Türkiye'deki Huzurevlerinde Kalan Yaşlılarda Rakımın Uyku Kalitesi, Günlük Yaşam Aktiviteleri ve Yaşam Kalitesi Üzerindeki Etkisi: Kesitsel Bir Analiz

Öz

Amaç: Bu çalışmanın amacı, Türkiye'nin farklı rakım bölgelerinde bulunan huzurevlerinde ikamet eden yaşlı bireylerde rakımın uyku kalitesi, günlük yaşam aktiviteleri ve yaşam kalitesi üzerindeki etkisini sistematik olarak değerlendirmektir. Yöntem: Bu kesitsel araştırma, Temmuz 2020 ile Ocak 2021 tarihleri arasında Türkiye'nin doğu ve batı bölgelerinde yer alan huzurevlerinde yaşayan 92 gönüllü yaşlı bireyi kapsamaktadır. Bilişsel işlevler Mini Mental Durum Testi (MMST) ile değerlendirilmiştir. Yaşam kalitesi Dünya Sağlık Örgütü Yaşlılar İçin Yaşam Kalitesi Ölçeği (WHOQOL-OLD), günlük yaşam aktiviteleri Barthel İndeksi, gündüz uykululuk durumu Epworth Uykululuk Ölçeği (ESS), uyku kalitesi ise son bir ayı kapsayacak şekilde Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ile ölçülmüştür. İstatistiksel analizlerde Ki-kare, Shapiro-Wilk, Mann-Whitney U ve Spearman testleri kullanılmıştır. Bulgular: Elde edilen veriler, farklı rakımlarda yaşayan yaşlı bireylerin PUKİ puanlarında istatistiksel olarak anlamlı farklılık bulunduğunu göstermektedir (p<0,05). Doğu bölgesinde yaşayan bireylerin ortalama PUKİ puanları, batı bölgesindekilere göre belirgin şekilde daha yüksek bulunmuştur. Benzer şekilde, WHOQOL-OLD puanları açısından da istatistiksel olarak anlamlı farklılık saptanmıştır (p<0,05); doğu bölgesinde yaşayan bireylerin yaşam kalitesi puanları batı bölgesindekilere kıyasla daha düşüktür. Sonuç: Bu çalışma, daha düşük rakımlı bölgelerde yaşayan yaşlı bireylerin daha yüksek rakımlı bölgelerde yaşayanlara kıyasla daha iyi uyku kalitesine sahip olduğunu ortaya koymuştur. Ayrıca, huzurevlerinde yaşayan yaşlı bireylerin genel olarak ortalamanın altında bir uyku kalitesi sergilediği belirlenmiştir.

Anahtar Kelimeler

• Yükseklik
• günlük yaşam aktiviteleri
• yaşlılar
• uyku kalitesi
• yaşam kalitesi

The Impact of Altitude on Sleep Quality, Daily Living Activities, and Quality of Life in Elderly Residents of Turkish Nursing Homes: A Cross-Sectional Analysis

Öz

Aim: This study aims to assess the influence of altitude on sleep quality, daily living activities, and quality of life among elderly residents in nursing homes located in distinct altitudinal regions within Türkiye. Method: A cross-sectional investigation encompassed 92 voluntary elderly participants residing in nursing homes situated in both the eastern and western regions of Türkiye during the period spanning from July 2020 to January 2021. Cognitive function was evaluated through the Mini Mental State Test (MMST), while the quality of life was gauged using the World Health Organization Quality of Life Scale for the Elderly Model (WHOQOL-OLD). Daily living activities were quantified via the Barthel Index test, and daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). The Pittsburgh Sleep Quality Index (PSQI) was employed to appraise sleep quality over a one-month period. Statistical analyses entailed Chi-square, Shapiro-Wilk, Mann-Whitney U, and Spearman tests. Results: The data reveal a statistically significant variance in the Pittsburgh Sleep Quality Index scores among elderly residents dwelling at distinct altitudes (p < 0.05). The mean PSQI scores of elderly inhabitants in the eastern region were notably higher compared to their counterparts in the western region. Additionally, a statistically significant contrast was discerned in the Quality of Life Scale (WHOQOL-OLD) among elderly individuals residing at varying altitudes (p < 0.05). The mean WHOQOL-OLD scores for elderly residents in the eastern region were notably lower than those observed in the western region. Conclusion: This study ascertained that elderly residents inhabiting lower-altitude regions experienced superior sleep quality compared to their counterparts in higher-altitude areas.

