miner, B., Kryger, M.H. (2016). Sleep in the aging population. Sleep Med Clin. http://dx.doi.org/10.1016/j.jsms.2016.10.008
Montero-Odasso, M. (2009). Dual-tasking and gait in people with mild cognitive impairment. The effect of working memory. BMC Geriatr, 9, 41.
Onder, G., Palmer, K., Navickas, R., Jurevičiene, E., Mammarella, F., Strandzheva M., et al. (2015). Time to face the challenge of multimorbidity. A European perspective from the joint action on chronic diseases and promoting healthy aging across the life cycle (JA-CHRODIS). Eur J Intern Med, 26, 157-159.
Rubenstein, L.Z. (2006). Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 35(2), ii37-ii41.
Salive, M.E. (2013). Multimorbidity in older adult, Epidemiol Rev, 35, 75-83.
Shan, Z., Ma, H., Xie, M., Yan, P., Guo, Y., Bao, W., et al. (2015). Sleep duration and risk of type 2 diabetes: a metaanalysis of prospective studies. Diabetes care, 38, 529-537.
Sheridan, P.L., Hausdorff, J.M. (2007). The role of higher-level cognitive function in gait: executive dysfunction contributes to fall risk in Alzheimer's disease. Dement Geriatr Cogn Disord, 24(2), 125-137.
Silva, G.E., Goodwin, J.L., Sherrill, D.L., Arnold, J.L., Bootzin, R.R., Smith T., et al. (2007). Relationship between reported and measured sleep times: the sleep heart health study (SHHS). JCSM, 3, 22-30.
Spiegel, K., Tasali, E., Leproult, R., van Cauter, E. (2009). Effects of poor and short sleep on glucose metabolism and obesity risk. Nat Rev Endocrinol, 5, 253-261. http://doi.org./10.1038/nrendo.2009.23
Thomas, K.M., Redd, L.A., Wright, J.D., Hartos, J.L. (2017). Sleep and mental health in the general population of elderly women. J Primary Prevent, published online 26 July 2017. http://doi.org/10.1007/s10935-017-0484-5
Tinetti, M.E. (1994). A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med, 331(13), 821-827.
Tinetti, M.E., Speechley, M., Ginter, S.F. (1988). Risk factors for falls among elderly persons living in the community. New England, Journal of Medicine, 319, 1701-1707.
Tromp, A.M. (2001). Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol, 54(8), 837-844.
van Iersel, M.B. (2008). Executive functions are associated with gait and balance in community living elderly people. J Gerontol A Biol Sci Med Sci, 63(12), 1344-1349.
van Schoor, N.M. (2002). Different cognitive functions in relation to falls among older persons. Immediate memory as an independent risk factor for falls. J Clin Epidemiol, 55(9), 85562.
Vellas, B.J. (1997). Fear of falling and restriction of mobility in elderly fallers. Age Ageing, 26(3), 189-193.
Wang, Y., Mei, H., Jiang, Y.R., Sun, W.Q., Song, Y.J., Liu, S.J., et al. (2015). Relationship between duration of sleep and hypertension in adults: a meta-analyis. JCSM, 11, 1047-1056.
Winkelman, J.W. (2015). Insomnia disorder. N Engl J Med, 373, 1437-1444. http://doi.org./10.1056/NEJMcp14122740
Wood, B.H. (2002). Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry, 72(6), 721-725.
Yardley, L., Smith, H. (2002). A prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people. Gerontologist, 42(1), 17-23.
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