Risk factors of poor sleep quality in older adults: an analysis based on comprehensive geriatric assessment.
OBJECTIVES
Sleep quality is associated with many diseases and conditions that affect individuals' health in various ways. We aimed to investigate the association between sleep quality and common geriatric conditions in older adults.


METHODS
The study included 237 older adults admitted to the geriatric outpatient clinic of a university hospital. All patients underwent comprehensive geriatric assessment (CGA). Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life (EQ-5D), Pittsburgh Sleep Quality Index (PSQI), Katz Index of Independence in Activities of Daily Living (ADL) and Lawton and Brody Instrumental Activities of Daily Living (IADL) questionnaires, Tinetti Balance and Gait Assessment (TBGA) and Mini Nutritional Assessment (MNA) were performed on the participants.


RESULTS
Participants had a mean age of 72.2 ± 6.3 years, and 146 (61.6%) of them had poor sleep quality. Of the participants, 61.2% were female. In the poor sleep quality group, GDS and BAI scores were higher while ADL, IADL, MNA and EQ-5D index scores were lower. PSQI score had a negative correlation with ADL (r = -0.207 p = 0.001), EQ-5D index (r = -0.372 p = 0.000), MNA (r = -0.277 p = 0.000) and TBGA (r = -0.263 p = 0.041) scores and a positive correlation with GDS (r = 0.426, p = 0.000) and BAI (r = 0.450, p = 0.000) scores according to the results of correlation analysis. Multivariate logistic regression analysis showed that the presence of diabetes mellitus (DM) and higher GDS and BAI scores were independent variables for poor sleep quality [(p = 0.048, OR = 1.92; p = 0.020, OR = 1.11; and p < 0.001 OR= 1.11, respectively)].


CONCLUSIONS
We found that DM and depressive and anxiety symptoms were the risks of poor sleep quality. In addition, participants with poor sleep quality had a worse quality of life and nutritional status. Improving sleep quality may be helpful in the management of geriatric syndromes and that sleep quality assessment should be part of CGA.