Sophie Desjardins

Daily hassles, physical illness, and sleep problems in older adults with wishes to die.

BACKGROUND Factors associated with the wish to die should be investigated in order to gain more opportunities for preventive interventions targeting older adults at risk for suicide. The goal of the research was to study the prevalence and associated factors of wishes to die in older adults living in the community using the data from a survey on the prevalence of mental disorders in this population. METHODS With a representative sample of community living older adults aged 65 years and over (N = 2777), we compared individuals with the wish to die (n = 163) to those without the wish to die on the basis of the presence and severity of daily hassles, physical illness, and sleep quality. RESULTS Logistic regression revealed that when depression and sociodemographic variables were held constant, self-rated physical health, number of chronic illnesses, number and intensity of daily hassles, as well as sleep problems were significantly associated with the wish to die in older adults. Painful illnesses and daytime dysfunction due to sleep problems were also associated factors with the wish to die. CONCLUSION Since desire for death is the first step into the suicidal process, health professionals should seriously consider the important and unique contribution of these variables in order to have more opportunities for detection and intervention.

Sleep problems in anxious and depressive older adults

Purpose The objective of this study was to identify the sleep problems most often encountered by the elderly according to the presence or absence of anxiety and mood disorders. The aim was also to determine whether groups of anxious, depressive, and asymptomatic individuals differ in relation to sleep onset latency; awakenings at night or early in the morning; subjective quality of sleep; taking of sleep medication; and daytime sleepiness. Methods Structured interviews based on the DSM-IV-TR were administered to a sample of 2,759 seniors aged 65 years and older at the participants’ home by health professionals. Results Awakening was found to be the most common disturbance. Increased sleep onset latency was the second most frequent sleep difficulty. Taking more than 30 minutes to fall asleep was associated with the likelihood of meeting the diagnostic criteria for an anxiety disorder, and even reduced the risk of meeting the diagnostic criteria for a mood disorder rather than an anxiety disorder. Awakenings were associated with the probability of suffering from an anxiety disorder or a mood disorder. Quality of sleep, as perceived by the elderly, was not found to be associated with the probability of suffering from a mental disorder. Conclusion These findings should help to facilitate the practitioner’s diagnosis and add further nuances to be considered when encountering symptoms of an anxious or depressive appearance. All of these data also add fuel to the ongoing debate about whether anxiety and depression are one or two distinct categories of disorders.

The relationship between sleep habits, anxiety, and depression in the elderly

Purpose The objective of this study is to determine which sleep-related behaviors are most often used by the elderly according to the presence or absence of anxiety and mood disorders. In particular, we are attempting to determine whether these behaviors are associated with the probability of suffering from a mental disorder. The behaviors being examined in the present study are taking naps, television watching or reading at bedtime, physical exercise at bedtime, relaxing activities at bedtime, and caffeine consumption in the evening. Methods The sample in this study consists of 2,759 participants aged 65 and over, with a mean age of 73.8. They were recruited through a method of random generation of telephone numbers according to a sampling strategy based on geographic location. After the goal of the study was explained to them, the participants agreed to have health professionals visit their home and to answer questions in an hour-and-a-half-long structured interview (after signing a consent form). Results Taking naps is the activity most often practiced by the elderly. Watching television and reading at bedtime are also frequent practices among them. The probabilities of suffering from anxiety are greater if the person never or rarely consumes caffeine after 6 pm, if the individual takes naps during the day, or if the person practices relaxation before bedtime. Television watching, reading, and physical exercise before bedtime are activities that are not associated with the probability of suffering from a mental disorder. Conclusion It would be beneficial for research to be conducted to support the findings on behavioral differences between depressive and anxious seniors so that these behaviors can become further indicators of the presence of mental disorders.

