Advanced Age and Depression are Associated with Poor Sleep Quality in Older Adults: Outpatients Setting at a Tertiary Care in Northeast Thailand

Manchumad Manjawong, MD¹, Apichart So-Ngern, MD², Panita Limpawattana, MD¹, Pongsak Chokkhatiwat, MD³, Natapong Manomaiwong, MD³, Thanison Kamsuanjig, MD³, Chudapha Khammak, MD³, Kamolthorn Srisuwannakit, MD³

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Background: Poor sleep quality is common and related to worse health outcomes in older adults. It is thus crucial to identify and treat modifiable risk factors.
Objective: To determine the factors associated with poor sleep quality in older adults in outpatient settings.
Materials and Methods: A cross-sectional study was conducted between October 1, 2019 to January 31, 2022, at Srinagarind Hospital in Thailand. Subjects aged ≥60 years at an outpatient clinic of the internal medicine department were included. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI). Demographic data, PSQI, Patient Health Questionaire (PHQ)-9, and Montreal Cognitive Assessment (MoCA) scores were obtained. Factors associated with poor sleep quality were analyzed using stepwise backward multiple logistic regression, and results were presented as adjusted odds ratio (aOR) with 95% confidence interval (CI).
Results: The study enrolled 198 subjects. Of these, the frailty occurred in 28.78%. The prevalence of poor sleep quality was 40.9%. The independent factors associated with poor sleep quality were advanced age (aOR of 1.07, 95% CI 1.01 to 1.13, p=0.04) and high PHQ-9 score (aOR of 1.49, 95% CI 1.27 to 1.80, p<0.001).
Conclusion: The prevalence of older adults in outpatient settings with poor sleep quality was high. Factors associated with poor sleep quality were advanced age and depression. Screening and treating depression in older adults who have poor sleep quality may help improve their sleep quality.

Received 22 January 2025 | Revised 11 July 2025 | Accepted 22 July 2025

Keywords : Factor; Poor sleep quality; Older adults; Depression; Advanced age; Outpatient setting

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