Sleep quality and its associations with disease activity and quality of life in older patients with rheumatoid arthritis


Deniz O., Cavusoglu C., SATIŞ H., AKIN B., Varan O., Atas N., ...Daha Fazla

EUROPEAN GERIATRIC MEDICINE, cilt.14, sa.2, ss.317-324, 2023 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 14 Sayı: 2
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1007/s41999-022-00739-w
  • Dergi Adı: EUROPEAN GERIATRIC MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Sayfa Sayıları: ss.317-324
  • Anahtar Kelimeler: Sleep quality, Older patients, Rheumatoid arthritis, Pittsburg Sleep Quality Index, RAQoL
  • Gazi Üniversitesi Adresli: Evet

Özet

Key summary pointsAimTo compare sleep quality and its associations with disease activity and quality of life between older patients with rheumatoid arthritis and age- and gender-matched controls. FindingsOlder RA patients had poor sleep quality compared with age- and gender-matched controls. Sleep quality is strongly associated with disease activity and quality of life in older patients with RA. MessageIn the geriatric population with rheumatologic diseases such as rheumatoid arthritis, sleep quality should be kept in mind, and evaluating the sleep quality must be incorporated into the routine management of older patients with RA. Purpose: Sleep disturbance is among the most important geriatric syndromes, and its evaluation is part of the routine comprehensive geriatric assessment (CGA). Previous studies have demonstrated that older patients with rheumatoid arthritis (RA) have poorer sleep quality than younger control patients. However, there needs to be more data on the sleep quality of older patients with RA with age-matched controls.Methods: Totally 100 participants, 50 older RA patients classified according to the ACR criteria, and 50 age- and gender-matched control patients without RA were included in the study. All patients underwent CGA, including assessing their functionality, depressive, cognitive, and nutritional status. In addition, sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI), and RA disease activity by a rheumatologist using the Disease Activity Score 28 (DAS28-CRP), and quality of life with the RA QoL questionnaire (RAQoL).Results: The median age was 70 years (min-max: 65-86), and 62.5% were female. Co-morbidities and comprehensive geriatric assessment parameters were similar between the two groups. Median PSQI global score was higher in patients with RA than controls [9 (min-max: 1-20) vs. 5 (min-max: 1-13), p = 0.029). When the patients were categorized with respect to being 'poor sleepers' (PSQI score > 5), 62% of patients with RA and 38% of controls were poor sleepers (p = 0.016). The patients classified as poor sleepers were more likely to have a diagnosis of RA, higher DAS28-CRP and RAQoL scores, lower grip strength, and be a woman. PSQI global scores were significantly positively correlated with DAS28-CRP scores (r = 0.514, p < 0.001), RAQoL scores (r = 0.689, p < 0.001), number of medications used (r = 0.292, p = 0.003), and YDS scores (r = 0.407, p < 0.001), and significantly negatively correlated with handgrip strength (r = - 0.351, p = 0.001).Conclusion: The results suggest that older patients with RA might have poorer sleep quality compared to age- and gender-matched controls. Moreover, sleep quality correlated with RA disease activity and QoL in old age.