Orthostatic hypotension and subjective sleep quality in older people.

Poor sleep quality and orthostatic hypotension are common complaints in an older population, and both are related to factors such as polypharmacy and depression. However, it is not known whether there is a direct association between the two. Our objective is to investigate a potential association between orthostatic blood pressure response and subjective sleep quality in older people. A within-subjects, cross-sectional design embedded in a larger longitudinal study design. Participants were recruited from the community to visit the TRIL clinic at St James's Hospital, where they underwent a structured medical and psychosocial assessment. A total of 505 community dwelling adults aged 60+ (321 females, mean age 72.44) were participated in this study. Orthostatic blood pressure responses were recorded during an active stand using Finometer equipment, and health-related factors such as pain ratings, co-morbidities, polypharmacy, timed up and go, Mini-Mental State Examination score, body mass index, as well as depression, anxiety, age and gender, were also recorded. Self-reported sleep quality was also assessed using the Pittsburgh Sleep Quality Index. The results showed that timed up and go, polypharmacy, depression, anxiety, gender and delayed recovery of blood pressure at orthostasis were associated with subjective poor sleep quality. There is an association between subjective sleep quality and delayed recovery of blood pressure at orthostasis, independent of mental health or polypharmacy effects, in older adults. This link may have implications for the management of sleep disorders in older people.

Psychological distress as a key component of psychosocial functioning in community-dwelling older people.

OBJECTIVES: To explore the key components representative of measures of psychosocial functioning with a focus on identifying the constituents of psychological distress in an Irish sample of community-dwelling older adults and to examine the relationship between these components and health outcomes such as frailty. METHOD: Cross-sectional observational study at the Technology Research for Independent Living (TRIL) Clinic, a comprehensive geriatric assessment facility in St. James's Hospital, Dublin. In this study, 579 participants were given eight primary assessments (Centre for Epidemiological Studies of Depression, Geriatric Adverse Life Events Scale, Pittsburgh Sleep Quality Index, De Jong-Gierveld Scale, Practitioner Assessment of Network Type, Eysenck Personality Inventory, Hospital Anxiety and Depression Scale, Lubben Social Network Scale) and a broad range of health and demographic secondary assessments. Principal factor analysis identified the core components relating to psychosocial functioning. Following this, the regression factors of these components were correlated with health outcomes. RESULTS: The first of three components identified accounted for 9.08% of the variance and related to a core internal component of psychological distress. The two other components related to external and physiological functioning, specifically social support networks and sleep. Spearman's Rho correlations indicated significant associations of walking speed, age, Berg Balance Scale and living alone with all three components. Additionally, the core component of psychological distress significantly correlated with the Fried Frailty Index, illness co-morbidity, ADL, IADL and nutrition. CONCLUSION: These results characterise the variation in psychosocial functioning in older adults and identifies psychological distress as a core facet of psychosocial functioning which has associations with frailty.

Perceived stress mediates the relationship between emotional loneliness and sleep quality over time in older adults.

OBJECTIVE: Both loneliness and poor sleep quality are common occurrences in late life and both are detrimental to physical and mental health. While loneliness may be difficult to intervene upon, there may be correlated factors, which, if alleviated, could mitigate the effects of loneliness and sleep quality on health in late life. DESIGN: A longitudinal, observational study whereby we gathered predictive variables at baseline and dependent variable (sleep) at follow-up. METHOD: We investigated the relationship between loneliness at baseline and sleep quality at follow-up in a group of 447 older adults attending the clinic for research participation. Loneliness, stress and sleep quality were all measured using self-report validated psychometric tools. RESULTS: We found that loneliness, specifically emotional loneliness, predicted sleep quality at follow-up, controlling for demographic factors and for sleep quality at baseline. Upon applying mediation methods to the data, we then found that this relationship was mediated in part by perceived stress. CONCLUSION: We conclude that the impact of emotional loneliness on sleep quality in older adults is partly because of the stress experienced as a result of feeling lonely.

Exercise and social support are associated with psychological distress outcomes in a population of community-dwelling older adults.

Exercise reduces the likelihood of psychological distress, but this may be due to incidental socializing. We gathered information on exercise, social support and three aspects of psychological distress from 583 community-dwelling older adults. Exercise and social support from friends were both associated with lower scores of depression, anxiety and perceived stress. For infrequent exercisers, having a low level of social support indicated higher levels of depression, whereas for frequent exercisers, having a low level of social support did not affect depression levels. Both exercise and social support have roles in regulating psychological well-being in older populations and exercisers are less susceptible to effects of low social support on depression.

The sound of the crowd: auditory information modulates the perceived emotion of a crowd based on bodily expressions.

Although both auditory and visual information can influence the perceived emotion of an individual, how these modalities contribute to the perceived emotion of a crowd of characters was hitherto unknown. Here, we manipulated the ambiguity of the emotion of either a visual or auditory crowd of characters by varying the proportions of characters expressing one of two emotional states. Using an intersensory bias paradigm, unambiguous emotional information from an unattended modality was presented while participants determined the emotion of a crowd in an attended, but different, modality. We found that emotional information in an unattended modality can disambiguate the perceived emotion of a crowd. Moreover, the size of the crowd had little effect on these crossmodal influences. The role of audiovisual information appears to be similar in perceiving emotion from individuals or crowds. Our findings provide novel insights into the role of multisensory influences on the perception of social information from crowds of individuals.