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Sleeping Medications and Prevention of Functional Disability in Older Adults with Low Care Needs: A Prospective
Naoko Otsuki1, Ryohei Yamamoto2, Ayumi Kono1
1Department of Community-based Integrated Care Science, School of Nursing, Osaka Metropolitan University, Osaka, Japan.
Introduction:
Sleeping disorders, a common health problem among older adults worldwide, are a risk factor for functional disability. Although sleeping medications are extensively used to treat sleep disorders in older adults, their safety and efficacy in terms of cognitive and physical effects are controversial. The present 3-year prospective cohort study clarifies the association between sleeping medication and the incidence of functional disability in 1,652 older adults aged ≥65 years with low care needs in Japan's long-term care insurance system (LTCI).
Methods:
We conducted a prospective cohort study using data from the Southern Osaka Health and Aging Study. The present study included 1,291 participants aged 65 years at the baseline date after excluding 302 (20.0%) participants who received long-term care certification during the six-month baseline period. The exposure was sleeping medication use. The outcome was the identification of functional disabilities based on LTCI certification. The association between sleeping medication use and the incidence of functional disabilities was assessed using unadjusted and adjusted Fine and Gray proportional subdistribution hazards models.
Results:
During the median observational period of 2.5 years, the incidence of functional disabilities was observed in 504 (54.6%) and 184 (49.7%) participants in the "No use" group and the "Use" group, respectively. This study clarified that the group using sleeping medications had a significantly lower risk of functional disability than the group not using them (sub-hazard ratios of "No use" and "Use": 1.00 [reference], 0.82 [confidence intervals, 0.68-0.99]).
Conclusions:
Our findings differ from those of previous studies and may provide useful suggestions for home care services for older adults with low care needs. Managing sleep with professional support, such as assessing sleeping medication doses, may help prevent functional disabilities in individuals with low care needs.
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