DOI QR코드

DOI QR Code

Association Between Cohabitation Status and Sleep Quality in Families of Persons With Dementia in Korea: A Cross-sectional Study

  • Kim, Seung Hoon (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Park, Minah (Institute of Health Services Research, Yonsei University) ;
  • Jeong, Sung Hoon (Institute of Health Services Research, Yonsei University) ;
  • Jang, Sung-In (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Park, Eun-Cheol (Department of Preventive Medicine, Yonsei University College of Medicine)
  • Received : 2021.02.10
  • Accepted : 2021.06.25
  • Published : 2021.09.30

Abstract

Objectives: The aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs). Methods: Data of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs' relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales. Results: Compared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively. Conclusions: The residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs' family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.

Keywords

Acknowledgement

We would like to thank the Korea Disease Control and Prevention Agency (KDCA), which provided the data based on a nationwide survey.

References

  1. World Health Organization. Dementia [cited 2021 Jan 14]. Available from: https://www.who.int/news-room/fact-sheets/detail/dementia.
  2. Cova I, Markova A, Campini I, Grande G, Mariani C, Pomati S. Worldwide trends in the prevalence of dementia. J Neurol Sci 2017;379:259-260. https://doi.org/10.1016/j.jns.2017.06.030
  3. Speechly CM, Bridges-Webb C, Passmore E. The pathway to dementia diagnosis. Med J Aust 2008;189(9):487-489. https://doi.org/10.5694/j.1326-5377.2008.tb02140.x
  4. Walter E, Pinquart M. How effective are dementia caregiver interventions? An updated comprehensive meta-analysis. Gerontologist 2020;60(8):609-619.
  5. Wimo A. Establishing and funding long term care infrastructure. In: the 33rd International Conference of Alzheimer's Disease International; 2018 July 26-29; Chicago, USA. 2018, p. 26-29.
  6. Prunty MM, Foli KJ. Guilt experienced by caregivers to individuals with dementia: a concept analysis. Int J Older People Nurs 2019;14(2):e12227. https://doi.org/10.1111/opn.12227
  7. Gallego-Alberto L, Losada A, Cabrera I, Romero-Moreno R, Perez-Miguel A, Pedroso-Chaparro MDS, et al. "I feel guilty". Exploring guilt-related dynamics in family caregivers of people with dementia. Clin Gerontol 2020:1-10.
  8. Almberg B, Grafstrom M, Krichbaum K, Winblad B. The interplay of institution and family caregiving: relations between patient hassles, nursing home hassles and caregivers' burnout. Int J Geriatr Psychiatry 2000;15(10):931-939. https://doi.org/10.1002/1099-1166(200010)15:10<931::AID-GPS219>3.0.CO;2-L
  9. Schulz R, Beach SR. Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA 1999;282(23):2215-2219. https://doi.org/10.1001/jama.282.23.2215
  10. Alzheimer's Disease International. World Alzheimer report 2018. The state of the art of dementia research: new frontiers; 2018 [cited 2021 Jan 14]. Available from: https://www.alzint.org/u/WorldAlzheimerReport2018.pdf.
  11. Yin J, Jin X, Shan Z, Li S, Huang H, Li P, et al. Relationship of sleep duration with all-cause mortality and cardiovascular events: a systematic review and dose-response meta-analysis of prospective cohort studies. J Am Heart Assoc 2017;6(9):e005947. https://doi.org/10.1161/JAHA.117.005947
  12. Fang H, Tu S, Sheng J, Shao A. Depression in sleep disturbance: a review on a bidirectional relationship, mechanisms and treatment. J Cell Mol Med 2019;23(4):2324-2332. https://doi.org/10.1111/jcmm.14170
  13. McCurry SM, Logsdon RG, Teri L, Vitiello MV. Sleep disturbances in caregivers of persons with dementia: contributing factors and treatment implications. Sleep Med Rev 2007;11(2):143-153. https://doi.org/10.1016/j.smrv.2006.09.002
  14. Gao C, Chapagain NY, Scullin MK. Sleep duration and sleep quality in caregivers of patients with dementia: a systematic review and meta-analysis. JAMA Netw Open 2019;2(8):e199891. https://doi.org/10.1001/jamanetworkopen.2019.9891
  15. Hogsnes L, Melin-Johansson C, Norbergh KG, Danielson E. The existential life situations of spouses of persons with dementia before and after relocating to a nursing home. Aging Ment Health 2014;18(2):152-160. https://doi.org/10.1080/13607863.2013.818100
  16. Baglioni C, Spiegelhalder K, Lombardo C, Riemann D. Sleep and emotions: a focus on insomnia. Sleep Med Rev 2010;14(4): 227-238. https://doi.org/10.1016/j.smrv.2009.10.007
  17. Sohn SI, Kim DH, Lee MY, Cho YW. The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index. Sleep Breath 2012;16(3):803-812. https://doi.org/10.1007/s11325-011-0579-9
  18. Buysse DJ, Reynolds CF 3rd, Monk TH, Hoch CC, Yeager AL, Kupfer DJ. Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep 1991;14(4):331-338.
