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Supportive Care in Cancer
Published in: Supportive Care in Cancer 10/2017

01-10-2017 | Original Article

Associations of sleep disturbance with physical function and cognition in older adults with cancer

Authors: Kah Poh Loh, Chintan Pandya, Jason Zittel, Sindhuja Kadambi, Marie Flannery, Natalie Reizine, Allison Magnuson, Giovanna Braganza, Karen Mustian, William Dale, Paul Duberstein, Supriya Gupta Mohile

Published in: Supportive Care in Cancer | Issue 10/2017

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Abstract

Purpose

Although sleep disturbances are common in older adults, studies evaluating the prevalence of sleep disturbance and its influence on functional outcomes in older adults with cancer are few. In this study, we examined the prevalence of sleep disturbance and its association with physical function and cognition in older adults with cancer.

Methods

This is a cross-sectional study of patients who were referred and evaluated in the Specialized Oncology Care & Research in the Elderly (SOCARE) clinics at the Universities of Rochester and Chicago from May 2011 to October 2015. All patients underwent a geriatric assessment (GA) as part of their routine evaluation. Our final study cohort included patients who completed a sleep assessment and consented to the study. We collected demographics (age, sex, race, marital status, and education level) and clinical characteristics (depression, comorbidity, cancer type, and stage) from the GA and medical chart reviews. Presence of sleep disturbance was self-reported (yes/no). Physical function was assessed using Instrumental Activities of Daily Living (IADLs), physical activity (PA) survey, falls in the preceding 6 months, and Short Physical Performance Battery (SPPB). Cognition was screened using the Blessed Orientation-Memory-Concentration Test (impairment >4) or Montreal Cognitive Assessment (impairment <26). Bivariate and multivariable analyses were used to examine the associations between sleep disturbance with functional outcomes and cognition.

Results

We included 389 older patients. The prevalence of sleep disturbance was 40%. Sixty-eight percent had ≥1 IADL impairment, 76% had PA limitation, 37% had ≥1 fall, 70% had impairment on SPPB, and 47% screened positive for cognitive impairment. On bivariate analyses, sleep disturbance was associated with IADL impairment (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.23–3.13, P = 0.005), and PA limitation (OR 2.43, 95% CI 1.38–4.28, P = 0.002). The associations remained significant on multivariable analyses. Sleep disturbance was not significantly associated with falls, impairment on SPPB, and performance on the cognitive screen.

Conclusion

Sleep disturbance was associated with IADL impairment and PA limitation. It is important for oncologists to inquire about sleep problems, and these patients should also be screened for functional impairment if sleep disturbance was present.
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Metadata
Title
Associations of sleep disturbance with physical function and cognition in older adults with cancer
Authors
Kah Poh Loh
Chintan Pandya
Jason Zittel
Sindhuja Kadambi
Marie Flannery
Natalie Reizine
Allison Magnuson
Giovanna Braganza
Karen Mustian
William Dale
Paul Duberstein
Supriya Gupta Mohile
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3724-6

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