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Predictors of change over time in subjective daytime sleepiness among older adult recipients of long-term services and supports

Published online by Cambridge University Press:  11 June 2020

Darina V. Petrovsky Open the ORCID record for Darina V. Petrovsky [Opens in a new window] ,
Karen B. Hirschman ,
Miranda Varrasse McPhillips ,
Justine S. Sefcik ,
Alexandra L. Hanlon ,
Liming Huang ,
Glenna S. Brewster ,
Nancy A. Hodgson  and
Mary D. Naylor
Darina V. Petrovsky*
Affiliation:
Family and Community Health Department, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
Karen B. Hirschman
Affiliation:
Family and Community Health Department, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
Miranda Varrasse McPhillips
Affiliation:
Biobehavioral Health Sciences Department, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
Justine S. Sefcik
Affiliation:
Drexel University College of Nursing and Health Professions, Philadelphia, PA, USA
Alexandra L. Hanlon
Affiliation:
Department of Statistics, Virginia Tech, Roanoke, VA, USA
Liming Huang
Affiliation:
Biobehavioral Health Sciences Department, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
Glenna S. Brewster
Affiliation:
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
Nancy A. Hodgson
Affiliation:
Biobehavioral Health Sciences Department, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
Mary D. Naylor
Affiliation:
Biobehavioral Health Sciences Department, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
*
Correspondence should be addressed to: Darina V. Petrovsky, University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA19104, USA. Phone: +1 215 898 9746. Email: dmolkina@nursing.upenn.edu.
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Abstract

Objectives:

Daytime sleepiness is associated with multiple negative outcomes in older adults receiving long-term services and supports (LTSS) including reduced cognitive performance, need for greater assistance with activities of daily living and decreased social engagement. The purpose of this study was to identify predictors of change in subjective daytime sleepiness among older adults during their first 2 years of receiving LTSS.

Design and Setting:

Secondary analysis of data from a prospective longitudinal study of older adults who received LTSS in their homes, assisted living communities or nursing homes interviewed at baseline and every 3 months for 24 months.

Participants:

470 older adults (60 years and older) newly enrolled in LTSS (mean = 81, SD = 8.7; range 60–98; 71% women).

Measurements:

Subjective daytime sleepiness was assessed every 3 months through 2 years using the Epworth Sleepiness Scale. Multiple validated measures were used to capture health-related quality of life characteristics of enrollees and their environment, including symptom status (Symptom Bother Scale), cognition (Mini Mental Status Exam), physical function (Basic Activities of Daily Living), physical and mental general health, quality of life (Dementia Quality of Life, D-QoL), depressive symptoms (Geriatric Depression Scale) and social support (Medical Outcomes Survey-Social Support).

Results:

Longitudinal mixed effects modeling was used to examine the relationship between independent variables and continuous measure of daytime sleepiness. Increased feelings of belonging, subscale of the D-QoL (effect size = −0.006, 95% CI: −0.013 to −0.0001, p = 0.045) and higher number of depressive symptoms (effect size = −0.002, 95% CI: −0.004 to −0.001, p = 0.001) at baseline were associated with slower rates of increase in daytime sleepiness over time.

Conclusions:

Comprehensive baseline and longitudinal screening for changes in daytime sleepiness along with depression and perceived quality of life should be used to inform interventions aimed at reducing daytime sleepiness among older adults receiving LTSS.

Keywords

daytime sleepinessquality of lifeolder adultssleepdepression
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 7: Issue Theme: Sleep and Sleep Disorders in Older Adults , July 2020 , pp. 849 - 861
Copyright
© International Psychogeriatric Association 2020

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