Impact of insomnia on self-perceived health in the elderly

To investigate the association between self-perceived health, and sociodemographic and clinical factors in a sample of elderly outpatients in Rio de Janeiro.

Methods

A sample of 345 elderly patients was assessed with an anamnesis, Lawton and Brody’s Scale, Katz Index, Geriatric Depression Scale, Timed Up and Go Test, and Study of Osteoporotic Fracture Index. Logistic regression analyses were performed to investigate the predictors of self-perceived health.

Results

Risk of falls, frailty, functional performance on the Instrumental Activities of Daily Living, insomnia, and familial support were related to self-perceived health. Insomnia was the variable that strongly influenced self-perceived health (OR = 0.47, CI 95%: 0.28–0.80, p = 0.01) in our sample.

Conclusions

The investigation of insomnia in the elderly should be routinely performed in primary care, because of the negative impact it imposes on the health of this population.

self concept; aged; sleep initiation and maintenance disorders

Variable	n	%
Gender
Female	216	66.3
Male	110	33.7
Age (years)
60–69	137	42.0
70–79	125	38.3
≥ 80	64	19.6
Marital status
Married	108	33.1
Single/ Divorced	119	36.5
Widow	99	30.4
Scholarship (year)
< 1	137	42.0
1–8	142	43.6
> 8	47	14.4
Socioeconic status
A	0	0%
B	1	1.2
C	61	18.7
D	197	60.4
E	64	19.6
Social support
Adequate	303	92.9
Inadequate	23	7.1
Familial support
Adequate	302	92.6
Inadequate	24	7.4

Variable	SPH good		SPH bad		p^*

	n	%	n	%
Gender					0.10
Female	74	22.7	142	43.6
Male	48	14.7	62	19.0
Age (years)					0.44
60–69	46	14.1	91	27.9
70–79	49	15.0	76	23.3
≥ 80	27	8.3	37	11.3
Marital status					0.88
Married	39	12.0	69	21.1
Single/ Divorced	44	13.5	75	23.
Widowed	39	12.0	60	18.4
Scholarship (year)					0.51
< 1	51	15.6	75	26.4
1–8	50	15.3	92	28.2
> 8	21	6.4	26	7.9
Socioeconimic status					0.24
A	0	0	0	0
B	3	0.9	1	0.3
C	23	7.1	38	11.6
D	78	23.9	88	36.5
E	18	5.5	46	14.1
Social support					0.24
Adequate	116	35.6	187	57.4
Inadequate	6	1.8	17	5.2
Familial support					0.08
Adequate	117	35.9	185	56.8
Inadequate	5	1.5	19	5.9

Variable	SPH good		SPH bad		p^a

	n	%	n	%
Hypertension					0.85
Yes	105	32.2	174	53.4
No	17	5.2	30	9.2
Diabetes					0.57
Yes	34	10.4	63	19.3
No	88	27.0	141	43.2
Osteoarthritis					0.14
Yes	29	8.9	64	19.6
No	93	28.5	140	42.9
Stroke					0.57
Yes	7	2.1	15	4.6
No	115	35.3	189	-58%
Depression					0.40
Yes	25	7.7	50	15.3
No	97	29.8	154	47.2
Vision*					0.84
Normal	80	25.6	130	41.5
Impaired	38	12.1	65	20.8
Risk of falls**					0.02
Without risk	98	32.1	141	46.3
With risk	17	5.6	49	16.1
Frailty					0.02
Non frail	110	33.7	164	50.3
Frail	12	3.7	40	12.3
Sleep disorder					< 0.01
Yes	32	9.8	93	28.6
No	90	27.6	111	34.1
IADL					0.01
Independent	99	30.4	140	42.9
Dependent	23	7.1	64	19.6
ADL					0.37
Independent	112	34.4	181	55.5
Dependent	10	3.1	23	-7

Variable	B	EP	Wald	df	p	OR	95%CI for OR
IADL	0.45	0.30	2.26	1	0.13	1.56	0.87–2.80
Insomnia	- 0.75	0.27	7.93	1	0.01	0.47	0.28–0.80
Frailty	0.45	0.39	1.32	1	0.25	1.56	0.73–3.35
Risk of falls	0.46	0.33	1.93	1	0.16	1.58	0.83–3.00
Familial support	0.78	0.59	1.72	1	0.19	2.17	0.68–6.90
Constant	0.69	0.25	7.89	1	0.01	2.00

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[1] Correspondence: Janiciene Silva; Centro de Estudo e Pesquisa do Envelhecimento; Av. Padre Leonel Franca, 248; 22451-000 Rio de Janeiro RJ, Brasil; E-mail: janiciene@yahoo.com.br