Subjective sleep quality in non‐demented older adults with and without cognitive impairment

Sleep problems are prevalent among older adults who are at risk of developing dementia. Until now, there have been relatively few studies investigating subjective sleep quality in these individuals. The first objective of this study was to compare seniors with cognitive impairment no dementia (CIND) and older adults without cognitive impairment (non‐CIND) on several subjective sleep measures. The second objective was to verify whether sleep parameters associated with CIND differ between men and women.

Wish to die and physical illness in older adults

The wish to die is the first step into the suicidal process. While depression is a major risk factor for the wish to die in old age, it seems that chronic physical illness could also be an important associated factor. Therefore, it would be interesting to look at the relations between 15 specific illnesses and the wish to die in old age. A representative probabilistic sample of community-dwelling older adults aged over 65 (M = 73.9) took part in a large survey on the prevalence of mental disorders, that also gathered information on chronic illness. RESULTS indicated that 5.2% of the 2,811 respondents believed that they would be better dead, and that nine types of chronic illnesses were found significantly more often in elderly persons with the wish to die compared to those without. A logistic regression, including these nine diseases, revealed that, when gender was controlled for, three types of chronic illnesses were significantly associated with increased odds of wish to die: arthritis/rheumatism (OR = 1.72), respiratory problems (OR = 1.85), and urinary/prostate disorders (OR = 1.76). Although many chronic illnesses were found significantly more often in persons with a wish to die, painful diseases causing functional limitations (arthritis) and illnesses that affect basic physiological needs (breathing, eliminating) were particularly important associated factors. New research should look at the possible mediating effects of helplessness, hopelessness, perceived burdensomeness, and reduced quality of life on the relation between chronic illness and the wish to die. Language: en

Sleep cognitions associated with anxiety and depression in the elderly

Purpose The objective of this study was to identify the maladaptive sleep-related cognitions most often maintained by the elderly, according to the presence or absence of anxiety and mood disorders. The presence of dysfunctional sleep-related beliefs and attitudes at bedtime in asymptomatic, depressive, and anxious seniors was thus compared. The second objective was to verify the relationships between various dysfunctional cognitions and mental disorders. Method The sample in this study consisted of 2,759 participants aged 65 years and over, with a mean age of 73.8 years. They were recruited through a method of random generation of telephone numbers according to a sampling strategy based on geographic location. After the goal of the study was explained to them, the participants agreed to have health professionals visit their home and to answer questions in a 1.5-hour-long structured interview (after signing a consent form). Results Depressive and anxious seniors adopt dysfunctional sleep-related cognitions in higher proportions than asymptomatic older persons. Once we had controlled for the other factors, we were able to specifically link two sleep-related beliefs and all the sleep-related attitudes studied to the probability of being anxious or depressive. Conclusion The clarifications obtained will make it possible to improve detection, assessment, and intervention processes regarding anxiety or mood disorders, by pinpointing the most direct link between each of the dysfunctional cognitions and the two types of mental disorders, and not just the link to sleep problems.

Sleep Environment and Insomnia in Elderly Persons Living at Home

The aim of this study was to draw a portrait of the sleep environment of elderly persons living in private households and to determine its relationship with the presence of insomnia. A sample of 599 individuals aged 70 years and older responded to questions about the comfort of their pillow and mattress and the noise level and brightness of their bedroom at night and in the morning. They were also asked whether or not they shared their bed or bedroom with a sleep partner. The Insomnia Severity Index was used to assess insomnia severity. Over 40% of the study participants were using a pillow that was not very comfortable, and almost 30% said that their bedroom was not completely quiet. Binomial logistic regression results revealed that two variables were significantly associated with insomnia symptoms: a pillow rated as moderately comfortable to very uncomfortable and a bedroom that was not completely quiet. No other sleep environment characteristics considered in this study were associated with the risk of insomnia. These results indicate that a nonnegligible proportion of the elderly population endures a suboptimal sleep environment. Although it is difficult to predict the real impact of changes to the sleep environment, this study supports the proposal that simple, minor changes to the bedroom can promote sleep in the elderly.