The association between subjectively impaired sleep and symptoms of depression and anxiety in a frail elderly population

Background: Most previous studies showed an association between sleep impairment in the elderly and symptoms of depression and anxiety. Majority of these studies were conducted in “strong”, community-dwelling elderly. Aim: To assess the association between subjective sleep impairment and its affective disturbances among frail elderly patients. Methods: The retrospective study included patients 65 years old and above. Data included socio-demographic characteristics, the mini-mental state examination, the short anxiety screening test, the 15-item Geriatric Depression Scale, and the Patient Health Questionnaire. The patients were asked about sleep complaints. Results: The study population consisted of 496 patients. The mean age was 83.7 ± 6.2 years, and only 7 (1.4%) did not report any sleep disturbance. After adjustment, depression symptoms were associated only with decreased overall sleep satisfaction (OR 2.62, 95% CI 1.18–5.81), while anxiety symptoms were associated with decreased overall sleep satisfaction (OR 3.17, 96% CI 1.71–5.88), difficulty falling asleep (OR 3.58, 95% CI 1.96–6.52), waking up during the night (OR 3.16, 95% CI 1.63–6.1), morning weakness (OR 2.68, 95% CI 1.44–5.0) and daytime drowsiness (OR 2.39, 95% CI 1.21–4.69). Discussion: Sleep impairment is very prevalent among frail elderly and associated much more with anxiety than with depression. Conclusion: The findings of the present study provide further evidence for the importance in taking a detailed history of sleep habits during the course of the geriatric assessment in frail elderly patients.