Anahtar Kelimeler

• Altitude
• daily living activities
• elderly
• sleep quality
• quality of life

Kaynakça

1. 1. Lee J, Kim HJ. Normal aging induces changes in the brain and neurodegeneration progress: Review of the structural, biochemical, metabolic, cellular, and molecular changes. Frontiers in Aging Neurosci. 2022;14:931536.
2. 2. Spira AP, Kaufmann CN, Stone KL. Sleep, Circadian Rhythms, and Aging: Advancing Knowledge to Promote Older Adults’ Health. Oxford University Press US, 2023.
3. 3. Drăgoi CM, Nicolae AC, Ungurianu A, Margină DM, Grădinaru D, Dumitrescu IB. Circadian rhythms, chrononutrition, physical training, and redox homeostasis—molecular mechanisms in human health. Cells. 2024;13(2):138.
4. 4. Gordon NP, Yao JH, Brickner LA, Lo JC. Prevalence of sleep-related problems and risks in a community-dwelling older adult population: A cross-sectional survey-based study. BMC Public Health. 2022;22(1):2045.
5. 5. Liu S, Chow IH, Lu L, et al. Comparison of sleep disturbances between older nursing home residents in high-and low-altitude areas. J. Geriatr. Psychiatry Neurol. 2020;33(6):370-376.
6. 6. Kong F. Updates in Sleep Neurology and Obstructive Sleep Apnea: Sleep Disorder at High Altitude. IntechOpen; 2021.
7. 7. Qin Z, Kang D, Feng X, Kong D, Wang F, Bao H. Resting-state functional magnetic resonance imaging of high altitude patients with obstructive sleep apnoea hypopnoea syndrome. Sci. Rep. 2020;10(1):15546.
8. 8. Xie Y, Wang N. The eye and high altitude. Integrative Ophthalmology. 2020:95-100.