  19. Mollayeva T, Thurairajah P, Burton K, Mollayeva S, Shapiro CM, Colantonio A. The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: a systematic review and meta-analysis. Sleep Med Rev 2016;25:52-73. https://doi.org/10.1016/j.smrv.2015.01.009
  20. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193-213. https://doi.org/10.1016/0165-1781(89)90047-4
  21. Choi H, Kim S, Kim B, Kim I. Psychometric properties of the Korean versions of three sleep evaluation questionnaires. Clin Nurs Res 2015;24(5):526-538. https://doi.org/10.1177/1054773814549827
  22. Lee SY, Ju YJ, Lee JE, Kim YT, Hong SC, Choi YJ, et al. Factors associated with poor sleep quality in the Korean general population: providing information from the Korean version of the Pittsburgh Sleep Quality Index. J Affect Disord 2020;271:49-58. https://doi.org/10.1016/j.jad.2020.03.069
  23. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16(9):606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  24. Chang AK, Choi J. Predictors of sleep quality among young adults in Korea: gender differences. Issues Ment Health Nurs 2016;37(12):918-928. https://doi.org/10.1080/01612840.2016.1235636
  25. Habibi F, Mahdavi SB, Khaniabadi BM, Habibi ME, Gharavinia A, Baghaei A, et al. Sleep quality and associated factors in Iranian inflammatory bowel disease patients. J Res Med Sci 2019;24:59. https://doi.org/10.4103/jrms.JRMS_14_18
  26. 2020 Alzheimer's disease facts and figures. Alzheimers Dement 2020;16(3):391-460. https://doi.org/10.1002/alz.12068
  27. Schoenmakers B, Buntinx F, DeLepeleire J. Supporting the dementia family caregiver: the effect of home care intervention on general well-being. Aging Ment Health 2010;14(1):44-56. https://doi.org/10.1080/13607860902845533
  28. Xie B, Champion JD, Kwak J, Fleischmann KR. Mobile health, information preferences, and surrogate decision-making preferences of family caregivers of people with dementia in rural hispanic communities: cross-sectional questionnaire study. J Med Internet Res.2018;20(12):e11682. https://doi.org/10.2196/11682
  29. Gessert CE, Forbes S, Bern-Klug M. Planning end-of-life care for patients with dementia: roles of families and health professionals. Omega (Westport) 2000;42(4):273-291. https://doi.org/10.2190/2MT2-5GYU-GXVV-95NE
  30. Peng HL, Lorenz RA, Chang YP. Factors associated with sleep in family caregivers of individuals with dementia. Perspect Psychiatr Care 2019;55(1):95-102. https://doi.org/10.1111/ppc.12307
  31. Jang SI, Bae HC, Shin J, Jang SY, Hong S, Han KT, et al. Depression in the family of patients with dementia in Korea. Am J Al-zheimers Dis Other Demen 2016;31(6):481-491. https://doi.org/10.1177/1533317515628048
  32. Kitamura T, Tanimoto C, Oe S, Kitamura M, Hino S. Familial caregivers' experiences with home-visit nursing for persons with dementia who live alone. Psychogeriatrics 2019;19(1):3-9. https://doi.org/10.1111/psyg.12352
  33. Gonyea JG, Paris R, de Saxe Zerden L. Adult daughters and aging mothers: the role of guilt in the experience of caregiver burden. Aging Ment Health 2008;12(5):559-567. https://doi.org/10.1080/13607860802343027
  34. Roach L, Laidlaw K, Gillanders D, Quinn K. Validation of the Caregiver Guilt Questionnaire (CGQ) in a sample of British dementia caregivers. Int Psychogeriatr 2013;25(12):2001-2010. https://doi.org/10.1017/S1041610213001506
  35. Wilson SJ, Padin AC, Birmingham DJ, Malarkey WB, KiecoltGlaser JK. When distress becomes somatic: dementia family caregivers' distress and genetic vulnerability to pain and sleep problems. Gerontologist 2019;59(5):e451-e460.
  36. Seiger Cronfalk B, Ternestedt BM, Norberg A. Being a close family member of a person with dementia living in a nursing home. J Clin Nurs 2017;26(21-22):3519-3528. https://doi.org/10.1111/jocn.13718
  37. Andren S, Elmstahl S. The relationship between caregiver burden, caregivers' perceived health and their sense of coherence in caring for elders with dementia. J Clin Nurs 2008;17(6):790-799. https://doi.org/10.1111/j.1365-2702.2007.02066.x
  38. Riedijk SR, De Vugt ME, Duivenvoorden HJ, Niermeijer MF, Van Swieten JC, Verhey FR, et al. Caregiver burden, health-related quality of life and coping in dementia caregivers: a comparison of frontotemporal dementia and Alzheimer's disease. Dement Geriatr Cogn Disord 2006;22(5-6):405-412. https://doi.org/10.1159/000095750
  39. Wang L, Qin P, Zhao Y, Duan S, Zhang Q, Liu Y, et al. Prevalence and risk factors of poor sleep quality among Inner Mongolia Medical University students: a cross-sectional survey. Psychiatry Res 2016;244:243-248. https://doi.org/10.1016/j.psychres.2016.04.011
  40. Harpe SE. How to analyze Likert and other rating scale data. Curr Pharm Teach Learn 2015;7(6):836-850. https://doi.org/10.1016/j.cptl.2015.08.001