Defense Date

2014

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Pharmacotherapy and Outcomes Science

First Advisor

Patricia W. Slattum

Abstract

The work presented in this dissertation focuses on the association between sleep medication use, poor sleep, and falls in community-dwelling adults 65 years or older. Sleep complaints and the consumption of medications to aid sleep are common in older adults. Psychotropic medications, such as sedative hypnotics, are associated with risk of falls in older adults. However, very few studies have assessed the impact of poor sleep and sleep medication use on the risk of falls in community-dwelling older adults. In the first project, a cross-sectional analysis of the Health and Retirement Study (HRS) 2010 data was conducted to determine the prevalence of sleep problems, sleep medication use and falls; and to evaluate the association between sleep problems, sleep medication use, and falls in community-dwelling older adults. A multiple logistic model adjusted for covariates was used. In the sample of community-dwelling older adults, 35.8% had reported a fall and 40.8% had reported sleep problems in the past two years. Sleep medication use was reported by 20.9% of the older adults. Older adults who had sleep problems and took sleep medications had a significantly higher risk of falls compared with older adults who did not have sleep problems and did not take sleep medications. The other two groups, older adults who had sleep problems and did not take sleep medications, and those who did not have sleep problems and took sleep medications also had a significantly greater risk for falls. The second project was a prospective cohort study of independently-living older adults from senior congregate housing. The effect of combined poor sleep quality and sleep medication use on risk of falls was assessed using logistic regression modeling. In this study of 113 community-dwelling older adults, 46.9% had at least one fall, and 62.8% had poor sleep quality. Sleep medication use was reported by 44.2% of the older adults. Older adults with poor sleep quality and sleep medication use had a significantly increased risk of falls compared with older adults with good sleep quality and no sleep medication use. Older adults with good sleep quality and sleep medication use, and those with poor sleep quality and no sleep medication use did not have a significantly greater risk for falls. In conclusion, poor sleep added to sleep medication use significantly increased the risk of falls in community-dwelling older adults. The research undertaken in this dissertation was the first to evaluate the associations between poor sleep, use of sleep medications, and falls in community-dwelling older adults.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

12-12-2014

Available for download on Wednesday, December 11, 2019

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