Daily Sleep Quality is Associated with Daily Cognition in Late-Life

Background: Older adults often face sleep disturbance or cognitive decline that goes beyond the scope of normal aging. The present study examined the relationship between self-reported sleep quality and self-reported daytime attention in a community-dwelling sample of older men at the between-persons and within-persons levels of association. Methods: Thirty-eight participants (M age =75.36 years, SD age =7.51 years, range=66-90 years) completed a twice-daily sleep diary for one week. Sleep quality and attention were assessed using a single-item 0-10 rating scales from the morning diary (“How was the quality of your sleep last night?”) and from the evening diary (“How was your attention today?”). A two-level multilevel model was parameterized with days nested within individuals to examine whether nightly sleep quality predicts an individual’s daily attention rating. Results: A multilevel model predicting self-reported attention revealed (1) older individuals who reported better sleep quality reported having better daily attention [Beta=0.64, t(248.15)=10.12, p\u3c0.001] and (2) following a day of above-average sleep quality, older individuals experienced above-average attention [Beta=0.16, t(259.79)=2.75, p=.006]. Conclusion: Not only was overall sleep quality associated with self-reported attention, but a good night\u27s sleep was associated with better self-reported next-day attention. Results point to the potential importance of fluctuations in sleep quality for daytime functioning. Interventions aimed at improving nightly sleep consistency may be worth exploring as methods to improve daytime cognitive functioning in older adults. Support: This work was supported by the Sleep Research Society Foundation/Jazz Pharmaceuticals (001JP13, PI: Dzierzewski) and by the National Institute on Aging of the National Institutes of Health under Award Number K23AG049955 (PI: Dzierzewski), and National Heart Lung and Blood Institute at the National Institutes of Health under award number K24HL143055 (PI: Martin). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Veterans Affairs.https://scholarscompass.vcu.edu/gradposters/1089/thumbnail.jp

Comprehensive health screening of well elderly adults: an analysis of a community program

We examined the yield of a health screening program in a free-standing community senior citizen center and identified factors associated with patient compliance with referral recommendations. Of elderly individuals screened, 94% had some positive finding requiring advice or intervention, and 54% were referred to a physician for further evaluation. The most prevalent findings were skin disorders (52%), genitourinary disorders (44%), and eye-ear-nose-throat disorders (33%). Of individuals referred to a physician, 70% complied with the referral. Of those who complied, 38% reported receiving treatment for the referred condition -15% of the entire group of clients screened. Factors positively associated with compliance with physician referral included the specific type of referred problem, the perceived seriousness of the problem, and absence of financial barriers to medical care. Though controlled trial data are lacking, this and other published studies indicate that many remediable problems can be identified among apparently healthy elderly individuals in community geriatric screening programs

Preventing Falls in Older Californians: State of the Art

In February 2003, the Foundation convened over 150 leaders in academic, legislative, community-based services, consumer advocates, aging network, housing, public health, public safety, and other leaders who worked for two days on a statewide blueprint on fall prevention.  In preparation for the convening, a Preconference White Paper was created and used to build the blueprint.  The California Blueprint describes state-of-the-art approaches to reducing the risks of falls, and the challenges to implementing fall prevention in California.  One of the top recommendations from this blueprint was the creation of a coordination center that could serve as a statewide resource and lead efforts in fall prevention.  This recommendation eventually led to the creation of the Fall Prevention Center of Excellence (FPCE)

Towards a New Definition of Return-to-Work Outcomes in Common Mental Disorders from a Multi-Stakeholder Perspective

Objectives: To examine the perspectives of key stakeholders involved in the return-to-work (RTW) process regarding the definition of successful RTW outcome after sickness absence related to common mental disorders (CMD's). Methods: A mixed-method design was used: First, we used qualitative methods (focus groups, interviews) to identify a broad range of criteria important for the definition of successful RTW (N = 57). Criteria were grouped into content-related clusters. Second, we used a quantitative approach (online questionnaire) to identify, among a larger stakeholder sample (N = 178), the clusters and criteria most important for successful RTW. Results: A total of 11 clusters, consisting of 52 unique criteria, were identified. In defining successful RTW, supervisors and occupational physicians regarded "Sustainability'' and "At-work functioning" most important, while employees regarded "Sustainability," "Job satisfaction," "Work-home balance,'' and " Mental Functioning" most important. Despite agreement on the importance of certain criteria, considerable differences among stakeholders were observed. Conclusions: Key stakeholders vary in the aspects and criteria they regard as important when defining successful RTW after CMD-related sickness absence. Current definitions of RTW outcomes used in scientific research may not accurately reflect these key stakeholder perspectives. Future studies should be more aware of the perspective from which they aim to evaluate the effectiveness of a RTW intervention, and define their RTW outcomes accordingly

Sleep Outcomes With Cognitive Behavioral Therapy for Insomnia Are Similar Between Older Adults With Low vs. High Self-Reported Physical Activity

We examined whether baseline self-reported physical activity is associated with the efficacy of cognitive behavioral therapy for insomnia (CBT-I) in older veterans. Community-dwelling veterans aged 60 years and older with insomnia received CBT-I in a randomized controlled trial. Participants who received active treatment were divided into low and high physical activity based on self-report. Sleep outcomes were measured by sleep diary, questionnaire and wrist actigraphy; collected at baseline, post-treatment, 6-month and 12-month follow-up. Mixed-effects models compared differences between physical activity groups in change in sleep outcome from baseline to each follow-up, and equivalence tests examined if physical activity groups were clinically equal. There were no significant differences in sleep outcomes between physical activity groups. Equivalence tests suggested possible equality in physical activity groups for five of seven sleep outcomes. Efficacy of CBT-I in older veterans was not associated with self-reported physical activity at baseline. Older adults with insomnia who report low levels of physical activity can benefit from CBT-I

Global urban environmental change drives adaptation in white clover

Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural clines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale