Sleep quality among community-dwelling elderly people and its demographic, mental, and physical correlates

J Chin Med Assoc. 2012 Feb;75(2):75-80. doi: 10.1016/j.jcma.2011.12.011. Epub 2012 Jan 31.


Background: Sleep quality is an important predictor of well being in the elderly. However, the effects of depression and physical activity on sleep quality among elderly are less clear.

Methods: One hundred older individuals who met the inclusion criteria were randomly sampled from a Taipei district elderly residential list. Door-to-door interviews were conducted. Sleep quality (the outcome variable), physical activity and depression symptoms were measured by the Pittsburgh Sleep Quality Index (PSQI), Physical Activity Scale for the Elderly (PASE), and Taiwanese Depression Questionnaire (TDQ), respectively. Logistic regression was performed to examine the relationship between the above major variables.

Results: A half of the elderly had short sleep onset (<15 minutes) but reported poor sleep quality (PSQI > 5). Twenty-two percent of community-dwelling elders used psychoactive medication for sleep. The prevalence of depressive disorders (TDQ ≥ 19) was 7%. Although both physical activity and depression were significantly associated with sleep quality in the univariate analysis, only depression remained significant after adjusting for age, gender, education, marital status, and chronic illness confounders in logistic regression (OR=1.31, 95% confidence interval=1.12-1.52).

Conclusion: Elderly depression symptoms was the only factor significantly associating with poor sleep quality after adjustment. Higher level of physical activity was associated with better sleep quality in univariate analysis but not in multivariate analysis, which considered the factor of elderly depression symptoms in the elderly. The role of physical activity in late life potentially influence sleep quality but may have less significance compared with depression. Therefore, we suggest the need for more future research to investigate the relationship between elderly people's sleep and physical activity.

MeSH terms

  • Aged, 80 and over
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / physiopathology*
  • Exercise*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Prevalence
  • Sleep* / physiology