9. 9. Srivali N, Tobias L. 1037 Central sleep apnea due to high altitude periodic breathing. Sleep. 2023;46(Supplement_1):A455-A455.
10. 10. Christodoulou E, Pavlidou E, Mantzorou M, et al. Depression is associated with worse health-related quality of life, lower physical activity levels, and inadequate sleep quality in a Greek elderly population. Psychol Health Med. 2023;28(9):2486-2500.
11. 11. Seol J, Lee J, Nagata K, et al. Combined effect of daily physical activity and social relationships on sleep disorder among older adults: Cross-sectional and longitudinal study based on data from the Kasama study. BMC Geriatrics. 2021;21:1-10.
12. 12. Awade AR, Ibrahim NAEF, Abd El Moniem MM. The Relationship between nocturia, sleep quality and daytime energy among community dwelling older adults. Alex. Sci. Nurs. J. 2020;22(1):81-91.
13. 13. Kim N, Park J, Hong H, Kong ID, Kang H. Orthostatic hypotension and health-related quality of life among community-living older people in Korea. QLife Res. 2020;29:303-312.
14. 14. Hayashino Y, Yamazaki S, Takegami M, Nakayama T, Sokejima S, Fukuhara S. Association between number of comorbid conditions, depression, and sleep quality using the Pittsburgh Sleep Quality Index: Results from a population-based survey. Sleep Med.. 2010;11(4):366-371.
15. 15. Dagnino AP, Campos MM. Chronic pain in the elderly: Mechanisms and perspectives. Front. Hum. Neurosci. 2022;16:736688.
16. 16. Ran L, Jiang X, Li B, et al. Association among activities of daily living, instrumental activities of daily living and health-related quality of life in elderly Yi ethnic minority. BMC Geriatrics. 2017;17:1-7.
17. 17. Wu R, Ditroilo M, Delahunt E, De Vito G. Age related changes in motor function (II). Decline in motor performance outcomes. Int J Sports Med. 2021;42(03):215-226.
18. 18. Leng M, Yin H, Zhang P, et al. Sleep quality and health-related quality of life in older people with subjective cognitive decline, mild cognitive impairment, and Alzheimer disease. The J Nerv Ment Dis. 2020;208(5):387-396.
19. 19. Petrovsky D, Varasse M, Hodgson N. Relationship between sleep and quality of life in older adults with mild cognitive impairment. Innov. Aging. 2020;4(Suppl 1):619.
20. 20. Gluhm S, Goldstein J, Loc K, Colt A, Van Liew C, Corey-Bloom J. Cognitive performance on the mini-mental state examination and the montreal cognitive assessment across the healthy adult lifespan. Cogn Behav Neurol. 2013;26(1):1-5.
21. 21. Gungen C. Standardize Mini Mental Test'in Türk toplumunda hafif demans tanısında geçerlik ve güvenilirliği. Turk Psikiyatri Derg. 2002;13:273-281.
22. 22. Gobbens RJ, van Assen MA. Psychometric properties of the Dutch WHOQOL-OLD. HQOL. 2016;14:1-9.
23. 23. Eser S, Saatlı G, Eser E, Baydur H, Fidaner C. The reliability and validity of the Turkish version of the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-Old). Turk. Psikiyatri Derg. 2010;21(1).
24. 24. Young Y, Fan MY, Hebel JR, Boult C. Concurrent validity of administering the functional independence measure (FIM) instrument by interview. American Am J Phys Med Rehabil. 2009;88(9):766-770.
25. 25. Smith TG, Robbins PA, Ratcliffe PJ. The human side of hypoxia‐inducible factor. British Journal of Haematology. 2008;141(3):325-334.
26. 26. Ağargün MY, Çilli AS, Kara H, et al. Epworth Uykululuk Ölçeği'nin geçerliği ve güvenirliği. Türk Psikiyatri Derg. 1999;10(4):261-267.
27. 27. Buysse D. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry. 2003;18:498.
28. 28. Ağargün MY. Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği. Turk Psikiyatri Derg. 1996;7:107-115.
29. 29. Pinto Leite CM, Mariano-Neto E, Rocha PLBd. Biodiversity thresholds in invertebrate communities: The responses of dung beetle subgroups to forest loss. PLoS One. 2018;13(8):e0201368.
30. 30. Gao C, Ciren J, Wang D, Zhang Z, Ge R, Yan Le. Assessment of psychological and social fitness in healthy adults permanently living at very high altitude. International Journal of Int. J. Environ. Res. Public Health. 2023;20(3):2013.
31. 31. Tremblay JC, Ainslie PN. Global and country-level estimates of human population at high altitude. Proc. Natl. Acad. Sci. 2021;118(18):e2102463118.
32. 32. Sakamoto R, Okumiya K, Norboo T, et al. Health and happiness among community‐dwelling older adults in Domkhar valley, Ladakh, India. Geriatr Gerontol Int. 2017;17(3):480-486.
33. 33. Siddiqui N, Farooq R, Saadat S, et al. Poor sleep quality: A wake-up call for the elderly at a tertiary care centre in Islamabad, Pakistan. Sleep. 2020;3:6.
34. 34. Alqahtani JS, AlRabeeah SM, Aldhahir AM, et al. Sleep quality, insomnia, anxiety, fatigue, stress, memory and active coping during the COVID-19 pandemic. Int. J. Environ. Res. Public Health. 2022;19(9):4940.
35. 35. Pinzón-Rondón AM, Botero JC, Mosquera-Gómez LE, Botero-Pinzon M, Cavelier JE. Altitude and quality of life of older people in Colombia: A multilevel study. J. Appl. Gerontol. 2022;41(6):1604-1614.
36. 36. Vitale JA, Ieno C, Baldassarre R, et al. The impact of a 14-day altitude training camp on olympic-level open-water swimmers’ sleep. Int. J. Environ. Res. Public Health. 2022;19(7):4253.
37. 37. Gupta R, Ulfberg J, Allen RP, Goel D. Comparison of subjective sleep quality of long-term residents at low and high altitudes: SARAHA study. J Clin Sleep Med. 2018;14(1):15-21.
38. 38. Kania A, Polok K, Celejewska-Wójcik N, et al. Clinical and polysomnographic features associated with poor sleep quality in patients with obstructive sleep apnea. Medicina. 2022;58(7):907.
39. 39. Olatunde K, Patton S. Insufficient sleep and health care utilization: A scoping review. Innov Aging. 2021;5(Suppl 1):832.
40. 40. Putekova S, Martinkova J, Hutkova M. Sleep disturbances in seniors with parkinson’s disease. Clinical Social Work and Health Intervention. 2020;11(4):68 – 77.
41. 41. Lin S. Functional disability among middle-aged and older adults in China: The intersecting roles of ethnicity, social class, and urban/rural residency. Int. J. Aging Hum. Dev. 2023;96(3):350-375.
42. 42. Ganidagli S, Ozturk E, Ozturk ZA. Risk factors of poor sleep quality in older adults: An analysis based on comprehensive geriatric assessment. Curr Med Res Opin. 2023;39(5):701-706.
43. 43. Hu Z, Zhu X, Kaminga AC, Zhu T, Nie Y, Xu H. Association between poor sleep quality and depression symptoms among the elderly in nursing homes in Hunan province, China: A cross-sectional study. BMJ Open. 2020;10(7):e036401.